[Demand for cleanliness of anesthesia machines and apparatus].

(1) Outer surface of anesthesia machines and patient monitors, and breathing bags are exposed to the contaminated anesthetists' hands and fingers. Disinfection by wiping surface of anesthesia machines with alcohol, and disinfecting hands and fingers with rubbing-type, alcohol-based antiseptics are encouraged. (2) Anesthesia equipments' breathing circuit part is contaminated by patients' breath and respiratory secretions.

[Anesthetic management of caesarean section in a parturient with ankylosing spondylitis complicated with severe cervical myelitis].

A 28-year-old patient with ankylosing spondylitis and cervical myelitis was scheduled for caesarean section. We selected general anesthesia because of her cervical myelitis. Her trachea was intubated using a flexible fiberscope.

[Anesthetic management for emergency cesarean section in a patient with intracranial hemorrhage due to ruptured arteriovenous malformation].

A 30 year-old pregnant woman (36 weeks) had intracranial hemorrhage due to arteriovenous malformation in the left frontal lobe. She underwent an emergency cesarean section under general anesthesia. To avoid hemodynamic changes and increasing intracranial pressure, intravenous lidocaine and inhaled sevoflurane were given prior to tracheal intubation, and a bolus dose of nicardipine was given prior to tracheal extubation.

[Tracheal intubation for emergent tracheostomy in a patient complicated with tracheal stenosis].

We report the management of anesthesia for emergent tracheostomy in a patient with severe tracheal stenosis. A 63-year-old male was scheduled for an emergency tracheostomy for severe tracheal stenosis due to the invasion of a thyroid cancer. A preoperative neck CT revealed the tracheal stenosis, extending from 1-2 cm below the vocal cord to the upper end of the sternum.

[Serum and urinary magnesium during and after cardiac surgery].

To investigate the effects of cardiopulmonary bypass (CPB) on the serum magnesium (Mg) level, we observed the perioperative changes in serum and urinary Mg in 20 patients undergoing open heart surgery. The serum Mg was in the normal range (mean +/- SE, 1.98 +/- 0.

[Premixing lidocaine reduces the incidence and severity of pain on injection of propofol].

The purpose of this study was to confirm the effect of premixed lidocaine for the reduction of pain during injection of propofol in adult patients. We conducted a prospective, randomized, double-blind trial on 106 patients. In the study group (n = 54), lidocaine 40 mg (2 ml of lidocaine 2%) was added to 180 mg of propofol (18 ml).

Airway management for patients with a tracheal bronchus.

A tracheal bronchus is an aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea, causing hypoxaemia, atelectasis, or both, during anaesthesia. We describe two patients with a tracheal bronchus found before anaesthesia. One tracheal bronchus was found by tracheobronchoscopy and the other by chest x-ray.

[Spinal anesthesia for oophorectomy in a patient with pulmonary lymphangiomyomatosis accompanied by hypochondriasis].

A 41-year-old woman with pulmonary lymphangiomyomatosis had been scheduled for bilateral oophorectomy which led to amelioration of the pulmonary pathology. The discrepancy between her dyspnea on exertion and lung function tests suggested that she had a marked tendency toward hypochondria. Therefore, we chose spinal anesthesia because of its technical simplicity, rapid onset, and effectiveness of some sedatives used perioperatively.

[Psychological evaluation of out-patients in our pain clinic using self-rating depression scale and state-trate anxiety inventory questionnaire].

In 98 out-patients who visited our pain clinic, we evaluated their psychological status before the first examination and one month after the treatment, using self-rating depression scale (SDS) and state-trate anxiety inventory (STAI). SDS, state anxiety, and trate anxiety scores were significantly higher in the patients with pain (trigeminal neuralgia, neck-shoulder-arm pain syndrome, lumbago and psychological pain, n = 55) compared with the patients without pain (sudden deafness and facial nerve palsy, n = 43) (P < 0.01, 0.

[Diagnosis of accidental subdural block].

Accidental subdural block occurred in a 47-year-old man who underwent gastrectomy under nitrous oxide-sevoflurane anesthesia combined with continuous epidural block. The development of subdural block was suspected from unexpectedly severe hypotension with small doses of mepivacaine during operation and was confirmed by a characteristic X-ray photograph after operation. The subdural block should be suspected from abnormal changes in vital signs and by careful observation of X-ray photographs, because it is not always easy to determine the presence of contrast media either in the subdural space or in the epidural space.

[Usefulness of continuous intra-arterial blood gas monitoring in a patient undergoing tracheal transection and reconstruction].

Usefulness of a new continuous intra-arterial blood gas monitoring system (PB3300, Puritan-Bennett, Carlsbad, California) was evaluated in a patient with tracheal cancer who was undergoing tracheal transection and reconstruction. The PB3300 detected continuous changes in pH, PaCO2, and PaO2 during the surgical intervention and provided reliable information to take appropriate therapeutic measures. PB3300 was superior to pulse oximetry because the latter can not detect changes in PaO2 more than 100 mmHg accompanying pulmonary dysfunction caused by surgical procedures.

[Changes in plasma concentrations of human hepatocyte growth factor before and after major intra-abdominal surgery under nitrous oxide-sevoflurane anesthesia].

The measurements of human hepatocyte growth factor (hHGF) in plasma and liver function tests were performed in 23 patients before and after major intra-abdominal surgery under nitrous oxide-sevoflurane anesthesia. Plasma concentrations of hHGF in 12 patients with normal liver function (Group 1) and in 11 patients with liver dysfunction (Group 2) were 0.34 +/- 0.

[Psychological evaluation of patients by state-trait anxiety inventory in pain clinic].

In 84 outpatients who visited our pain clinic, we evaluated their anxiety before the first examination, using State-Trait Anxiety Inventory. State anxiety scores were high in all the patients regardless of their underlying disease. Trait anxiety scores in patients with chronic pain such as postherpetic neuralgia or cervic-shoulder-hand syndrome were higher than in patients with facial nerve palsy, sudden hearing loss or herpetic pain.

[Intravenous lidocaine in the treatment of post treatment neuropathy].

A 46-yr-old man with a 3-month history of post treatment neuropathy following insulin treatment for diabetes mellitus was suffering from severe pain and dysesthesia in his bilateral feet and legs. The patient described his pain as constant burning sensation which was severest in the soles and extended circumferentially over the legs. Previous trials of tricyclic antidepressants and nonsteroidal antiinflammatory drugs were uneffective.

[Serum nitroglycerin concentrations during extracorporeal circulation with a membrane oxygenator incorporated with a cardiopulmonary bypass circuit].

The effect of a cardiopulmonary bypass circuit (CPB) on serum nitroglycerin (TNG) concentrations was studied in eight patients scheduled for cardiac surgery. The CPB consisted of polyvinyl chloride tubes and polypropyrene membrane oxygenator. TNG was administered intravenously at a rate of 1 microgram.

[Rapid induction of anesthesia with inhalation of sevoflurane].

Induction of anesthesia with inhalation of sevoflurane was evaluated in 45 patients. Inhalation anesthesia was induced by a single vital capacity breath followed by spontaneous breathing. The compositions of anesthetic gases were as follows: 5% sevoflurane in oxygen, 5% sevoflurane in 67% nitrous oxide and oxygen, and 7% sevoflurane in 67% nitrous oxide and oxygen.

[Right ventricular perforation and cardiac tamponade caused by a central venous catheter].

A 5 year old girl with ASD was scheduled for open heart surgery. A central venous catheter was placed via the right infraclavicular vein after induction of anesthesia. Thirty minutes after insertion of the catheter, a decrease in arterial pressure and pulse pressure, an increase in heart rate and central venous pressure were observed.

[Postoperative pain relief by continuous epidural infusion of bupivacaine and buprenorphine].

Continuous postoperative pain relief produced by epidural block with bupivacaine and buprenorphine was evaluated in 12 patients after thoracotomy, 19 patients after upper abdominal surgery, and 14 patients after lower abdominal surgery. Patients initially received 8 ml of 0.25% bupivacaine and 0.

The echocardiographic assessment of left ventricular performance during sevoflurane and halothane anesthesia.

The cardiovascular effects of sevoflurane were studied and compared with those of halothane in 30 healthy patients. The patients were assigned to receive 1 MAC sevoflurane (n = 10), 2 MAC sevoflurane (n = 10) or 1 MAC halothane (n = 10) in N(2)O 2 l.min(-1) and O(2) 4 l.

Anesthesia for a patient with recessive dystrophic epidermolysis bullosa.

Two different anesthetic methods were employed for a patient with recessive dystrophic epidermolysis bullosa (R-DEB). One was plexus brachial block in combination with ketamine infusion. The other was general anesthesia with N2O-O2-halothane via a face mask.

The influence of ventricular extrasystoles and postextrasystoles on cardiovascular dynamics in anesthetized dogs.

The influence of ventricular extrasystoles and postextrasystoles on cardiovascular dynamics were assessed in terms of maximum rate of rise of left ventricular pressure (max dP/dt), ascending aortic flow, left ventricular stroke volume, and left ventricular end-diastolic transverse dimension in anesthetized dogs. A single ventricular extrasystole, two and three consecutive ventricular extrasystoles (couplet and triplet) were induced by applying mechanical stimulation to the surface of the right ventricule. In any of these ventricular extrasystoles, max dP/dt, stroke volume and end-diastolic transverse dimension were decreased, compared with those in preceding sinus beats, i.

[Effects of acute hypoxia on cardiovascular dynamics, myocardial metabolism and ECG in dogs].

In pentobarbital-pancuronium anesthetized open chest dogs, left ventricular pressure (LVP), first derivative of LVP (dp/dt) and left ventricular end-diastolic pressure (LVEDP) were measured by a micromanometer tipped catheter, stroke volume and cardiac output (CO) by an electromagnetic flow meter and coronary sinus blood flow (CSBF), by a thermal dilution catheter, respectively. Mean arterial pressure (mAP), mean pulmonary arterial pressure (mPAP), lead II of ECG and esophageal temperature were monitored. Blood gas, catecholamines and lactate of arterial blood and coronary sinus blood were measured and myocardial lactate extraction ratio (MCL) was calculated.

Effects of sevoflurane on cardiovascular dynamics, coronary circulation and myocardial metabolism in dogs.

The effects of 2.5% and 5% of sevoflurane anesthesia on hemodynamics and myocardial metabolism were studied in pentobarbital-pancuronium anesthetized dogs. The interaction between nicardipine and 2.