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Biomedical subjects

T Omote

Publications and source records attributed to T Omote.

At least 19 recordsLinked to original sources
PubMed1992

[A case of postoperative hepatic injury after sevoflurane anesthesia].

A 63 year old man underwent MCA aneurysmal neck clipping under O2-N2O-enflurane anesthesia. On the 46th postoperative day after the first operation, he had cranioplasty under O2-N2O-sevoflurane anesthesia. Hepatic injury occurred after the operation, and GOT, GPT and bilirubin increased above 700 IU.l-1, 800 IU.l-1 and 15.0 mg.dl-1 respectively but consciousness disturbance, hyperammonemia and DIC did not appear. His hepatic injury improved on conservative therapy. It seems that his hepatic injury was not caused by hepatitis viruses or hepatotoxicity of any drugs, but caused by cross sensitization between halogenated inhalation anesthetics, especially enflurane and sevoflurane, judging from drug induced lymphocyte stimulating test (DLST). We have to select an anesthetic method considering potential hepatic injury by halogenated anesthetics in a case of repeated anesthesia and operations during a short-term.

Anesthesia, Inhalation↗
PubMed1992

[Acute pulmonary edema in five patients undergoing sevoflurane anesthesia].

Four adults and a child undergoing surgery with sevoflurane anesthesia developed acute pulmonary edema immediately after anesthesia. Prior to development of pulmonary edema all patients exhibited severe arterial hypertension and tachycardia. Their episodes of circulatory changes were, we believed, caused by the local injection of epinephrine for hemostasis in 2 patients (9 y.o. child, 45 y.o. man) and the intrusion of painful surgical stimuli in one patient (67 y.o. man). Circulatory changes in these three patients were treated by increasing the inspired sevoflurane concentration. We, however, speculate that the increase in inspired sevoflurane decreased the cardiac output and that the resulting increase in pulmonary wedge and capillary pressures was caused by an abrupt increase of arterial blood pressure, followed by a rapid increase in afterload due to cardiac suppression from the high concentration of sevoflurane. In 2 patients (74 y.o. man, 61 y.o. woman) arterial hypertension occurred during endotracheal extubation after sevoflurane anesthesia. Because of fast uptake and elimination of sevoflurane due to a low blood/gas partition coefficient, a fast awakening in the latter 2 patients, may be responsible for the abrupt increase in arterial blood pressure. In conclusion, it should be noted that pulmonary edema may be involved when severe circulatory changes occur in a patient undergoing sevoflurane anesthesia.

Acute Disease↗
PubMed1991

Effects of thoracic epidural anesthesia on myocardial pH and metabolism during ischemia.

The effect of thoracic epidural anesthesia (TEA) on the ischemic myocardium was examined in open-chest dogs anesthetized intravenously. Ischemia induced by brief coronary artery occlusion caused an elevation of the ST segment in epicardial ECG and a reduction in myocardial pH and contractile force. TEA with 0.15 ml/kg of 0.4% bupivacaine solution attenuated an ischemia-induced decrease in myocardial pH and an increase of the ST segment in epicardial ECG. This attenuation was maintained even after the restoration of blood pressure and heart rate, which had been decreased significantly after TEA, to pre-TEA levels, suggesting that a beneficial effect of TEA should not be confined to its hemodynamic changes such as decreased blood pressure and heart rate. In contrast, the subendocardial contents of ATP, creatine phosphate (CP) and lactate were not affected by TEA, either in the presence or the absence of 5 min LAD occlusion. These results suggest that neither hemodynamic nor metabolic changes are responsible for the reduced myocardial ischemic acidosis induced by TEA after brief coronary artery occlusion. The acidosis-saving property of TEA is favorable for the ischemic heart.

Adenosine Triphosphate↗
PubMed1991

[Effects of high-dose fentanyl on intraductal pressure in the choledochoduodenal junction in dogs].

Changes in intraductal pressure in choledochoduodenal junction were studied following intravenous administration of fentanyl in dogs. The intraductal pressure was measured with constant-rate infusion method. A statistically significant increase in the intraductal pressure was demonstrated after the intravenous administration of fentanyl 5 micrograms.kg-1 and 75 micrograms.kg-1. The increase in intraductal pressure following fentanyl administration at a dose of 75 micrograms.kg-1 persisted for more than 5 hours. We conclude that in case of intravenous high-dose fentanyl administration special attention should be paid to spasm of choledochoduodenal sphincter.

Animals↗
PubMed1991

[Effects of ketamine on behavioral responses to somatic and visceral stimuli in rats].

The responses to colorectal distension as a visceral stimulus were observed and tail-flick test was performed in rats, after intraperitoneal administration of ketamine 30 mg.kg-1 (n = 6) or 100 mg.kg-1 (n = 5). After determining control colorectal distension and tail-flick values, both procedures were repeated every 10 minutes for one hour in both groups. The control thresholds for colorectal distension and tail-flick latencies were 20.8 +/- 1.0 mmHg and 4.5 +/- 0.3 sec (mean +/- SD), respectively in ketamine 30 mg.kg-1 group. They were 21.2 +/- 1.1 mmHg and 4.7 +/- 0.4 sec in ketamine 100 mg.kg-1 group. These baseline threshold and latency values in the two groups were not significantly different. Ten minutes after ketamine administration, the colorectal distension thresholds and tail-flick latencies were 43.7 +/- 7.2 mmHg and 6.4 +/- 0.9 sec, respectively in ketamine 30 mg.kg-1 group. They were 53.3 +/- 14.8 mmHg and 7.2 +/- 0.8 sec, respectively in ketamine 100 mg.kg-1 group. These values were significantly greater than the preketamine control values in both groups. The present study demonstrates that ketamine exerts apparent analgesic effects against both visceral and somatic stimuli. These results led us to consider that ketamine may be clinically useful to control visceral pain.

Animals↗
PubMed1991

[Comparison of the effect of propofol and that of pentobarbital on behavioral responses to somatic and visceral stimuli in rats].

The behavioral responses to tail-flick and colorectal distension after intraperitoneal administration of either small or large dose of propofol as well as of pentobarbital were studied in rats. Immediately after baseline testing, animals were randomly divided into four groups; propofol groups of 50 mg.kg-1 (n = 4) or 100 mg.kg-1 (n = 4) and pentobarbital groups of 10 mg.kg-1 (n = 4) or 20 mg.kg-1 (n = 4). Both tests were repeated every 10 minutes for 1 hour in each group. There were no changes in the thresholds of colorectal distension and tail-flick latencies in those animals receiving small doses of propofol and pentobarbital. The thresholds for colorectal distension following administration of large doses of propofol and pentobarbital had greatly increased at 10 minutes and this increase persisted for about 30 minutes although it declined gradually. In contrast, the state of high sensitivity to tail-flick test was seen in the large dose groups of both drugs. It is concluded that there are no pharmacological differences between propofol and pentobarbital in behavioral responses to somatic and visceral stimuli in rats.

Animals↗
PubMed1990

[Effects of lactation on pregnancy induced analgesia during the postpartum period in rats].

Activation of an endogenous opioid system has been associated with an elevation in pain threshold during late pregnancy and the early postpartum period in rats. It is well established that endogenous opiates are involved in the physiological regulation on prolactin secretion. This study examined the influence of lactation on pregnancy-induced analgesia during the early postpartum period in rats. Three tests (colorectal distension, tail-flick and hot-plate) were used to assess each animal's response to painful stimuli. After determining pregnant baseline values, one group of rats (lactating, n = 21) were mated and retested on Day 7 and 21 of gestation and 1, 3, 5, 7 and 14 days after parturition. A non-lactating group of animals (n = 14) whose pups were removed immediately after delivery was tested in the same manner. On Day 21 of gestation significantly higher thresholds and longer latencies were observed. On Day 1 and 3 in both lactating and non-lactating rats, the values were still elevated. No significant difference was observed during the early postpartum period between the two groups. This study confirms the existence, in rats, of pregnancy-induced analgesia late in pregnancy and the early postpartum period. The analgesia during the early postpartum period is not influenced by lactation.

Animals↗
PubMed1989

[Anesthetic management of caesarean section in a patient with idiopathic thrombocytopenic purpura and placenta praevia].

A 24-year-old female with idiopathic thrombocytopenic purpura (ITP) and total placenta praevia was scheduled for caesarean section. Anesthetic management during caesarean section with ITP and placenta praevia is critical because of possibility of massive intra- and postpartal bleeding. The patient received prednisolone 30 mg per day for 10 days before surgery. Bleeding time and value of platelet count returned to normal range on the operative day. Hydrocortisone 100 mg and atropine sulfate 0.3 mg were given intravenously just before the start of anesthesia. Anesthesia was induced with thiamylal 4 mg.kg-1 and SCC 1 mg.kg-1 and maintained with N2O-O2-enflurane. A baby girl was delivered after 7 min, and the Apgar score was 9 at 1 min after delivery. Intraoperative bleeding totaled 1,314 ml, but we could avoid total hysterectomy.

Adult↗
PubMed1985

Response differences of paretic and healthy extremities to pancuronium and neostigmine in hemiplegic patients.

The purpose of this study was to examine differences in train-of-four (TOF) ratios between paretic and healthy extremities after pancuronium and neostigmine administration in 31 patients with hemiparesis. The TOF ratios on the paretic side after pancuronium administration were greater than those on the healthy side in all patients. Patients were classified according to the size of the difference in the TOF ratio on both sides. In group 1, differences in TOF ratios were greater than 20%, and in group 2, they were less than 20%. Fifteen of 17 patients in group 1 had hemiparesis for over three weeks, and in group 2, 10 of 14 patients had hemiparesis for less than three weeks. Patients with flaccid hemiparesis were distributed equally in both groups, while all patients with spastic hemiparesis belonged to group 1. The difference in increase in TOF ratios after neostigmine was the same as the difference in decrease produced by pancuronium.

Adult↗