Biomedical subjects

T Kushikata

Publications and source records attributed to T Kushikata.

44 records · Page 3Linked to original sources

PubMed1993

[EEG pattern during total intravenous anesthesia with droperidol, fentanyl and ketamine].

We evaluated EEG pattern during total intravenous anesthesia with droperidol, fentanyl and ketamine (DFK). Four surgical patients, ranged in age from 35 to 43, were the subjects of this study. Two male underwent oral or orthopedic surgery and the other two female patients underwent gynecological surgery. They were all free from hepato-renal dysfunction and central nervous system disorders. For the induction of anesthesia, droperidol 0.06-0.1 ml.kg-1, fentanyl 2-4 micrograms.kg-1, and ketamine 1.0-1.5 mg.kg-1 were slowly administered intravenously. A total dose of 5-15 micrograms.kg-1 of fentanyl was given intravenously with continuous infusion of ketamine 2 mg.kg-1.h-1 during the surgical procedure. The total amounts of fentanyl and ketamine administered were 4.9-22.2 micrograms.kg-1 and 240-340 mg.kg-1, respectively. We used HZI'Brain Function Monitoring system to evaluate their EEG patterns. When adequate depth of anesthesia was obtained as clinically evaluated by vital signs, theta wave pattern was dominant on the EEG tracings in any of these patients. DFK anesthesia would provide a stable anesthetic course, if those drugs are administered adequately considering vital signs including systemic blood pressure, heart rate, lacrimation and involuntary muscle movements of the face and extremities.

Adult↗

PubMed1993

[Plasma levels of isosorbide dinitrate and its metabolites during intravenous infusion in surgical patients--effect of preoperative administration of isosorbide dinitrate].

Nineteen patients with ischemic heart disease were studied to determine plasma levels of isosorbide dinitrate (ISDN) and its metabolites, isosorbide-2-mononitrate (2-ISMN) and isosorbide-5-mononitrate (5-ISMN) for 6 hrs during intravenous administration of ISDN, using gas chromatography. Differences in plasma levels of these substances were also evaluated in patients with or without preanesthetic medication of ISDN. These patients ranging in ages from 42 to 80 years were administered ISDN intravenously at a rate of 1 micrograms.kg-1 x min-1 during anesthesia and surgery. Preanesthetic administration of ISDN consisted of transdermal application of 40 mg dose. Surgery included gastrectomy, pneumonectomy, extended cholecystectomy, radical mastectomy and so on under either enflurane anesthesia or neuroleptanesthesia. Plasma ISDN levels increased and reached a plateau 3 hrs after the start of intravenous infusion of ISDN in patients of both groups. Plasma 2-ISMN levels increased gradually and reached a plateau 5 hrs after the commencement of intravenous administration of ISDN in patients of both groups. Plasma 5-ISMN levels increased gradually reaching the peak 6 hrs after the start of intravenous infusion of ISDN in both groups. Plasma ISDN, 2-ISMN and 5-ISMN levels were slightly higher in patients who received preanesthetic ISDN than in those who did not receive preanesthetic ISDN. However, there were no statistical differences in plasma ISDN or 2-ISMN levels between the groups except prior to the infusion. On the contrary, plasma 5-ISMN levels were significantly higher in patients who received preanesthetic ISDN than in those who did not receive preanesthetic ISDN for 3 hrs after the start of the infusion.

Adult↗

PubMed1992

[Effect of M1 blocker or H2 blocker on gastric secretion during anesthesia and surgery].

Effect of pirenzepine, famotidine or a combination of both agents on gastric secretion during anesthesia and surgery was evaluated in 42 surgical patients ranged in age from 17 y to 70 y. They underwent orthopedic, ophthalmic, ENT, plastic, oral or non-abdominal surgery under either neuroleptanesthesia or enflurane anesthesia. They received either pirenzepine 10 mg, famotidine 20 mg or the combination of both agents intravenously just before the induction of anesthesia. Volume and acidity of gastric juice were measured during 3 hours after the administration of these agents. A continued decrease in volume and acidity of gastric juice was observed 3 hrs after the administration of the agents both in the pirenzepine group and in the famotidine group. Efficacy of the combination of pirenzepine and famotidine on gastric secretion tended to be more prominent than that of either pirenzepine or famotidine alone.

Adolescent↗

PubMed1991

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--9. Control of intraoperative hypertension with diltiazem].

Intraoperative hypertension over 160 mmHg systolic and sinus tachycardia over 100 bpm are often observed during total intravenous anesthesia with droperidol, fentanyl and ketamine. Fifty-seven surgical patients who developed hypertension over 160 mmHg systolic during various operative procedures under this type of anesthesia were given diltiazem intravenously to overcome the situation. Their blood pressure and heart rate decreased soon after the administration of diltiazem. The rate pressure product was reduced significantly. Neither preoperative hypertension nor difference of doses between 5 mg and 10 mg of diltiazem had any significant relationship with hypotensive effect of intravenous diltiazem. But the higher the systolic-pressure was just before the administration of diltiazem, the more effective diltiazem was. No adverse effects with this drug was observed. We can conclude that intravenous diltiazem in a dose of 5 mg or 10 mg may be repeatedly given to overcome hypertension or sinus tachycardia during this type of anesthesia without any adverse effects.

Anesthesia, Intravenous↗

PubMed1991

[Clinical study on total intravenous anesthesia with droperidol, fentanyl, and ketamine--6. Effects on postoperative liver function].

We have developed a new method of total intravenous anesthesia with droperidol, fentanyl, and ketamine, and have administered it to more than 700 surgical patients. We studied whether this method of anesthesia would influence postoperative liver function or not. A total of sixty elective surgical patients were the subjects of this study. Thirty patients underwent total hysterectomy under either the total intravenous anesthesia (15 patients) or modified neurolept-anesthesia with pentazocine (15 patients). The remaining 30 patients underwent gastrectomy under either this total intravenous anesthesia (15 patients) or enflurane-N2O anesthesia (15 patients). The hepatic function was evaluated as judged by s-GOT, s-GPT, ALP, gamma-GPT and total bilirubin levels, before anesthesia and during the first to third postoperative day. The patients for gastrectomy under enflurane-N2O anesthesia had significantly increased postoperative gamma-GPT levels compared with the patients of total intravenous anesthesia. Any other variables showed no significant difference among groups. We consider that this method of total intravenous anesthesia has no adverse effects on postoperative liver function as compared with other usual anesthetic methods.

Anesthesia, Inhalation↗

PubMed1990

[Marked changes in the core temperature during anaphylactic shock].

Three cases of anaphylactic shock were reported in which the core temperature was measured continuously. Two core temperature thermister probes were fixed on the forehead and the sole. Temperature dissociation between the core and the periphery disappeared in a few minutes after the administration of the causative agents. The clinical signs of the anaphylactic shock such as erythema, wheal and marked hypotension also developed in a few minutes after the disappearance of temperature dissociation. Thus treatment of anaphylactic shock could be started even before the patients develop severe hypotension. This clinical study suggests that a sudden disappearance of the temperature dissociation is a incipient sign of anaphylactic shock and to monitor the core as well as the peripheral temperature is a useful method for early diagnosis and treatment of anaphylactic shock.

Aged↗

PubMedDate not supplied

Xenon inhalation increases norepinephrine release from the anterior and posterior hypothalamus in rats.

PURPOSE: To investigate the effect of xenon (Xe) and nitrous oxide (N(2)O) on norepinephrinergic neuronal activity in the rat medial preoptic area (mPOA) and posterior hypothalamus (PH) using microdialysis. METHODS: Sixty male Wistar rats were equally allocated to two groups: mPOA and PH. A microdialysis probe was implanted into the mPOA or the PH. In both groups, each animal was exposed to one of the following inhalations: 25% oxygen (control, n=6), 30% Xe (n=6), 60% Xe (n=6), 30% N(2)O (n=6) or 60% N(2)O (n=6). Norepinephrine concentration in the perfused artificial cerebrospinal fluid was measured by high pressure liquid chromatography at ten-minute intervals. After plotting the time-norepinephrine concentration curve, the area under the curve (AUC) in each group was calculated. RESULTS: In the mPOA, 30 and 60% Xe, but only 60% N(2)O significantly increased norepinephrine release. The AUC in the 30% Xe, 60% Xe or 60% N(2)O group was 160 +/- 9 (P <0.05), 288 +/- 42 (P <0.01) or 237 +/- 46 pg x min/sample (P <0.01), respectively, compared to that in the control group: 77 +/- 14 pg x min/sample. In the PH, only 60% Xe significantly increased norepinephrine release compared to control (AUC: 191 +/- 38 vs. 71 +/- 1 pg x min/sample, P <0.01). CONCLUSION: The present data suggest that Xe stimulates norepinephrinergic neurons more potently than N(2)O; 1.2 times more in the mPOA and 2.5 times more in the PH. This stimulant effect may contribute to the hypnotic and sympathotonic effects of Xe in rats.

Anesthetics, Inhalation↗

PubMedDate not supplied

Insertion of intradermal needles into painful points provides analgesia for intractable abdominal scar pain.

BACKGROUND AND OBJECTIVES: Conventional treatments are often ineffective for patients having painful abdominal scars. There are painful points in and around scar tissue. We tested the hypothesis that insertion of intradermal needles into these painful points reduces scar pain. METHODS: Patients with abdominal scar pain with painful points that is not relieved by conventional treatments were allocated to a treatment group (n = 23), a sham-treatment group (n = 23), or a control group (n = 24). In the treatment group, intradermal needles were inserted into painful points detected by a pressure threshold meter (pain < or = 2.5 kg/cm(2)). In the sham-treatment group, the same needles were inserted into nonpainful points. The needles were kept in place for 24 hours. This process was repeated 20 times over a 4-week period. Responses were evaluated before and at the end of treatment, and 4 and 26 weeks after the treatment. Continuous and lancinating pain was evaluated on a 10-cm visual analog scale. We measured the area of pain and the pressure required to initiate painful-point pain. All patients took diclofenac as needed and completed a diary of daily diclofenac consumption. RESULTS: Patients in the treatment group showed a marked reduction in all pain parameters (>70%). In contrast, analgesia was minimal in the other groups. The decreases in the pain threshold pressure correlated with the decreases in continuous and lancinating pain (r =.57 and r =.63, respectively). CONCLUSION: Our data suggest that insertion of intradermal needles into painful points is a remarkably effective treatment for intractable abdominal scar pain. Analgesia presumably results from inactivation of painful points, through a yet to be elucidated mechanism.

Abdomen↗