Masui. The Japanese journal of anesthesiology
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We have studied the effects of prostaglandin E1 (PGE1) on the release of lysosomal enzymes such as beta-glucuronidase in leukocyte (beta-GL) and granulocyte elastase (GEL) in 52 patients for major abdominal surgery. All patients were divided into two groups; the PG group (24 patients) and the control group (28 patients). The patients of the PG group received PGE1 continuously at the rate of 0.03 to 0.1 micrograms.kg-1.min-1 during surgery. ⋯ The GEL/granulocyte ratio in the PG group was significantly smaller than that of the control group during surgery. The rate of change of beta-GL was significantly depressed in the PG group compared to that of the control group. These findings suggest that the administration of PGE1 during major abdominal surgery inhibits the release of lysosomal enzymes, and this prevents tissue injury during and after surgery.
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We studied the postoperative anti-emetic effects of low dose droperidol which was compared with that of metoclopramide in 60 gynecological patients. The effects at the third and 24th hours after surgery were evaluated by means of the nausea and vomiting score; 0 = none, 1 = discomfort, 2 = nausea, 3 = vomiting. ⋯ However, there was a significant difference between the two groups after 24 hours (D: 0.2 +/- 0.5, M: 0.8 +/- 1.0). We conclude that droperidol has a potent antiemetic effect that lasts after 24 hours.
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Brachial plexus block using a nerve stimulator is an accurate procedure. But prolonged analgesic effect can not be obtained. Therefore we used "around the needle" catheter technique to have a long analgesic effect. ⋯ The success rate is about 90%. If we stimulate other nerves in the same sheath, it is not necessary to seek aimed one. But the musculocutaneous nerve is the only exception, because it may be stimulated outside the neurovascular sheath.
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We studied the fatigue and stress of anesthesiologists at work using a flicker photometer, visual reaction time test and questionnaires to them. The two kinds of visual apparatus enabled us to measure two types of fatigue. On the other hand, the questionnaires relating to fatigue and stress indicated the stress tendencies and stressors by age, anesthetic experience, and sex. The results suggest that these methods are useful for measuring the fatigue and stress of anesthesiologists.
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Over 60% of preoperative surgical patients are reported to suffer from preoperative anxiety. Since 1986, an anesthesia video, explaining our routine anesthesia procedures has been shown to elective surgical patients preoperatively at our clinic. ⋯ The patients who were to undergo a major surgery, such as gynecological patients also belonged to the most anxious patient group. After demonstrating the video any patient group including gynecological patients of 30-59 years of age was less anxious about the upcoming anesthesia and surgery.