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Biomedical subjects

M Sanuki

Publications and source records attributed to M Sanuki.

14 recordsLinked to original sources
PubMed2001

[Evaluation of adhesive tape containing lidocaine using current perception threshold measurement].

Lidocaine adhesive tape (Penles; Wyeth Lederle Japan, Ltd, Tokyo, Japan) is placed for pain relief prior to puncturing a vein with a needle. We investigated the optimal time interval from application of Penles to vein puncture by measuring current perception threshold (CPT) levels with a Neurometer, by which it was possible to measure the extent of nerve block in a non-invasive and quantitative manner with 3 electrical stimulus rates (2000 Hz, 250 Hz, and 5 Hz). Penles was applied to the dorsum of volunteers' hands for 1, 2, 4, 6 and 12 hours before measuring CPT levels. With a stimulation rate of 2000 Hz and 250 Hz, CPT, levels were found to increase 4 hours after the Penles application, while peak CPT levels for 5 Hz stimulation were observed from 6 to 12 hours after application. However, CPT levels tended to decrease 12 hours after application, regardless of the stimulus rate. From the result, we conclude that Penles provides maximum benefit when applied 6 hours prior to vein puncture.

Administration, Topical↗
PubMed2001

[Perforation of the superior vena cava and hemothorax caused by insertion of a pulmonary artery catheter].

A 70-year-old woman with aortic regurgitation was scheduled for aortic valve replacement. After induction of anesthesia resistance was encountered when attempting to remove the guide wire with a sheath dilator prior to insertion of a pulmonary artery (PA) catheter through the right internal jugular vein. Ten hours after catheter insertion, chest X-ray examination in ICU showed poorly delineated right lung field, and hemothorax was suspected, as a large amount of fluid was also seen draining from the chest drain tube. Twenty two hours after catheter insertion, we opened her chest and found that the superior vena cava (SVC) had been perforated. After surgical closure of the hole on the SVC, the hemodynamics because stabilized and active bleeding was controlled. The patient was subsequently discharged from the hospital without any further complications. This perforation was thought to be caused by carelessness during insertion of the PA catheter. To prevent serious complications, such as perforation of the great vessels or heart by a catheter, the results of the present case suggest that careful attention is required during catheterization, especially when resistance is encountered.

Aged↗
PubMed2001

[Effect of bolus propofol administration on muscle evoked potential (MsEP) during spine surgery].

Intraoperative monitoring of descending pathways by means of muscle evoked potential (MsEP) is a reliable method to monitor spinal cord motor function, but MsEP is readily affected by anesthetics. We monitored MsEP evoked by repetitive transcranial electrical stimulation of the motor cortex in 30 patients receiving spine surgery. Total intravenous anesthesia was maintained with propofol and fentanyl without any muscle relaxant. Onset latencies and peak to peak amplitudes of MsEP were evaluated before and after the bolus propofol administration. The concentrations of propofol in blood and the effect-site during MsEP monitoring were predicted by computer simulation software. The amplitude of MsEP decreased slightly by bolus propofol administration, but the latencies showed no significant change with propofol under the same condition. We consider that total intravenous anesthesia with propofol and fentanyl without muscle relaxants is compatible with the recording of MsEP evoked by high frequency repetitive electrical transcranial stimulations. When MsEP is monitored during spine surgery, anesthetic condition should be controlled carefully in order to maintain a stable blood concentration of propofol and thus to assure the reliability of MsEP measurements.

Adolescent↗
PubMed2001

[Coronary artery spasm during low flow anesthesia].

A 70-year-old man, without history of angina pectoris, was scheduled for aorto-femoral bypass graft surgery under epidural anesthesia supplemented with nitrous oxide and sevoflurane. At the beginning of operation, twenty minutes after the start of low flow anesthesia (2 l.min-1), ECG showed an elevation of the ST segment during hypotension. Rising blood pressure and bolus injection of nitroglycerin relieved the elevation and his circulation became stable. It was suspected that a coronary spasm attack was induced by hypotension, as well as vagal stimulation from an inadequate amount of anesthesia. For prevention of intraoperative coronary spasm, it is important to maintain anesthesia at sufficient levels using monitors.

Aged↗
PubMed2000

Effects of pneumoperitoneum on cardiac autonomic nervous activity evaluated by heart rate variability analysis during sevoflurane, isoflurane, or propofol anesthesia.

BACKGROUND: The effects of pneumoperitoneum on the activity of the cardiac autonomic nervous system have not been completely understood. METHODS: In this study, 45 unpremedicated adult patients who underwent laparoscopic cholecystectomy were anesthetized with either 3.5% sevoflurane, 2% isoflurane, or 8 mg/kg/h propofol (15 patients in each group). The status of cardiac autonomic nervous activity was evaluated by heart rate variability analysis three times: once when the patient was awake, once after induction of general anesthesia, and once after insufflation for pneumoperitoneum. Intra-abdominal pressure was maintained automatically at 10 mm Hg by a carbon dioxide (CO(2)) insufflator. For each measurement, electrocardiogram was recorded for 256 s and played back offline to detect R-R intervals. Power spectral analysis of heart rate variability was applied, and the low-frequency (LF, 0.04-0.15 Hz) and high-frequency (HF, 0.15-0. 40 Hz) bands of the spectral density of the heart rate variability were obtained from a power spectra of R-R intervals using the fast-Fourier transform algorithm. The HF/LF ratio also was analyzed. RESULTS: Measurements of heart rate variability in the three groups showed similar change. Although the power of HF, which represents parasympathetic nervous activity, did not change, the power of LF, which represents both sympathetic and parasympathetic nervous activity, decreased during the anesthetized stage and increased during the insufflated stage. The HF/LF ratio, which represents the balance of parasympathetic and sympathetic activity, increased after induction of general anesthesia, and decreased after insufflation. CONCLUSIONS: Our results suggest that pneumoperitoneum increases sympathetic cardiac activity. The choice of general anesthetic did not seem to have a major influence on the change in the cardiac autonomic nervous system after induction of pneumoperitoneum for laparoscopic cholecystectomy.

Adult↗
PubMed2000

Effects of one-lung ventilation on cardiac autonomic nervous activity as evaluated by power spectral analysis of heart rate variability.

The purpose of this prospective study was to evaluate the effects of one-lung ventilation on the activity of the cardiac autonomic nervous system. Ten adult patients who underwent thoracotomy were endotracheally intubated with a double-lumen tube under general anesthesia using isoflurane. After induction of anesthesia, a continuous, 256-sec electrocardiogram (ECG) was obtained during bilateral lung ventilation (control) followed by recordings during one-lung ventilation of each side. Using the R-R interval tachograms obtained for the 256-sec ECGs, low frequency (LF: 0.04-0.15 Hz) and high frequency (HF: 0.15-0.40 Hz) bands of the spectral density of the heart rate variability and the HF/LF ratio were analyzed using the fast Fourier transform algorithm. Log(HF), which indicates parasympathetic activity, increased during one-lung ventilation on each side, but did not differ between ventilated sides. Log(LF), which represents sympathetic and parasympathetic activity, increased similarly to log(HF) on both sides. Log(HF/LF), the balance of the sympathetic and parasympathetic activity, did not change during one-lung ventilation. We suggest that one-lung ventilation alone does not substantially affect the cardiac autonomic nervous system.

Adult↗
PubMed2000

Perioperative temporal profile of cognitive function in elderly patients undergoing hip surgery.

To test the hypothesis that elderly patients who have surgery for femoral neck fractures may have delirium not only after surgery but before surgery, we prospectively investigated the perioperative temporal profile of cognitive function in such patients. We performed the Abbreviated Mental Test (AMT) six times in each patient (on the day of admission, 3 days after admission, on the day before surgery, 2 days after surgery, 7 days after surgery, and on the day of discharge). Patients were given no premedication and were anesthetized with spinal anesthesia using 0.2% hypobaric tetracaine. Of the 68 patients who were admitted because of a diagnosis of fractured neck of the femur and were scheduled to have surgery, 27 patients were subjected to analysis. Four and three patients showed a significant decrease (3 or more points) in AMT score 2 and 7 days after surgery, respectively. We conclude that surgery may have a stronger impact on cognitive function than environmental change shortly after admission in elderly patients with femoral neck fractures.

Aged↗
PubMed1994

Sevoflurane inhibited beta-adrenoceptor-G protein bindings in myocardial membrane in rats.

The effects of sevoflurane on the beta-adrenoceptor (beta AR) system, consisting of the receptor, stimulatory guanosine triphosphate (GTP) binding protein (Gs), and adenylate cyclase (AC), were studied in rat myocardial membrane. Cyclic adenosine monophosphate (cAMP) production rate was measured as cAMP generation stimulated by l-isoproterenol, guanosine 5"-O-(3-thiotriphosphate) (GTP gamma S), and forskolin, respectively. The receptor studies were performed by using the dihydroalprenolol ([3H]DHA) binding method. Nonspecific binding was determined in the presence of l-propranolol. beta AR binding capacity determined by the maximum number of binding sites (Bmax) and the dissociation constant (Kd) for [3H]DHA were calculated. beta AR affinity for agonists was assessed by an inhibition constant (Ki), calculated from the concentration of l-isoproterenol to produce half-maximum inhibition of [3H]DHA binding (IC50). At 2.0 mM sevoflurane, cAMP production rate was significantly depressed by 87.1% +/- 4.8% with l-isoproterenol and by 79.4% +/- 7.0% with GTP gamma S, but not significantly depressed by forskolin. In the presence of 0-2.0 mM sevoflurane, Kd for [3H]DHA and Ki for l-isoproterenol increased in a concentration-dependent manner, whereas Bmax remained unchanged. The ratio of high affinity state against the high and low affinity state of the adrenoceptor decreased significantly from 0.60 +/- 0.15 to 0.35 +/- 0.12. We conclude that sevoflurane might depress the beta AR signal transduction system by reducing ligand-receptor bindings and disrupting the relationship between the receptor and Gs.

Anesthetics↗
PubMed1994

[Usefulness of the interchangeable medical bibliography: introduction of "reference transform utility" program for Macintosh].

We made a text file format exchange program on HyperCard 2.0 for medical bibliography. Some database applications on Macintosh to manage the medical bibliography were available. FileMaker ProJ, EndNotePlus and Microsoft Excel were well known as popular databases and spread sheet application for Macintosh. The data format among the applications is not uniform. We need to translate a data format into another format to share the same data among these database applications. But it requires a lot of time and labor to make this conversion by manual operation. We have developed a file conversion utility program with HyperCard as a user friendly software.

Bibliography of Medicine↗
PubMed1993

[Anesthetic management of patients with pheochromocytoma for adrenalectomy using balanced anesthesia with continuous infusion of nicardipine and nitroglycerin].

Four patients underwent surgical removal of pheochromocytoma under balanced anesthesia with fentanyl, sevoflurane and epidural anesthesia combined with continuous infusion of nicardipine and nitroglycerin. Circulation was stable during the operation in all the patients. There were no serious hypertension and hypotension, arrhythmia and pulmonary edema during the postoperative period. We conclude that the anesthetic management of patients with pheochromocytoma for adrenalectomy using balanced anesthesia with continuous infusion of nicardipine and nitroglycerin is one of the most useful anesthetic methods.

Adrenal Gland Neoplasms↗
PubMed1993

[Anesthesia for venoplasty of right hepatic vein and liver portion of inferior vena cava using veno-venous bypass].

A patient with Budd-Chiari syndrome who underwent a new surgical technique; venoplasty of right hepatic vein and liver portion of inferior vena cava using veno-venous bypass, was reported. The patient was 31 year-old man whose weight and height were 55 kg and 157 cm, respectively. During the anesthetic management of this patient, we encountered following problems; continuous massive bleeding, profound hypothermia and hemodynamic derangement. These problems were similar to those of liver surgery using veno-venous bypass such as extracorporeal liver surgery and liver transplantation.

Adult↗
PubMed1992

[A program for continuous infusion of cardiovascular agents (CIRCULATION)--how to derive the algorithm and how to use the mathematical formula in this program].

Recently, many cardiovascular agents came to be administered to serious or perioperative cases continuously, and difficult calculation became necessary. For continuous infusion of cardiovascular agents, we devised a personal computer program (CIRCULATION) to avoid difficult calculation for PC-9801 series (NEC) by a C language (Turbo-C, Version 2.0). It is easy to use the program, and it calculates the algorithm for many cardiovascular agents in a second. The program is very useful for anesthesiologists and for other doctors when they administer various cardiovascular agents.

Algorithms↗