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Biomedical subjects

Katsuyasu Kitaguchi

Publications and source records attributed to Katsuyasu Kitaguchi.

22 records · Page 2Linked to original sources

[Effects of amrinone in patients undergoing off-pump coronary artery bypass grafting].

We evaluated the effect of amrinone in 41 patients undergoing off-pump coronary artery bypass grafting(CABG) retrospectively. Amrinone was intravenously administered at the rate of 5 mcg.kg-1.min-1 after coronary artery anastomosis (A 1 group: 11 cases) or after induction of anesthesia(A 2 group: 13 cases). The hemodynamic variables and use of concomitant drugs were compared among A 1, A 2 and the non-amrinone group (control group: 17 cases). Hemodynamics was measured before, during, after coronary artery anastomosis, and after the chest closure. Catecholamine and vasodilator were used to maintain mean arterial pressure (> 60 mmHg) and cardiac index(> 3.0 l.min-1.m-2). Mean pulmonary artery pressure, right atrial pressure and pulmonary artery wedge pressure were significantly higher during anastomosis than before anastomosis in control and A 1 group, but no significant changes in these parameters were observed in A 2 group. In addition, these variables increased significantly after chest closure in control group, but were unchanged in A 1 and A 2 groups. Patients with concomitant use of catecholamine and vasodilator in A 2 group were fewer than those in control and A 1 group. In conclusion, in the patients undergoing off-pump CABG, infusion of amrinone was recommended from the end of the induction of anesthesia.

Aged↗

[The relationship between end-tidal isoflurane concentration and electroencephalographic bispectral index during isoflurane/epidural anesthesia].

We studied the effects of increases in isoflurane concentration on the bispectral index (BIS) in 16 patients undergoing lower abdominal surgery during isoflurane/epidural anesthesia. In 8 patients, the lungs were ventilated with an air/oxygen mixture (inspired oxygen fraction 0.33) [N(-) group], and in another 8 patients, the lungs were ventilated with 66% nitrous oxide in oxygen [N(+) group]. During surgery, patients received 1.0 MAC (1.15%) end-tidal isoflurane and the BIS was recorded after 10 min of unchanged end-tidal concentration. After this, we increased the end-tidal concentration of isoflurane by 0.2 MAC to 1.8 MAC. At each concentration step, the BIS was recorded again after 10 min of unchanged end-tidal concentration. At isoflurane concentration < 1.4 MAC, the BIS did not change with increasing isoflurane concentration in both groups (BIS values = about 40). In N (-) group, the BIS decreased in all patients at isoflurane concentration > 1.6 MAC. The mean BIS values were 22 (SD 18) at 1.6 MAC and 2(4) at 1.8 MAC, respectively. In N (+) group, the BIS decreased in four patients at isoflurane concentration > 1.6 MAC, and the BIS did not decrease at 1.8 MAC in another four patients. The mean BIS values were 27 (17) at 1.6 MAC and 21(21) at 1.8 MAC. The present data suggest that BIS may not correlate with anesthetic effect of isoflurane at isoflurane concentration > 1.0 MAC.

Adult↗

[Paradoxical embolism during MIDCAB surgery].

A 36-year-old woman underwent MIDCAB surgery. During the exposure of LAD, the right ventricular wall was injured. The bleeding was controlled by compression. After that, she developed hypotension followed by cardiac arrest. At the same time, TEE showed bubbles in all of the right ventricle. The open chest massage and epinephrine 1 mg restored the heart beat. It was thought that bubbles were brought to the right ventricle via the injured wall by the blower. A few minutes after the cardiac arrest, bubbles were detected in the left atrium by TEE. This phenomenon was suspected as transpulmonary paradoxical embolism because no cardiac shunt could be detected by TEE.

Adult↗

[Incidence and duration of hoarseness following endotracheal intubation].

The incidence and duration of hoarseness following tracheal intubation with general anesthesia were studied retrospectively from November 1998 to October 2000 in postanesthetic clinic of Nara Medical University. Total number of patients was 3977 and 37.1% of them complained of hoarseness. Most of there patients recovered within three days after surgery but in 4.2% the hoarshness persisted over ten days and in 0.7% persisted over one month after surgery. Most of these persistent hoarseness were considered to have originated from surgical procedures (such cervical, pulmonary, cardioaortic operation, etc.) and those following only tracheal intubation recovered within two months after surgery. The hoarseness decreased the satisfactory level for anesthesia in 1.0% of total patients and 12.8% of patients with persistent hoarseness. We consider that preoperative explanation and postoperative communication by anesthesiologists are important.

Adult↗