A comparison of the effect on QT interval between thiamylal and propofol during anaesthetic induction*.

The aim of this study was to determine the effect of thiamylal and propofol on heart rate-corrected QT (QTc) interval during anaesthetic induction. We studied 50 patients undergoing lumbar spine surgery. Patients were administered 3 microgxkg(-1) fentanyl and were randomly allocated to receive 5 mgxkg(-1) thiamylal or 1.

[A case of transorbital penetrating brain injury by a blunt metal rod].

This report presents a case of a transorbital penetrating brain injury caused by a metal rod. A 47-year-old male injured his left lower eyelid with no witness during working hours. The two days later, he presented with a right hand tremor and abnormal behavior, and was admitted to the hospital.

Postoperative analgesia with minidose intrathecal morphine for bipolar hip prosthesis in extremely elderly patients.

Purpose: It is known that an optimal dose of intrathecal morphine for analgesia after total hip arthroplasty in older patients is 0.1 mg. On the other hand, minidose intrathecal morphine (0.

Postoperative analgesic effect of preoperative intravenous flurbiprofen in arthroscopic rotator cuff repair.

Purpose: This study was carried out to evaluate the postoperative analgesic effects of preoperative intravenous flurbiprofen in patients undergoing arthroscopic rotator cuff repair under general anesthesia.

Methods: We studied 44 patients who underwent an elective arthroscopic rotator cuff repair in a prospective, randomized, and double-blind fashion. The patients were divided into two groups.

[Usefulness and the limitation of QT dispersion].

The prolongation of QT interval and the increase of QT dispersion in the electrocardiogram are closely related with torsade de pointes and useful for the assessment of the risk of the anesthetic drugs and ischemic heart diseases.

Landiolol, a new ultra-short-acting beta1-blocker, reduces anaesthetic requirement during sevoflurane/N(2)O/fentanyl anaesthesia in surgical patients.

Background And Objective: It is known that esmolol, a short-acting beta1-blocker, reduces anaesthetic requirement. In this study, we evaluated whether a low dose of landiolol, a new ultra-short-acting beta1-blocker, can reduce the sevoflurane requirement.

Methods: Twenty-five patients undergoing hip surgery were randomly divided into two groups.

Age-dependent relationship between bispectral index and sedation level.

Study Objective: To determine the relationship between bispectral index (BIS) and sedation.

Design: Prospective, observational clinical study.

Setting: Intensive care unit of a public hospital in Japan.

Influence of low-molecular-weight hydroxyethyl starch on microvascular permeability in patients undergoing abdominal surgery: comparison with crystalloid.

Purpose: Adequate volume therapy is essential for stable hemodynamics and sufficient urinary output perioperatively. Hydroxyethyl starch (HES) has been reported to attenuate the microvascular hyperpermeability which occasionally occurs in surgical patients. This study was carried out to evaluate the effect of low-molecular-weight HES on the urinary microalbumin/creatinine ratio (MACR), a marker of microvascular permeability, in surgical patients.

Admission microalbuminuria and neurologic outcomes in intensive care unit patients with spontaneous intracerebral hemorrhage.

This study was performed to determine the prevalence and the prognostic significance of microalbuminuria in patients admitted to intensive care unit (ICU) after spontaneous intracerebral hemorrhage (ICH). From May 2004 to April 2006, we studied 59 consecutive ICH patients verified using computed tomography and admitted to our ICU within a day after stroke. General clinical, neurologic data, and Glasgow Coma Scale (GCS) were recorded at admission to ICU.

Comparison of oxygen consumption calculated by Fick's principle (using a central venous catheter) and measured by indirect calorimetry.

We investigated the clinical usefulness of the Fick method using central venous oxygen saturation ScvO2 and cardiac output (CO) measured by pulse dye densitometry (PDD) for monitoring oxygen consumption VO2. This prospective clinical study was performed in 28 mechanically ventilated postoperative patients after major abdominal surgery. VO2 was determined by two methods, i.

The effect of sevoflurane-induced hypotension in combination with acute hypervolaemic haemodilution on middle cerebral artery flow velocity in surgical patients.

Background And Objective: This study was carried out to clarify the effect of the combination of acute hypervolaemic haemodilution and hypotensive anaesthesia induced with sevoflurane on human middle cerebral artery flow velocity using transcranial Doppler ultrasonography.

Methods: Thirty patients who were maintained with N2O-O2-sevoflurane anaesthesia undergoing hip surgery were randomly divided into two groups (no controlled hypotension group, Group A, and controlled hypotension group, Group B). Haemodilution was produced by acute preoperative infusion of 1000 mL of hydroxyethylstarch without removing blood in both groups.

Malignant hyperthermia susceptibility diagnosed with a family-specific ryanodine receptor gene type 1 mutation.

Malignant hyperthermia (MH) is an autosomal dominant disorder of skeletal muscle calcium regulation, and the rate of calcium-induced calcium release (CICR), determined by using skinned fibers of skeletal muscle, has been employed as a diagnostic test for MH susceptibility in Japan. The ryanodine receptor (RYR1), encoding the major calcium-release channel in skeletal muscle sarcoplasmic reticulum, has been shown to be mutated in a number of MH pedigrees. We experienced the detection of accelerated CICR and/or an RYR1 mutation in a patient with an MH episode and his family.

Microalbuminuria is a prognostic predictor in aneurysmal subarachnoid hemorrhage.

Objective: To determine the prevalence and the prognostic significance of microalbuminuria in patients after aneurysmal subarachnoid hemorrhage (SAH).

Design: Prospective and observational clinical study.

Setting: Multidisciplinary intensive care unit.

Preadministration of flurbiprofen suppresses prostaglandin production and postoperative pain in orthopedic patients undergoing tourniquet inflation.

Study Objectives: To evaluate the effect of preadministration of flurbiprofen on the plasma concentrations of prostaglandin E2 (PGE2) and postoperative pain.

Design: Prospective, randomized, controlled and double-blind study.

Setting: Inpatient surgery at Nagasaki Rosai Hospital.

Selective transvenous coil embolization of dural arteriovenous fistula. A report of three cases.

We herein report three cases of dural arteriovenous fistula (DAVF) in which the venous outlet immediately adjacent to the fistula was selectively embolized. Case 1: A 69-year-old man presented with a subarachnoid hemorrhage (SAH). Angiography demonstrated a DAVF in the left superior petrous sinus.

[Case of fulminant type 1 diabetes mellitus complicated with acute renal failure treated with continuous hemodiafiltration].

A 50-year-old male patient developed diabetic ketoacidosis with shock, acute renal failure treated with continuous hemodiafiltration (CHDF) and high serum CPK levels. Because of acute onset of ketoacidosis accompanied with an elevation of serum amylase, and negative findings of antibodies associated with autoimmune type 1 diabetes mellitus, he was diagnosed as a fulminant type 1 diabetes mellitus, which is a newly established subtype of type 1 diabetes mellitus. We managed to keep blood glucose concentrations within 150-200 mg x dl(-1) with continuous insulin intravenous infusion, and controlled circulation with dopamine.

Preoperative administration of intravenous flurbiprofen axetil reduces postoperative pain for spinal fusion surgery.

Purpose: The aim of the study was to investigate postoperative analgesia and the opioid-sparing effect of the preoperative administration of intravenous flurbiprofen axetil in patients undergoing spinal fusion surgery.

Methods: Thirty-six patients were randomly allocated into one of three groups. Group A received preoperative flurbiprofen axetil, 1 mg x kg(-1).

Effect of cyclooxygenase-2 inhibitor pretreatment on gas exchange after hydrochloric acid aspiration in rats.

The present study was carried out to determine the effect of cyclooxygenase-2 (COX-2) inhibitor on acid aspiration-induced lung injury in rats. Rats were allocated into one of four groups. Group H received intratracheal instillation of HCl.

Human middle cerebral artery flow velocity during controlled hypotension combined with hemodilution-transcranial Doppler study.

Study Objective: To evaluate the effects of controlled hypotension combined with hemodilution on human middle cerebral artery flow velocity (Vmca) by transcranial Doppler ultrasonography.

Design: Randomized prospective study.

Setting: Inpatient surgery at Nagasaki Rosai Hospital.

Preadministration of low-dose ketamine reduces tourniquet pain in healthy volunteers.

We evaluated whether preadministration of low-dose ketamine could attenuate tourniquet pain and arterial pressure increase using high tourniquet pressure in ten healthy awake volunteers. Ketamine, 0.1 mg x kg(-1), or normal saline was given intravenously in a double-blind fashion before tourniquet inflation with a pressure of 400 mmHg at the thigh.

[Management of postoperative pharyngeal swelling after anterio-posterior cervical fusion under pharyngoscopy].

A 47-year-old man with traumatic cervical spinal cord injury underwent anterio-posterior cervical fusion, which accompanied high-risk of upper airway obstruction by postoperative reactive pharyngeal swelling. After the operation, we ascertained that he had no paralysis of his extremities, and sedation and mechanical ventilation were started at ICU. We evaluated the degree of edema in the hypopharyngeal and supraglottic regions with pharyngoscopy.

Increased incidence of emergency airway management after combined anterior-posterior cervical spine surgery.

Among some kinds of cervical spine surgeries, combined anterior-posterior cervical spine surgery (CAP-CS surgery) requires prolonged operative time and highly invasive procedure. This study was performed to determine whether CAP-CS surgery was associated with increased risk of emergency airway management compared with other cervical spine surgeries (O-CS surgeries). The records of the patients who underwent cervical spine surgery between July 2001 and March 2003 at our institution were reviewed retrospectively, and we determined whether the CAP-CS surgery was associated with an increased risk of emergency airway management in comparison with O-CS surgeries, using the logistic regression analysis.

Is circulating phospholipase A2 removed by large-pore continuous venovenous hemodiafiltration in septic acute renal failure?

Group II A phospholipase A2 (PLA2) produces many inflammatory lipid mediators, and the elevation in the level during sepsis has been correlated positively with the decrease in the arterial blood pressure. We studied the effect of large-pore continuous venovenous hemodiafiltration (LP-CVVHDF) on the plasma PLA2 concentration and the clearance mechanism during septic acute renal failure. The subjects were 10 consecutive patients with septic acute renal failure receiving CVVHDF.