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Biomedical subjects

Hideyuki Higuchi

Publications and source records attributed to Hideyuki Higuchi.

31 records · Page 2Linked to original sources
PubMed2002

Renal function in surgical patients after administration of low-flow sevoflurane and amikacin.

PURPOSE: Compound A, a degradation product of sevoflurane, is nephrotoxic in rats, while aminoglycosides induce nephrotoxic injury in humans. Combining an aminoglycoside with a known nephrotoxin can enhance nephrotoxicity. We investigated the effects of aminoglycosides on renal function in surgical patients anesthetized with low-flow sevoflurane. METHODS: We compared the urinary excretion of several biochemical markers (such as total protein, albumin, beta(2)-microglobulin, glucose, and N-acetyl-beta-glucosaminidase [NAG]) in an amikacin group ( n = 18) and a control group ( n = 19) of surgical patients anesthetized with low-flow anesthesia (1 l.min(-1)) with sevoflurane. All patients received cefotiam as an antibiotic perioperatively. In addition, the amikacin group received amikacin, an aminoglycoside, given intravenously twice a day (400 mg per day) from immediately after the induction of anesthesia to day 2 after anesthesia. RESULTS: Duration of anesthesia and mean compound A concentration were 5.2 +/- 1.4 h and 27.2 +/- 8.7 ppm (mean +/- SD) in the amikacin group, and 5.1 +/- 1.7 h and 27.1 +/- 7.8 ppm in the control group respectively ( P > 0.05). The two groups did not differ in clinical laboratory baseline values (blood urea nitrogen and serum creatinine concentration). There were no significant differences between the groups in either the maximum or the average values for the urinary excretion of biochemical markers after anesthesia. CONCLUSION: Our study demonstrates that there is no synergic effect of compound A and amikacin on nephrotoxicity in humans.

Journal Article↗
PubMed2002

Halothane enhances acetylcholine release by decreasing dopaminergic activity in rat striatal slices.

The present study investigated the effect of halothane on acetylcholine (ACh) and dopamine (DA) release from the rat striatum. Halothane decreased DA release in a concentration-dependent manner, while increased ACh release. In our previous investigation, a volatile anesthetic, halothane, inhibited DA release from the rat striatal slices in a concentration-dependent manner. Although the release of ACh from cholinergic interneurons is tonically modulated by DA in the striatum, the effect of halothane on the relationship between the release of ACh and DA has not been discussed. Using double-labeled techniques, we investigated the effect of halothane on ACh and DA release simultaneously. The slices were incubated with [14C]-choline and [3H]-DA and superfused with modified Krebs solution containing 1 microM of hemicholinium-3. We applied electrical field stimulation (2 Hz, 240 shocks), and the amount of the release of radioactivity evoked by stimulation was calculated by subtraction of the basal radioactive outflow from the total outflow at the beginning of the respective stimulation periods. The effects of drugs on the release were expressed as the ratio of stimulation-evoked fractional releases (FR), measured in the presence and absence (FRS2/FRS1) of the drug. Halothane decreased DA release in a concentration-dependent manner (FRS2/FRS1=0.767+/-0.021, 0.715+/-0.026, 0.671+/-0.014 and 0.639+/-0.033 at the concentration of 0, 0.5, 2 and 4%, respectively), while ACh release showed a biphasic change in the presence of different concentrations of halothane. The release of ACh was significantly increased at the concentration of 2%, but not at 0.5 or 4%. Halothane failed to increase the release of ACh in striatal slices after lesion by 6-OH-dopamine. The application of amphetamine reduced the release of ACh and abolished the effect of halothane. These results indicate that the effect of halothane on ACh release is indirect: it increases the release by attenuating the inhibitory effect of DA released from the nigro-striatal pathway. The nonsynaptic interaction between DA and ACh release is involved in the effect of halothane on ACh release.

Acetylcholine↗
PubMed2002

Oral clonidine premedication reduces the awakening concentration of propofol.

UNLABELLED: To investigate the effects of oral clonidine premedication on emergence from propofol/fentanyl anesthesia, we studied 72 healthy male patients who were undergoing elective orthopedic surgery: the Control group, the 2.5 microg/kg Clonidine group, and the 5.0 microg/kg Clonidine group (n = 24 each). Nothing was administered to the Control group. Clonidine (2.5 or 5.0 microg/kg) was orally administered 90 min before the induction of anesthesia in the Clonidine groups. Patients were anesthetized with computer-assisted continuous infusion of propofol and fentanyl, with the three groups receiving the same concentrations of propofol (3 microg/mL) and fentanyl (1 ng/mL) starting 20 to 30 min before the end of surgery. Propofol infusion was then abruptly discontinued at the end of surgery in all patients. After propofol was discontinued, the response to verbal commands was evaluated every 30 s, and arterial blood samples for propofol and clonidine concentrations were taken when the patients opened their eyes. The time required to respond to a verbal command was 14.9 plus/minus 8.3 min for the 5.0 microg/kg Clonidine group, and this was significantly longer than the Control (8.2 plus/minus 5.0 min) and the 2.5 microg/kg Clonidine (9.0 plus/minus 3.7 min) groups (P < 0.01). Serum propofol concentration at awakening in the 5.0 microg/kg Clonidine group was 1.0 plus/minus 0.4 microg/mL, which was significantly smaller than the Control (1.6 plus/minus 0.4 microg/mL) and the 2.5 microg/kg Clonidine (1.4 plus/minus 0.3 microg/mL) groups (P < 0.01). The blood clonidine concentration was associated with a decrease in the awakening propofol concentration. In conclusion, 5 microg/kg oral clonidine premedication decreases the awakening propofol concentration and delays arousal from propofol/fentanyl anesthesia. IMPLICATIONS: Preanesthetic medication with 5 microg/kg oral clonidine, but not 2.5 microg/kg clonidine, is associated with prolonged recovery from propofol/fentanyl anesthesia.

Administration, Oral↗
PubMed2002

The interaction between propofol and clonidine for loss of consciousness.

UNLABELLED: Clonidine premedication reduces the intraoperative requirement for opioids and volatile anesthetics. Clonidine also reduces the induction dose of IV anesthetics. There is no information, however, regarding the effect of oral clonidine premedication on the propofol blood concentrations required for loss of consciousness, and the interaction between propofol and clonidine. We randomly administered target effect-site concentrations of propofol ranging from 0.5 to 5. 0 microg/mL by using computer-assisted target-controlled infusion to 3 groups of healthy male patients: Control (n = 35), 2.5 microg/kg Clonidine (n = 36), and 5.0 microg/kg Clonidine (n = 36) groups. Nothing was administered to the Control group. Clonidine (2.5 or 5.0 microg/kg) was administered orally 90 min before the induction of anesthesia in the Clonidine groups. After equilibration between the blood and effect-site for 15 min, a verbal command to open their eyes was given two times to the patients. Arterial blood samples for analysis of the serum propofol and clonidine concentrations were taken immediately before verbal commands were given. Measured serum propofol concentrations in equilibrium with the effect-site at which 50% of the patients did not respond to verbal commands (EC50 for loss of consciousness) were determined by logistic regression. The EC50 +/- SE values in the Control, 2.5 microg/kg Clonidine, and 5.0 microg/kg Clonidine groups were 2.67 +/- 0.18, 1.31 +/- 0.12, and 0.91 +/- 0.13 microg/mL, respectively. The EC50 in the 2.5 and 5.0 microg/kg clonidine groups was significantly smaller than that in the Control group (P < 0.001). The use of a response surface modeling analysis indicated that there was an additive interaction between measured arterial propofol and clonidine concentrations in relation to loss of consciousness. These results indicate that propofol and clonidine act additively for loss of consciousness. IMPLICATIONS: Oral clonidine 2.5 and 5.0 microg/kg premedication decreases the propofol concentration required for loss of consciousness.

Administration, Oral↗
PubMed2002

Fentanyl attenuates the hemodynamic response to endotracheal intubation more than the response to laryngoscopy.

UNLABELLED: We examined the effectiveness of avoiding laryngoscopy in reducing the hemodynamic responses to orotracheal intubation during the induction of anesthesia. One hundred surgical patients who required orotracheal intubation were randomly allocated into four groups. The first and third groups underwent fiberoptic intubation, in which an anesthesiologist inserted the endotracheal tube into the trachea under TV monitoring through a bronchoscope, and the second and fourth groups underwent conventional orotracheal intubation using a rigid laryngoscope. The third and fourth groups were pretreated with 2 microg/kg fentanyl IV immediately before the induction of anesthesia. Blood pressure and heart rate were measured noninvasively. A significant reduction in hemodynamic response was seen in only the group treated with fentanyl and intubated using the fiberoptic technique. Without fentanyl, there was no significant difference in hemodynamic changes between the groups. We conclude that the administration of fentanyl suppresses the hemodynamic responses to endotracheal intubation more than it does to laryngoscopy. There was no significant difference in the hemodynamic responses to orotracheal intubation by fiberscopy and laryngoscopy without fentanyl pretreatment, whereas 2 microg/kg fentanyl significantly reduced the hemodynamic responses in the group intubated by fiberscopy. IMPLICATIONS: We assessed the effectiveness of avoiding laryngoscopy for orotracheal intubation. There was no significant difference in the hemodynamic responses to orotracheal intubation by fiberscopy and laryngoscopy without fentanyl pretreatment, whereas 2 microg/kg fentanyl significantly reduced the hemodynamic responses in the group intubated by fiberscopy. Pretreatment of fentanyl and fiberoptic intubation might be recommended for avoiding hyperdynamic responses.

Adult↗
PubMed2002

[The effect of normobaric oxygen inhalation and halothane anesthesia on the level of interstitial striatal dopamine of rats using in vivo microdialysis study].

We investigated the effect of normobaric oxygen inhalation on the level of interstitial dopamine and its metabolites in in vivo brain striatum of awake, free moving rats using microdialysis techniques. Rats were implanted a microdialysis probe to the right striatum of the brain and administered pure oxygen for 1 hour, and dialysates from the probe were examined every 20 minutes by HPLC. Normobaric oxygen inhalation reduced the amount of dopamine derived from the dialysate and increased that of metabolites. Halothane anesthesia with oxygen showed a slight effect on the changes induced by oxygen inhalation, whereas halothane significantly increased the level of dopamine metabolites. Pretreatment with glutathione failed to prevent increase of dopamine metabolites. We hypothesized that oxygen inhalation and halothane anesthesia might increase the level of dopamine metabolites in different mechanisms, and the changes induced by oxygen inhalation might not be the result of simple oxidative stress in rat striatum.

Administration, Inhalation↗
PubMed2002

[Repeated coronary artery spasm under general anesthesia].

A 52-year-old man without history of angina pectoris underwent emergent abdominal surgery for acute abdomen. General anesthesia was maintained with isoflurane, nitrous oxide and fentanyl. The depth of anesthesia during surgery was considered adequate for the stimuli, but the patient developed ECG abnormality repeatedly finally followed by short run. After anesthesia, we re-examined the recorded ECG and coronary spasm was strongly suspected. Fatal arrhythmia might be avoidable if the prior abnormality in ECG is properly assessed.

Abdomen, Acute↗
PubMed2002

[A simple method for determination of flurbiprofen in human plasma by gas chromatography-mass spectrometry].

A method for gas chromatograph-mass spectrometric assay has been developed for the quantitation of flurbiprofen in human plasma. Extraction or condensing procedure was not required and the method reduced time involved in sample preparation. The analytes were separated on the fused-silica capillary column. The operating conditions were: injector, 250 degrees C; detector, 300 degrees C; and column, 50-280 degrees C. The total gas flow-rate of helium (carrier) was 50 ml.min-1 and the pressure of column inlet was 100-200 kPa. The retention time was 18.1 min and the limit of quantitation was 0.5 microgram.ml-1. This method provides an easy and simple method for the detection of flurbiprofen.

Flurbiprofen↗
PubMed2002

[Intubation in a patient with lingual tonsil hypertrophy using an intubating laryngeal mask airway in combination with fiberoptic intubation].

A 66-yr-old man was scheduled for colon resection under general anesthesia. There were no findings suggesting difficulty of airway management. After induction of anesthesia, manual ventilation via a facemask was suboptimal, but increased fresh gas flow improved it. At direct laryngoscopy after achieving muscular relaxation, the arytenoids and epiglottis could not be seen even by an expert anesthesiologist. Intubating laryngeal mask airway (ILMA) was inserted to patient's larynx and ventilation could be continued. Tracheal intubation through ILMA was impossible because of hard resistance for inserting the endotracheal tube. Fiberoptic bronchoscopy revealed that the hypertrophied lingual tonsil obstructed the aperture of ILMA. Several attempts were made for intubation using fiberoptic tracheal intubation technique through ILMA and finally the patient's trachea was intubated without any bleeding or swelling of laryngeal tissues. The effectiveness of ILMA for the patient with lingual tonsil hypertrophy is still unknown, but the insertion of ILMA might be considered for safe airway management in combination with a fiberscope.

Aged↗
PubMed2002

[The changes of bispectral index induced by administration of midazolam during propofol anesthesia].

The effect of the additional administration of midazolam or flumazenil on bispectral index (BIS) during propofol anesthesia was investigated in 22 scheduled surgical patients. Midazolam 10 or 30 micrograms.kg-1, or flumazenil 6 or 12 micrograms.kg-1 was injected to the patients to evaluate their effect on BIS after achieving steady state of hypnosis more than 1 hr of propofol anesthesia with 5 mg.kg-1.hr-1. The only midazolam 30 micrograms.kg-1 significantly reduced BIS value from 47.8 +/- 8.6 to 36.8 +/- 6.5. The synergistic interaction between midazolam and propofol assessed by BIS might be less clear than that assessed by hypnotic dose of propofol using psychopharmacological investigation.

Adjuvants, Anesthesia↗
PubMed2002

[The effectiveness of perioperative intravenous flurbiprofen in minor ear, neck and nose surgery].

To evaluate the effect of perioperative intravenous administration of flurbiprofen, a nonsteroidal anti-inflammatory drug, on the postoperative pain after minor ear, neck and nose surgery, eighty patients were randomly allocated into three groups. Control group of 40 patients, received a placebo. The second group (n = 20) received 1 mg.kg-1 flurbiprofen i.v. at the end of surgery, and the third group (n = 20) received the same dose of flurbiprofen before the start of surgery. The ratio of the patients and the time for requirement of analgesics after the operation and the serum concentration of flurbiprofen were assessed. The ratio of the patients who required analgesics was higher in control group (0.45, 0.35 and 0.10 in each group). The time without analgesics was longer in pre-treatment group. The serum concentration of flurbiprofen decreased in pre-treatment group at the end of surgery, but the effectiveness of flurbiprofen on postoperative pain might be more apparent in pre-treatment group. Administration of flurbiprofen before the start of surgery is more effective for peri-operative analgesia in minor ear, neck and nose surgery.

Adult↗