Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study
[Influence of tidal volume on functional residual capacity during general anesthesia].
Ventilation with lower tidal volume improves outcome in acute respiratory distress syndrome (ARDS). However, it is questionable if ventilation strategy using lower tidal volumes created for patients with ARDS can be transferred to healthy patients undergoing general anesthesia. We assessed the effects of ventilation with lower tidal volumes and conventional tidal volumes on functional residual capacity (FRC) and Pa(O2)/FI(O2) (P/F) ratio in patients undergoing general anesthesia for upper abdominal surgery. ⋯ Lower tidal volumes are better than conventional tidal volumes in view of airway pressure and lung protective strategy during general anesthesia.
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Randomized Controlled Trial Comparative Study
[Effect of different perioperative analgesic methods on postoperative cognitive dysfunction in elderly patients undergoing upper abdominal surgery].
We investigated whether the early postoperative cognitive dysfunction (POCD) was affected by different perioperative analgesia methods using intravenous remifentanil or epidural ropivacaine in the elderly undergoing major upper abdominal surgery. ⋯ Perioperative analgesia using intravenous remifentanil and epidural ropivacaine showed no significant difference in the incidence of early POCD after upper abdominal surgery in elderly patients.
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Randomized Controlled Trial
[Usefulness of Epidrum for teaching identification of the epidural space].
Epidrum (ED) is a device to facilitate the epidural anesthesia procedure. Using ED, we can visually confirm the needle's penetration into the epidural space by collapse of the diaphragm. We investigated the usefulness of ED for teaching identification of the epidural space. ⋯ The results suggest that ED is a useful device for teaching identification of the epidural space.
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Randomized Controlled Trial Comparative Study
[Postoperative analgesia of continuous intravenous fentanyl or dexmedetomidine for patients receiving anticoagulant therapy].
It is difficult to achieve good postoperative analgesia in patients who undergo abdominal aortic surgery without epidural analgesia and who have a bleeding tendency or are undergoing anticoagulation therapy. Intravenous fentanyl analgesia can be used in such patients, but it occasionally causes respiratory depression. Dexmedetomidine is used to achieve postoperative sedation and analgesia without respiratory depression. We compared the methods used to achieve postoperative analgesia after abdominal aortic surgery. ⋯ With regard to respiratory depression, intravenous dexmedetomidine analgesia is safer and more useful than intravenous fentanyl analgesia.
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Randomized Controlled Trial Comparative Study
[Comparison of intraoperative stress hormones release between propofol-remifentanil anesthesia and propofol with epidural anesthesia during gynecological surgery].
Remifentanil recently comes to be used for intraoperative analgesia instead of epidural anesthesia in gynecological surgery. It seems to offer the same stability in vital signs, but stress response during remifentanil anesthesia has not been evaluated. Therefore, we compared remifentanil anesthesia with epidural anesthesia regarding stress hormones. ⋯ The inhibition of stress hormone secretion during operation was less in R than E. Regarding stress response, total intravenous anesthesia with remifentanil seems to be a proper method, but to have less potency than general anesthesia using epidural block.