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Sato T, Okamoto K, Sadanaga M, Board J, McEniery J. High incidence of postoperative pulmonary complications after orthotopic liver transplantation in children. J Anesth 2013; 8:274-6. [PMID: 23568111 DOI: 10.1007/bf02514649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/1993] [Accepted: 12/17/1993] [Indexed: 11/30/2022]
Abstract
Postoperative pulmonary complications were investigated in a total of 41 pediatric recipients who underwent orthotopic liver transplantation (OLT) between January, 1990 and March, 1992 at the Royal Children's Hospital, Brisbane. Atelectasis was seen in 40 cases (98%) of the 41 recipients, and occurred in the left lower lobe in 28 cases (68%), and in the right upper lobe in 25 cases (61%). Radiographic pulmonary edema occurred on 23 occasions in 18 recipients (45%). Pulmonary edema was observed just after operation in 9 cases, and in the later stage from the 3rd to 25th postoperative day in 14 cases. Five recipients experienced two episodes of pulmonary edema during their ICU stay. The duration of mechanical ventilatory support was significantly longer in the patients with pulmonary edema than in those without (9.6±3.8vs 3.9±2.2 days,P<0.01). Pleural effusions were observed in 21 cases (52%), of which 18 had right-sided effusion and 3 had bilateral effusions. Pneumothorax occurred in three cases. Pyothorax, hemothorax, bronchial asthma, and subglottic granulation occurred in one case each. The present study demonstrated that postoperative pulmonary complications are frequently observed in pediatric recipients undergoing OLT.
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Affiliation(s)
- T Sato
- Division of Intensive and Critical Care Medicine, Kumamoto University School of Medicine, 1-1-1 Honjo, 860, Kumamoto, Japan
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2
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Affiliation(s)
- M Sadanaga
- Surgical Center, Kumamoto University Hospital, Kumamoto, Japan
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3
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Adachi H, Tashiro T, Tashiro T, Goto K, Sadanaga M, Asai S. [Sudden decrease in the level of consciousness due to subarachnoid bleeding attack in a patient undergoing ophthalmic surgery under retrobulbar anesthesia]. Masui 1998; 47:82-84. [PMID: 9492506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We experienced a case of intraoperative subarachnoid bleeding attack under retrobulbar anesthesia in a 71 year-old female. Immediately after retrobulbar anesthesia with bupivacaine, the patient showed a sudden decrease in her level of consciousness, respiratory depression, convulsions and her blood pressure increased to 258/63 mmHg. The clinical symptoms and onset of the attack were very similar to those of acute local anesthetic intoxication, where local anesthetics reached the central nervous system through cerebrospinal fluid or via ophthalmic artery. We gave oxygen and provided ventilatory assist by bag and mask, and administered anticonvulsant and antihypertensive agents. After we confirmed recovery of consciousness and stability of hemodynamics and respiration, the extracapsular lens extraction began. The same attack reoccurred 20 minutes later, and we treated the patient with the same procedure as in the first attack and asked the surgeon to shorten the operation. After surgery the patient was diagnosed by computed tomography as having subarachnoid bleeding from a ruptured aneurysm of the anterior cerebral artery. When a patient's level of consciousness suddenly decreases under local anesthesia, we recommend terminating the surgery to clarify the cause. In such cases, serious cardio- and cerebrovascular disorders might be involved, rather than complications due to local anesthetic intoxication.
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Affiliation(s)
- H Adachi
- Department of Anesthesiology, Kumamoto Red Cross Hospital
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4
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Abstract
The purpose of this study was to determine whether endothelin-1 (ET-1), endothelin-2 (ET-2) or endothelin-3 (ET-3) alter the vascular diameter of capillaries in the spiral ligament. Changes in vascular tone were measured in capillaries from the isolated spiral ligament in vitro. Capillaries were occluded on one end and opened on the other end. Red blood cells trapped in the capillaries served as markers for a luminal volume defined by the red cell itself, the capillary wall and the occluder. Movement of the red cell toward the open end was taken as evidence for vasoconstriction and movement of the red cell toward the occluder was taken as evidence for vasodilation. The inner diameter of the capillaries was 7.0 microm and decreased maximally by a factor of 0.8 in response to ET-1 and ET-2 (both 10(-8) M). Vasoconstriction induced by ET-1 and ET-2 was concentration-dependent in the range between 10(-12) and 10(-8) M whereas ET-3 (10(-8) M) had no effect. The EC50s for ET-1 and ET-2 were 1.2 x 10(-10) M and 1.4 x 10(-9) M, respectively. Thus, the potency order was ET-1 > ET-2 >> ET-3. Vasoconstriction induced by ET-1 and ET-2 was completely inhibited by the competitive antagonist 10(-6) M BQ-123 (cyclic D-Asp-L-Pro-D-Val-L-Leu-D-Trp). Vasoconstriction induced by ET-1 or ET-2 continued for more than 1 min after removal of agonist from the perfusate. Rapid vasodilation of capillaries preconstricted by ET-1 was observed in response to 10(-3) M sodium nitroprusside. Sodium nitroprusside, however, had no significant effect on the vascular diameter of resting capillaries. These results demonstrate that capillaries in the spiral ligament can constrict and the endothelin-mediated vasoconstriction occurs via ET(A) receptors.
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Affiliation(s)
- M Sadanaga
- Cell Physiology Laboratory, Boystown National Research Hospital, Omaha, NE 68131, USA
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5
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Abstract
The chronological developmental processes of endocochlear potential (EP) and negative endocochlear potential (-EP) were investigated as a function of age from birth in the basal and second cochlear turns in normal ICR-strain mice. The EP of the basal turn developed between 5 and 17 days after birth (DAB). The -EP of the basal turn attained to its mature level on 11 DAB and it increased its absolute value further between 12 and 16 DAB and then, recovered to its mature level again on 20 DAB. The developmental processes of EP and -EP of the second turn followed similar courses to those of the basal turn although they were several millivolts different on each day in detail. The results suggest that the developmental processes of the +EP and the -EP are different. The time of reaching minimum -EP during anoxia were measured and the rate of EP decline were calculated on each animal. The rate of EP decline increased rapidly on 10 DAB, almost coinciding the day which EP began to increase abruptly. Although the rate of EP decline is influenced by several processes, this result showed one of the possibility that the sensitivity of the stria vascularis to hypoxia may develop parallel to the development of the EP.
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Affiliation(s)
- M Sadanaga
- Department of Otorhinolaryngology, Miyazaki Medical College, Japan
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6
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Kano T, Shimoda O, Higashi K, Sadanaga M. Effects of neural blockade and general anesthesia on the laser-Doppler skin blood flow waves recorded from the finger or toe. J Auton Nerv Syst 1994; 48:257-66. [PMID: 7963259 DOI: 10.1016/0165-1838(94)90054-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Effects of neural blockade and general anesthesia on the basic wave (BW) and the reflex wave (RW) among the laser-Doppler (L-D) skin blood flow waves recorded on the finger or toe were studied in 2 volunteers and 42 patients. The BW was continuous, rhythmic and independent of respiratory movements. The RW, which was induced by a deep inspiration or a snapping sound, was a transient marked reduction in blood flow. The BW was almost flattened and the RW was no longer induced at the finger under complete wrist block (n = 2), or under cervical or upper thoracic epidural anesthesia extended caudally over T7 (n = 2). On the other hand, the BW was still detected with reducing frequency and the RW could be provoked with one exception at the finger on the side with a sympathetic ganglion block at the C6 vertebral level (n = 14). The BW and RW at the toe were retained under lumbar subdural anesthesia (n = 6) as well. However, under the combination of lumbar subdural anesthesia and lower thoracic epidural anesthesia extending rostrally over T4 (n = 6), both the BW and the RW disappeared at the toe. In the course of deepening nitrous oxide/enflurane anesthesia (n = 10), the BW gradually reduced in frequency until it was almost flattened, and it became difficult to provoke the RW. L-D flowmetry of the finger or toe could be a useful clinical measure for detecting the presence or absence of sympathetic function controlling cutaneous vasomotion.
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Affiliation(s)
- T Kano
- Surgical Center, Kumamoto University Hospital, Japan
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7
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Kano T, Sadanaga M, Sakamoto M, Higashi K, Matsumoto M. Effects of systemic cooling and rewarming on the evoked spinal cord potentials and local spinal cord blood flow in dogs. Anesth Analg 1994; 78:897-904. [PMID: 8160987 DOI: 10.1213/00000539-199405000-00011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Changes in evoked spinal cord potential (ESCP) and in local spinal cord blood flow (local SCBF) were measured simultaneously in eight dogs in the course of systemic cooling and rewarming using a water mattress. PaCO2 was maintained at 35-40 mm Hg (temperature-uncorrected values) by adjusting ventilatory volume every 1 degree C change of esophageal temperature under N2O (60%)-O2-isoflurane (1.15%) anesthesia. Local SCBF and arterial blood pressure decreased and ESCP latencies increased linearly with the decrease in body temperature to 23-24 degrees C. The conductive ESCPs (non-synaptic components) showed temporary augmentation in amplitude before eventual decrease under cooling. These showed a tendency to return to the precooling baselines after the initiation of rewarming. These results demonstrate that conductive ESCPs could be available for intraoperative monitoring of spinal function under hypothermia down to 23-24 degrees C.
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Affiliation(s)
- T Kano
- Surgical Center, Kumamoto University Hospital, Japan
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8
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Suga K, Nishigauchi K, Sadanaga M, Kume N, Uchisako H, Matsumoto T, Nakanishi T. I-123 IMP scintigraphy in two patients with primary pulmonary malignant lymphoma. Ann Nucl Med 1994; 8:65-9. [PMID: 8204399 DOI: 10.1007/bf03164988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
123I-IMP lung scintigraphy was performed in two patients with primary malignant lymphoma, whose radiographic features were difficult to differentiate from inflammatory or atelectatic lesions. 123I-IMP scans revealed a defect in the lesions on the delayed (24 hr) image, suggesting a tumorous lesion. 123I-IMP scan may contribute to differential diagnosis of this rare tumorous entity from benign disorders having a different appearance.
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Affiliation(s)
- K Suga
- Department of Radiology, Yamaguchi University School of Medicine, Japan
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9
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Kano T, Shimoda O, Higashi K, Sadanaga M, Sakamoto M. Fundamental patterns and characteristics of the laser-Doppler skin blood flow waves recorded from the finger or toe. J Auton Nerv Syst 1993; 45:191-9. [PMID: 8106709 DOI: 10.1016/0165-1838(93)90051-u] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Three different components, Basic Wave (BW), Cardiac Wave (CW) and Reflex Wave (RW), among the laser-Doppler (L-D) skin blood flow waves on the finger- or toe-tip, were studied in 32 healthy volunteers. The cycle of the rhythmic BW was 8.1 +/- 1.7.min-1 and was independent of respiratory movements. The BW was synchronous with the baseline fluctuation in the digit-photoplethysmogram. Power spectral analysis of rhythmic fluctuations in the simultaneously recorded R-R interval on ECG, systolic blood pressure, and L-D skin blood flow disclosed that the BW was correspondent with the Mayer wave, i.e., low frequency component. The cycle of the CW was consistent with the heart rate and was superimposed on the BW. The RW was a transient marked reduction in blood flow, which was induced by a deep inspiration or various sensory stimuli. A sympathetic skin response on the palm and a venoconstrictive response on the occluded arm were observed concomitantly with the RW. Good synchronization was observed in each component of the L-D skin flow waves between the fingers and toes. These findings suggest that the BW and the RW on the finger- or toe-tip are predominantly driven by tonic and reflex phasic activities of descending sympathetic outflows via the supraspinal center, respectively.
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Affiliation(s)
- T Kano
- Surgical Center, Kumamoto University Hospital, Japan
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10
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Hashiguchi A, Kano T, Sadanaga M, Ashimura K, Sakamoto M, Mizoguchi S, Etoh M, Morioka T. [Studies of emergency cardiopulmonary bypass (ECPB) for cardiopulmonary-cerebral resuscitation--(3). Neurological outcome and pathological changes of the brain]. Masui 1993; 42:1451-8. [PMID: 8230696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Neurological outcome and pathological changes of the brain were studied in 5 female mongrel dogs, which were subjected to normothermic ventricular fibrillation (Vf) cardiac arrest of 15 min and resuscitated by using cardiopulmonary bypass through the femoral artery and veins (F-F bypass). Spontaneous circulation was restored by one or two defibrillating countershocks in all 5 dogs 5.2 +/- 1.1 (mean +/- SD) min after initiation of the F-F bypass. The F-F partial bypass was continued for 164 +/- 30 min under mild hypothermia. After weaning from the bypass, intensive care including controlled ventilation was carried out for the subsequent 6 to 36 h. Intermittent slow waves appeared on the electroencephalogram 62.8 +/- 11.6 min after initiation of the F-F bypass resuscitation and continuous waves at 145.6 +/- 27.5 min. Soon after extubation, the animals barked, moved the forelegs and could drink water. Neurological deficit scores (normal: 0, brain death: 500) improved to become below 100 except in 1 dog. However, macroscopic examination of the brain in 2 dogs with prominent recovery disclosed atrophy of the central gyrus and microscopic examination revealed typical ischemic injuries of the vulnerable neurons at the cerebellum, hippocampus and cerebral cortex in the frontal lobe.
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Affiliation(s)
- A Hashiguchi
- Department of Anesthesia, National Medical Center, Tokyo
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11
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Sadanaga M, Kano T, Hashiguchi A, Sakamoto M, Higashi K, Morioka T. Simultaneous laser-doppler flowmetry of canine spinal cord and cerebral blood flow: Responses to $$Pa_{CO_2 } $$ and blood pressure changes. J Anesth 1993; 7:427-33. [PMID: 15278792 DOI: 10.1007/s0054030070427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/1992] [Accepted: 01/12/1993] [Indexed: 10/26/2022]
Abstract
We observed the relative changes of both spinal cord blood flow (local SCBF) and local cerebral blood flow (local CBF) using independent laser-Doppler flowmeters (LDF) in 12 dogs under N2O(50%)-O2-enflurane(1.0%) anesthesia. The dorsal surface of the lumbar spinal cord and the parietal surface of the brain were partially exposed. Two fine LDF probes were placed between the exposed surfaces and the dura maters at each site. Both local SCBF and local CBF decreased simultaneously with hyperventilation and increased with hypoventilation within several seconds. The local SCBF responses to PaCO2 changes were similar in direction and degree as those of the local CBF. Autoregulation of local SCBF to arterial blood pressure (ABP) changes was abolished, though that of the local CBF was still recognized in a blunted fashion within a mean ABP range of 50 to 150 mmHg.
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Affiliation(s)
- M Sadanaga
- Surgical Center, Kumamoto University Hospital, Kumamoto, Japan
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12
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Hashiguchi A, Kano T, Sadanaga M, Ashimura K, Morioka T. [Emergency cardiopulmonary bypass (ECPB) for cardiopulmonary-cerebral resuscitation; (2). Physiologic changes]. Masui 1993; 42:1283-90. [PMID: 8230715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
After normothermic ventricular fibrillation (Vf) cardiac arrest of 15 min, 15 female mongrel dogs received conventional cardiopulmonary resuscitation (CPR) for 3 min and then cardiopulmonary bypass through the femoral artery and veins (F-F bypass). Cardiac beat did not return in any dogs during the initial 3-min CPR. Spontaneous circulation was restored by defibrillation 5.2 +/- 3.8 (mean +/- SD) min after the initiation of the F-F bypass in all dogs except in one with bypass trouble. Life-threatening ventricular dysrhythmias appeared in 8 of the 14 dogs (57%). Eleven of the 14 dogs (79%) were successfully weaned from the F-F bypass. Spontaneous respiration and circulation remained stable for the subsequent 1-h observation period in 8 dog (57%). The values of cardiac output measured just before weaning from the bypass and 30 to 60 min after weaning were significantly lower than those before inducing Vf (n = 5). On the electroencephalogram, intermittent burst waves reappeared 90.0 +/- 24.7 min after the initiation of resuscitation and EEG showed continuous waves 130.7 +/- 28.1 min (n = 7) after the initiation of resuscitation. The values of blood glucose, lactate and potassium 5 to 15 min after the initiation of F-F bypass were significantly higher than those before induction of Vf, while the values of hemoglobin, hematocrit, platelet and serum protein decreased significantly (n = 14).
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Affiliation(s)
- A Hashiguchi
- Department of Anesthesia, National Medical Center, Tokyo
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13
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Kano T, Hashiguchi A, Sadanaga M, Ashimura K, Sakamoto M, Morioka T. Cardiopulmonary-cerebral resuscitation by using cardiopulmonary bypass through the femoral vein and artery in dogs. Resuscitation 1993; 25:265-81. [PMID: 8351424 DOI: 10.1016/0300-9572(93)90124-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Twenty-seven dogs, divided into three groups, were subjected to a normothermic ventricular fibrillation (VF) cardiac arrest of 15 min and resuscitated by using cardiopulmonary bypass through the femoral veins and artery (F-F bypass). Group I (n = 15): Cardiac beating did not return in any dogs during an initial 3-min conventional cardiopulmonary resuscitation, but it returned 5.2 +/- 3.8 min (mean +/- S.D.) after the successive initiation of the F-F bypass in all dogs, except in one with bypass trouble. Intermittent burst waves appeared on the electroencephalogram and continuous waves returned, 90.0 +/- 24.7 min and 130.7 +/- 28.1 min after the start of resuscitation, respectively. Values of blood glucose, lactate and potassium 5-15 min after the F-F bypass were significantly higher than those before induction of VF, while those of blood pH, base excess, hemoglobin, hematocrit, platelet and serum protein decreased significantly. Group II (n = 7): Both local cerebral (CBF) and myocardial blood flow (MCBF) returned to the pre-arrest level soon after the initiation of the F-F bypass, even though spontaneous cardiac beating was not yet restored. Closed or open chest cardiac massage could not produce as much blood flow as the F-F bypass did. In the early stage of restoration of spontaneous circulation, temporary interruption of the bypass led to a decrease in both local CBF and MCBF. Group III (n = 5): Spontaneous circulation was restored in all five dogs 5.2 +/- 1.1 min after the institution of the F-F bypass, which was continued for 164 +/- 30 min under mild hypothermia. After intensive care for a subsequent 6-36 h, the animals barked, moved their forelegs and could drink water. The mean neurological deficit score (normal: 0, brain death: 500) was 100.6. However, macroscopic examination of the brain in two dogs with prominent recovery revealed atrophy of the central gyrus and microscopic examination revealed injuries of the vulnerable neurons of the brain.
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Affiliation(s)
- T Kano
- Surgical Center, Kumamoto University Hospital, Japan
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14
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Sakamoto M, Kano T, Sadanaga M, Shimoda O, Morioka T, Mishima M, Nakano M. Dermal patch anaesthesia: comparison of 10% lignocaine gel with absorption promoter and EMLA cream. Anaesthesia 1993; 48:390-2. [PMID: 8317646 DOI: 10.1111/j.1365-2044.1993.tb07010.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The analgesic effects of transdermally applied 10% lignocaine aquagel containing 3% glycyrrhetinic acid monohemiphthalate disodium (as an absorption enhancer) and EMLA cream were compared on the forearms of 34 adult volunteers in a double-blind fashion. The mean pinprick pain scores (graded by noting the number of painful pinpricks out of five) at 30, 60 and 90 min after application and 30 min after removal of the anaesthetics were 3.3 (0.3) (mean SE), 1.2 (0.3), 0.3 (0.1) and 0.3 (0.1) respectively, in the lignocaine gel group. Corresponding scores were 3.5 (0.3), 1.5 (0.3), 0.7 (0.2) and 0.1 (0.1) respectively, in the EMLA group. Insertion of a 26-gauge needle into the treated skin to a depth of 1 mm at 90 min after application was not painful in 91% of the volunteers in the lignocaine gel group and 88% of those in the EMLA group. There was no significant difference in any of the corresponding pain scores between the two groups.
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Affiliation(s)
- M Sakamoto
- Department of Anaesthesiology, Kumamoto University Hospital, Japan
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15
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Sakamoto M, Kano T, Nakamura M, Higashi K, Sadanaga M, Morioka T. Perioperative management of two patients with respiratory problems undergoing Abdominal surgery with high spinal anesthesia. J Anesth 1993; 7:108-12. [PMID: 15278505 DOI: 10.1007/s0054030070108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/1992] [Accepted: 06/03/1992] [Indexed: 11/30/2022]
Affiliation(s)
- M Sakamoto
- Surgical Center, Kumamoto University Hospital, Kumamoto, Japan
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16
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Kano T, Nakamura M, Hashiguchi A, Sadanaga M, Morioka T, Mishima M, Nakano M. Skin pretreatments for shortening onset of dermal patch anesthesia with 3% GA MHPh 2Na-10% lidocaine gel mixture. Anesth Analg 1992; 75:555-7. [PMID: 1530169 DOI: 10.1213/00000539-199210000-00015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Three types of skin pretreatments (stripping with adhesive tape, scrubbing with Skin-Pure jelly, and cleaning with benzine) were studied in 21 volunteers to determine whether the pretreatments could shorten the application period of transdermal 3% GA MHPh 2Na-10% lidocaine gel. Before application of the gel, each subject received skin pretreatment on the volar surface of one forearm. Then, the lidocaine gel soaked in a round sponge was applied on both the pretreated area of the forearm and the unpretreated contrast area of the other forearm. A pain score was obtained from each subject at 30, 45, 60, and 75 min after placement of the dermal patch by noting the number of painful pinpricks of five delivered. The mean pain scores on the pretreated side were significantly lower at 30, 45, and 60 min in the stripping study group and at 45 and 60 min in the cleaning study group, compared with the corresponding scores on the unpretreated side (P less than 0.05). Skin pretreatments, such as stripping and cleaning, are useful for shortening the onset of the dermal patch anesthesia.
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Affiliation(s)
- T Kano
- Department of Anesthesiology, Kumamoto University Hospital, Japan
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17
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Shibata Y, Okamoto K, Matsumoto M, Suzuki K, Sadanaga M, Morioka T. Cardiovascular responses to fiberoptic intubation: A comparison of orotracheal and nasotracheal intubation. J Anesth 1992; 6:262-8. [PMID: 15278535 DOI: 10.1007/s0054020060262] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/1991] [Accepted: 10/24/1991] [Indexed: 11/24/2022]
Abstract
We compared the cardiovascular responses between nasal and oral intubation with a fiberoptic bronchoscope under the combination of neuroleptic analgesia (NLA) and topical anesthesia. The 16 patients studied were divided into 2 groups: the nasal intubation group (N group: 8 patients) and the oral intubation group (O group: 8 patients). There were significant changes in systolic, diastolic and mean arterial pressures in the N group and in the pressure rate quotient in the O group. Diastolic arterial pressure and heart rate were significantly higher in the N group than in the O group before induction of general anesthesia. The rate pressure product (RPP) was significantly higher in the N group than in the O group at some points during the procedure. The individual RPP in both groups was relatively stable except for one patient in the N group, who had a marked increase in RPP during the procedure. We conclude that, under the combination of NLA and topical anesthesia, the cardiovascular responses to oral fiberoptic intubation are less severe than those to the nasal approach. The oral approach is recommended, especially in patients with coronary artery disease, taking into consideration of the cardiovascular responses to fiberoptic intubation.
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Affiliation(s)
- Y Shibata
- Department of Anesthesiology, Kumamoto University Medical School, Kumamoto, Japan
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18
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Ashimura K, Kano T, Hashiguchi A, Sadanaga M, Sakamoto M, Morioka T. [Studies of emergency cardiopulmonary bypass (ECPB) for cardiopulmonary-cerebral resuscitation; (1) Introduction of a portable-percutaneous ECPB system]. Masui 1992; 41:1011-7. [PMID: 1613945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The authors have developed an ECPB system, which can be applied quickly, safely and easily under an emergency condition requiring cardiac massage and artificial ventilation. Fundamentally, the ECPB system consists of 3 parts; a portable ECPB apparatus, a pair of percutaneous cannulae and a short circuit connecting an oxygenator with the cannulae. The ECPB apparatus is assembled with commercially available components (i.e., a centrifugal pump, a battery pack, a temperature controller, a compact membrane oxygenator with a heat exchanger, etc) and they are placed on a mobile cart. The circuit is primed with 300 ml of lactated Ringer solution. The priming can be done within 15 minutes via a reservoir. It is also possible to keep the primed circuit to be ready for emergency use at least for a week. The cannulae are placed intravascularly through the femoral artery and vein by using the Seldinger's percutaneous method. In an emergency situation, the arterial and venous cannulations are carried out separately on the both inguinal regions to save time. The tip of the venous cannula is adjusted to be placed near the right atrium under fluoroscopy. Initiation of ECPB via the femoro-femoral V-A cannulae assures instant and stable supply of oxygenated blood to all of the vital organs. At the present time, nothing is more important than a quick supply of oxygenated blood to the brain to ameliorate the post-ischemic brain damage.
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Affiliation(s)
- K Ashimura
- Department of Anesthesia, Kumamoto University Hospital
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Tsuno K, Terasaki H, Tsutsumi R, Sadanaga M, Higashi K, Morioka T. To-and-fro veno-venous extracorporeal lung assist for newborns with severe respiratory distress. Intensive Care Med 1989; 15:269-71. [PMID: 2745870 DOI: 10.1007/bf00271065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A veno-venous to-and-fro bypass method through a single blood access for extracorporeal lung assist with an artificial membrane lung is introduced. A premature newborn with severe respiratory distress was treated with this method. A 12 Fr. single lumen catheter with a spiral-embedded thin-wall, 0.25 mm in wall thickness, was placed in the right internal jugular vein. Venous blood was withdrawn and oxygenated blood returned alternately through the same catheter. Thus both carotid arteries and other large veins were kept intact. During the extracorporeal bypass, the patient was put on intermittent mandatory ventilation of 2 times/min for lung rest providing adequate arterial blood gases, and he survived.
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Affiliation(s)
- K Tsuno
- Department of Anaesthesiology, Kumamoto University Medical School, Japan
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Abstract
For the clinical evaluation of vidian neurectomy, questionnaires were sent to 250 cases operated on from 1971 to 1982, with answers obtained from 171. For sneezing, 56.8% of cases were evaluated markedly effective, 36.7% effective, 4.3% unchanged, and 2.2% aggravated. For rhinorrhea, markedly effective was 54.7%; effective, 39.4%; unchanged, 3.7%; aggravated, 2.2%. For nasal obstruction, markedly effective was 67.5%; effective, 27.4%; unchanged, 5.1%; and aggravated, 0%. On the other hand, 20% of cases complained of relapse of nasal allergic symptoms. Concerning the side effects, 28.7% of cases complained of cheek, upper lip, or palate numbness. Decrease of lacrimation was noted in 9.4% of cases. Several kinds of disturbances in the eye movement were observed in 4% of cases. Among them, 16 cases showed complete recovery within 24 h. In 3 cases, abducens paralysis continued for several months. Postoperative arterial bleeding occurred in one case. My recent strategy for the treatment of allergic rhinitis is conservative treatment at first, secondary nasal surgery such as septoplasty or turbinotomy, and at last vidian neurectomy if the patient agrees to be operated on after understanding the side effects.
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Tanoue T, Terasaki H, Higashi K, Goto K, Masuda K, Okamoto T, Sadanaga M, Tutumi R, Tsuno K, Morioka T. [Extracorporeal lung assist (ECLA) for a premature infant with severe barotrauma as a sequela of mechanical pulmonary ventilation]. Kokyu To Junkan 1988; 36:999-1003. [PMID: 3238189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Tsuno K, Terasaki H, Hashiguchi A, Nakamura M, Tanoue T, Okamoto T, Sadanaga M, Higashi K, Yano T, Saito Y. [Extracorporeal lung assist on premature sheep and goat delivered by cesarean-section used as an experimental model of infant respiratory failure]. Masui 1987; 36:909-13. [PMID: 3656658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Nosaka Y, Sadanaga M, Shiga A, Taigi H, Asano S. [Development of disturbance of hearing acuity, vestibular function, sense of taste and speech in Minamata disease]. Nihon Jibiinkoka Gakkai Kaiho 1970; 73:Suppl:1006-7. [PMID: 5311775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Nosaka Y, Sadanaga M. [Tonsillectomy]. Jibiinkoka 1969; 41:781-5. [PMID: 5390489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Pirsig W, Pfalz R, Sadanaga M. Postsynaptic auditory crossed efferent inhibition in the ventral cochlear nucleus and the blocking of it by strychnine nitrate (guinea pig). Kumamoto Med J 1968; 21:75-82. [PMID: 5700713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Sadanaga M, Hirada Y. [Case of tracheal adenoma]. Jibiinkoka 1967; 39:1101-5. [PMID: 4298823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Sadanaga M. [Diagnostic difficulty met with a mixed tumor affecting the pharynx and the neck]. Jibiinkoka 1966; 38:843-8. [PMID: 5949862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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