[Utility of bicarbonated Ringer's solution as an intraoperative fluid during long-term laparotomy].

Background: We compared the effects on intraoperative acid-base balance of bicarbonated Ringer (BR) and those of acetated Ringer (AR) solutions as an intraoperative fluid during long-term laparotomy.

Methods: Forty patients scheduled for laparotomy expected to take more than 5 hours were divided into two groups according to the type of infused solution, BR or AR. Each solution was intravenously administered at a rate between 8 and 10 ml x kg(-1) x hr(-1).

Cardioprotective effect and mechanism of action of landiolol on the ischemic reperfused heart.

Purpose: The authors examined the cardioprotective effect of landiolol, an ultra short-acting, highly selective beta1-blocker, and its role in cardiac work, antioxidative effect, and sarcoplasmic reticulum (SR) function in hearts subjected to ischemia-reperfusion.

Methods: Isolated guinea pig hearts were subjected to ischemia-reperfusion by stopping the perfusion for 45 min and reperfusing. Before the ischemia, hearts were treated with landiolol (20, 100, or 500 microM) for 15 min (LAN group).

Comparison of prostaglandin E1 and epidural anesthesia for mastectomy.

Hypotensive anesthesia has been used in an attempt to reduce intraoperative blood loss. Although both epidural anesthesia and vasodilators have been used to establish the controlled hypotensive anesthesia, little is known about the differences between the two method. We compared epidural anesthesia and prostaglandin (PG) El in patients scheduled for total mastectomy.

Propofol increases pulmonary vascular resistance during alpha-adrenoreceptor activation in normal and monocrotaline-induced pulmonary hypertensive rats.

Background: Using isolated perfused lungs of normal or monocrotaline (MCT: 50 mg/kg)-induced pulmonary hypertensive rats, we tested the hypothesis that the pulmonary vascular effects of propofol depend on activation of the alpha-adrenoreceptor.

Methods: Changes in pulmonary perfusion pressure induced by propofol (10(-5) to 10(-4) M) were measured with or without phenylephrine (10(-6) M) pretreatment. Before phenylephrine administration, we assessed the effects of inhibitors of nitric oxide synthase (N(omega)-nitro-l-arginine methylester: 10(-4) M), cyclooxygenase (indomethacin: 10(-5) M), and protein kinase C inhibitor, bisindolylmaleimide I (10(-6) M) or calphostin C (10(-6) M).

[Case of papillary muscle rupture diagnosed by preoperative transesophageal echocardiography].

A 46-year-old man with severe mitral regurgitation (MR) was scheduled for emergency surgery for chordae tendae repairment. Preoperative transesophageal echocardiography (TEE) revealed massive MR due to a rupture in the antero-lateral papillary muscle. We changed the operation procedure to mitral valve replacement.

[Reduction of the concentration of isoflurane prevents tachycardia and hypertension associated with tracheal intubation].

Background: High concentration of isoflurane often induces not only tachycardia but also hypertension during induction of anesthesia and causes further hyperdynamic changes after tracheal intubation.

Methods: Forty patients, ASA physical status I, were randomly assigned to receive 4% or 2.5% isoflurane.

Effects of ulinastatin on pulmonary artery pressure during abdominal aortic aneurysmectomy.

Study Objective: Abdominal aortic aneurysmectomy (AAAectomy) results in a general ischemia-reperfusion syndrome accompanied by an acute rise in pulmonary artery pressure (PAP). We examined whether ulinastatin, a urinary trypsin inhibitor, prevents ischemia-reperfusion injury and increase in PAP after aortic unclamping (XU) during AAAectomy.

Design: Prospective study.

[In vitro evaluation of lubrication properties of a suction catheter].

Background: Lubrication is an important factor for passage of a suction catheter through a tracheal tube. This study was carried out to evaluate the effects of lubricants on resistance against removal of a suction catheter from a tracheal tube in an experimental setting.

Methods: A tracheal tube (I.

A comparison of the failure times of pulse oximeters during blood pressure cuff-induced hypoperfusion in volunteers.

Important information may not be obtained if the pulse oximetry signal is lost during inflation of a cuff for blood pressure measurement, particularly in patients with hemodynamic instability. In the present study, we compared the failure times of pulse oximeters during cuff-induced hypoperfusion in volunteers. A pulse oximeter sensor was attached to the index finger, and a blood pressure cuff was attached to the same arm of each volunteer.

[The usefulness of intraoperative TEE monitoring in a patient with renal cell carcinoma].

A 55-year-old man was admitted to our hospital for treatment of renal cell carcinoma. Preoperative MRI showed infradiaphragmatic extension of the tumor thrombus. However, intraoperative transesophageal echocardiography (TEE) revealed intracardiac extension of the thrombus.

Differential pressor response to intravenous ephedrine during recovery from deliberate hypotension.

Study Objective: To determine whether nitroglycerin or trimethaphan alters pressor response to intravenous (i.v.) ephedrine.

Forehead is as sensitive as finger pulse oximetry during general anesthesia.

Purpose: To compare the performance of a forehead probe to a conventional finger pulse oximetry probe in anesthetized patients.

Methods: Eighteen patients participated in the study. Each probe was connected to a Nellcor N-550 pulse oximeter.

[A case of suspected pulmonary thrombosis in a patient with reactive thrombocytemia who underwent liver subsegmentectomy].

A 68-year-old man with reactive thrombocytemia (platelet count: 97.2 x 10(4).mm-3) underwent liver subsegmentectomy for hepatocellular carcinoma.

Hemodynamic and bispectral index responses to tracheal intubation during isoflurane or sevoflurane anesthesia.

Purpose: The effects of volatile anesthetics on change in the bispectral index (BIS) due to tracheal intubation are unclear. We investigated hemodynamic and BIS responses to intubation during isoflurane or sevoflurane anesthesia.

Methods: After obtaining Institutional Review Board approval and informed consent, we randomly allocated 40 patients of American Society of Anesthesiologists (ASA) physical status I to receive either isoflurane (ISO group; n = 20) or sevoflurane (SEV group; n = 20).

Monitoring of skeletal muscle oxygenation using near-infrared spectroscopy during abdominal aortic surgery.

Purpose: To examine the utility of near-infrared spectroscopy (NIRS) in assessing lower-leg perfusion, NIRS was performed on the calf muscles of patients who underwent abdominal aortic surgery.

Methods: Thirty patients undergoing elective infrarenal abdominal aortic surgery for abdominal aortic aneurysm (AAA group; n = 16) and aorto-occlusive disease (AOD group; n = 14) were studied. Before induction of anesthesia, NIRS probes were placed over both calf muscles, and muscle oxygen saturation (S(tO2)) was continuously monitored throughout the surgery.

Landiolol, esmolol and propranolol protect from ischemia/reperfusion injury in isolated guinea pig hearts.

Purpose: Beta blockers are thought to exert beneficial effects on the ischemic heart. The authors examined the effects of landiolol (ONO 1101), a highly selective beta1 antagonist, propranolol, a nonspecific beta blocker, and esmolol, a selective beta1 antagonist, on postischemic contractile recovery. Drugs were given prophylactically.

Solid-supported Robinson annulation under microwave irradiation.

Robinson annulation on alumina occurred efficiently on heating with microwave irradiation.

A comparison of hyperbaric 1% and 3% solutions of small-dose lidocaine in spinal anesthesia.

Unlabelled: We examined whether the concentration of hyperbaric lidocaine affected the regression of motor block when the dose of lidocaine was kept constant at 30 mg. We also examined the spread, duration, and regression of sensory block. Sixty-five patients (ASA physical status I or II), scheduled for elective perineum or lower limb surgery, were enrolled in this study.

Intravenous droperidol causes a reduction in the bispectral index in propofol-sedated patients during spinal anesthesia.

Unlabelled: We investigated the effect of IV droperidol on the bispectral index (BIS) in conscious and propofol-sedated patients during spinal anesthesia. Thirty minutes after the induction of spinal anesthesia, 20 patients were given 2 mg of droperidol IV without administration of other sedatives (conscious group). Another group of patients were sedated with a propofol infusion to maintain BIS at 60 +/- 5 and were administered IV saline (placebo group; n = 20), droperidol 1 mg (dro-1 group; n = 20), or droperidol 2 mg (dro-2 group; n = 20) in a randomized order and in a double-blinded fashion.

Differential effects of propofol and sevoflurane on heart rate variability.

Background: Propofol is reported to reduce both sympathetic and parasympathetic tone; however, it is not clear whether the changes in heart rate variability are associated with depth of anesthesia. The purposes of the present study were (1) to evaluate the changes in heart rate variability at different depths of hypnosis and (2) to compare the effects of propofol on heart rate variability with that of sevoflurane.

Methods: Thirty patients were randomly allocated into the propofol or sevoflurane for induction of anesthesia.

[Effect of nitrous oxide on the bispectral index during sevoflurane anesthesia].

We studied the effects of nitrous oxide on the relationship between end-tidal sevoflurane concentration and bispectral index (BIS) in patients undergoing abdominal surgery. Anesthesia was maintained with combination of epidural and sevoflurane anesthesia in air (control group; n = 15) or with 67% nitrous oxide (nitrous oxide group; n = 15). The end-tidal sevoflurane concentration was increased by 0.