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W Ueda

Publications and source records attributed to W Ueda.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Effect of dopamine administration on ICG-disappearance rate during prone position anesthesia].

We evaluated the effect of dopamine administration (3 micrograms.kg-1.min-1) on ICG-disappearance rate during prone position in 10 patients undergoing elective spinal cord surgery. Anesthesia was maintained with isoflurane and 50% nitrous oxide in oxygen. ICG-disappearance rate was determined at 3 points, i.e., the day before surgery, during prone position and during the administration of dopamine. Systolic arterial pressure showed no significant difference before and during dopamine administration. ICG-disappearance rate during prone position was significantly lower than the preoperative value. However, ICG-disappearance rate showed no significant difference during dopamine administration and preoperative period. We conclude that dopamine administration may attenuate the depressant effect of the prone position on the hepatic blood flow.

Adult↗
PubMed1994

[ICG-disappearance rate during sevoflurane- or neurolept anesthesia].

We evaluated the effect of sevoflurane or neuroleptanesthesia on ICG-disappearance rate in 22 patients undergoing elective extra-abdominal surgery. We divided the patients into three groups, i.e., SN-group (n = 8), SH-group (n = 8) and NLA-group (n = 6). Systolic arterial pressure (SAP) in the patients of SN-group or SH-group was maintained with sevoflurane at about 100% or 70% of the preoperative value respectively. There was no significant difference in SAP between SN-group and NLA-group. In SN-group and NLA-group, there was no significant difference in the ICG-disappearance rate between the values during anesthesia and those during preoperative period. In SH-group, however, it was significantly lower than the preoperative value. We conclude that, when normal systolic arterial pressure can be maintained, sevoflurane or neuroleptanesthesia has little effect on the liver function and hepatic blood flow. Sevoflurane anesthesia with 70% of preoperative SAP, however, may depress the liver function and hepatic blood flow.

Aged↗
PubMed1993

Lidocaine inhibits priming and protein tyrosine phosphorylation of human peripheral neutrophils.

The addition of agents, such as tumor necrosis factor-alpha, to human peripheral neutrophils (HPPMN) induces priming, which enhances the receptor-mediated superoxide (O2-) generation and tyrosine phosphorylation of several HPPMN proteins. Lidocaine, a local anesthetic, inhibited both enhanced O2- generation and tyrosine phosphorylation of a 115 kDa protein in a concentration- and time-dependent manner. Lidocaine also inhibited protein kinase C sensitive O2- generation induced by phorbol myristate acetate, but not time dependently. Furthermore, lidocaine inhibited O2- generation by non-primed HPPMN induced by formylmethionyl-leucyl-phenylalanine, but this inhibition needed a higher concentration of lidocaine compared with that of primed HPPMN. These results suggest that lidocaine inhibits the priming step of neutrophil activation and that it is linked to the inhibition of tyrosine phosphorylation of a 115 kDa protein.

Humans↗
PubMed1993

Modification of intravenous lidocaine-induced convulsions by epinephrine in rats.

We studied intravenous lidocaine-induced convulsions in rats to determine whether added epinephrine influences the provocation of lidocaine toxicity. Wistar rats (200-250 g) were divided into three groups of ten, depending on the concentration of epinephrine added to lidocaine. Group 1: plain 1.5% lidocaine; Group 2: 1.5% lidocaine with 1:200,000 epinephrine; Group 3: 1.5% lidocaine with 1:100,000 epinephrine. After surgical preparation and recovery from anaesthesia, all rats received a continuous i.v. infusion of lidocaine (15 mg.ml-1) at a rate of 4.0 mg.kg-1 x min-1 until generalized convulsions occurred. The epinephrine-treated animals developed acute hypertension after one minute of lidocaine infusion (105 +/- 2 to 141 +/- 2 mmHg in Group 2 and 103 +/- 2 to 151 +/- 2 mmHg in Group 3). The PaO2 values in the epinephrine groups at the onset of convulsions were decreased significantly (88.3 +/- 1.0 to 84.0 +/- 1.5 mmHg in Group 2 P < 0.05 and 86.9 +/- 1.2 to 78.1 +/- 2.4 mmHg in Group 3 P < 0.01). However, these values were still within physiological ranges. Serum potassium concentrations in all groups were decreased P < 0.05, (4.24 +/- 0.09 to 3.52 +/- 0.12 mEq.L-1 in Group 1, 4.02 +/- 0.09 to 3.63 +/- 0.17 mEq.L-1 in Group 2, and 4.15 +/- 0.10 to 3.69 +/- 0.17 mEq.L-1 in Group 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Effect of gentle massage on regression of sensory analgesia during epidural block.

We investigated the effect of gentle epigastric massage on the regression of the sensory analgesia of epidural block. Sixteen patients, who underwent minor obstetric or gynecologic surgery under epidural block with lidocaine, were divided into two groups. Group A was the control group. Group B received gentle massage of the epigastric area for 30 min. The proximal extent of sensory analgesia before massage and 0 and 30 min after the massage was T9 +/- 1, T10 +/- 1, and T10 +/- 1 in group A, and T9 +/- 1, T11 +/- 1 and L1 +/- 1 in group B (mean +/- SD), respectively. The regression of sensory analgesia in group B was significantly (P < 0.001) faster than in group A 30 min after the massage. We conclude that peripheral sensory stimulation as weak as gentle massage may initiate a series of indirect mechanisms that lead to accelerated regression of sensory analgesia.

Abdomen↗
PubMed1993

[Effect of deliberate hypotension with PGE1 on PaO2 in pediatric patients].

We compared the effect of deliberate hypotension with PGE1 on PaO2 between pediatric and adult patients. Seven children, aged 3-9 yrs and 10 adults, aged 35-65 yrs who were scheduled for elective head and neck surgeries were studied. Anesthesia was maintained with enflurane, 50% N2O in oxygen and supplemental infusion of fentanyl. Ventilation was controlled to maintain PaCO2 at 35-40 mmHg. Hypotension was induced with continuous infusion of PGE1 and the systolic blood pressure was maintained at 70% of the presurgical value. Blood gases were measured three times, i.e. before, during, and after hypotension. The hypotension in adults caused a significant reduction in PaO2. In children, on the contrary, PaO2 was not affected by the hypotension. The results suggest that intrapulmonary shunting is smaller in children than in adults during PGE1-induced hypotension.

Adult↗
PubMed1993

[Effect of the prone position on ICG excretion during normotensive or hypotensive isoflurane anesthesia].

We evaluated the effect of prone position on ICG excretion during normotensive and hypotensive isoflurane anesthesia. In supine position, either normotensive or hypotensive anesthesia produced no significant prolongation in ICG excretion. In prone position, however, both normotensive and hypotensive anesthesia caused a significant prolongation in the excretion. The results suggest that prone position decreases the hepatic blood flow or hepatic function during isoflurane anesthesia.

Adult↗
PubMed1992

Adrenaline absorption: effect of pH in mepivacaine and bupivacaine solutions. A clinical study during halothane anesthesia.

The effect of the pH of the solution on the rate of absorption into the blood stream of locally-injected adrenaline using an adrenaline solution mixed with either mepivacaine or bupivacaine was investigated. Forty patients undergoing elective craniotomy received one of the following five solutions for subcutaneous and subgaleaic injection in the dose 0.5 ml/kg: 1) mepivacaine-adrenaline (pH = 6.1), 2) mepivacaine-adrenaline (pH = 7.5), 3) bupivacaine-adrenaline (pH = 6.1), 4) bupivacaine-adrenaline (pH = 7.4), or 5) adrenaline (pH = 6.1). Both mepivacaine and bupivacaine added to the adrenaline solution increased the plasma concentration of adrenaline. Alkalinization attenuated the peak concentration of adrenaline in the case of a mepivacaine-adrenaline solution, but not in the case of a bupivacaine-adrenaline solution.

Absorption↗
PubMed1992

Role of afferent neural input in regression of sensory paralysis during epidural analgesia.

This study was designed to determine the role of the afferent peripheral neural input in the regression of sensory analgesia during epidural analgesia. Eighteen patients who underwent minor obstetric or gynecologic surgery under lumbar epidural analgesia with lidocaine were divided into three groups. Group A received electrical single twitch stimulation at the spinal nerve dermatome one segment rostrad of the proximal extent of sensory paralysis. Group B received electrical twitch stimulation at the anterior crural region where nerve block may have been most profound in this study. Group C was assigned as a control and did not receive any stimulation. The patients received the stimulation for 60 min (i.e., from 80 to 140 min after the epidural injection). The range of sensory analgesia at 140 min was compared with that at 80 min. The regression of sensory analgesia in group B or C was 1 +/- 0 (mean +/- SD) spinal nerve segments, but in group A it was 5 +/- 1, which was significantly (P less than 0.0025) larger than the others. We conclude that the afferent peripheral neural input to a spinal segment where the nerve block is incomplete may accelerate the regression of sensory analgesia from epidural analgesia.

Adult↗
PubMed1992

[Perioperative blood glucose levels in children].

The perioperative blood glucose (BG) level may represent autonomic responses to various stresses by anesthesia and surgery. We studied the effects of regional blocks combined with general anesthesia on the BG response in pediatric patients. We could not find any significant differences in BG levels between blocked and non-blocked patients. However, BG levels of the children who had been hysterical or crying during the induction of anesthesia were significantly higher than those of the children who had been calm or sleeping. Forty healthy children, aged 1-3 yrs who were scheduled for elective urological surgery were studied. Anesthesia was induced with halothane in oxygen. The anesthesiologist recorded the children's attitude before and during the induction of anesthesia, and described as "calm or asleep (Calm-group), and hysterical or crying (Crying-group)". Patients were assigned randomly to two groups as follow; Group A (n = 20): receiving nerve blocks, Group B (n = 20): without the blocks. The anesthesia was maintained with 1-2.5% halothane in oxygen required to maintain the hemodynamic parameters within 10% of baseline value before surgery. Both groups received lactated-Ringer's solution during the study period. The venous BG levels were determined 5 times, i.e. immediately after asleep, 5, 15, 30 minutes after skin incision and at the conclusion of surgery. BG levels were compared between groups using Mann-Whitney Test. There was no significant difference in BG levels between Group A and B throughout the study period. But BG values of Crying-group (n = 9) were significantly higher than those of Calm-group (n = 31) during perioperative period.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗
PubMed1992

[Anesthesia for a patient with Bloom's syndrome].

Bloom's syndrome (BS) is a rare autosomal recessive disorder. The disease is due to chromosome breakage and recombination. The principal features of the syndrome are short stature of prenatal onset, a photosensitive telangiectasic erythema of the face and a marked predisposition to the development of malignant diseases. We are unaware of any previous report of the anesthetic management of a BS patient. In this paper, we reported the anesthetic experience of a male patient (37-yr-old, 26 kg, 136 cm) with Bloom's syndrome who underwent emergency laparotomy. The awake laryngoscopy was carried out, but we could not see the vocal cord directly. The trachea was blindly intubated and anesthesia was induced and maintained with fentanyl, vecuronium and enflurane in 100% oxygen. In a BS patient we should pay attention to potential difficulties with mask fit and laryngoscopy.

Adult↗
PubMed1992

[Effects of lidocaine on stimulation-coupled responses of neutrophils and protein kinase C activity].

The effects of lidocaine on superoxide generation and other stimulation-coupled responses of neutrophils induced by 12-phorbol myristate 13-acetate (PMA) were studied. Depolarization of membrane potential, superoxide generation and chemiluminescence response were inhibited by lidocaine in a concentration dependent manner. Lidocaine inhibited protein kinase C (PKC) activity in a manner competitive with phosphatidylserine. Lidocaine also inhibited the phosphorylation of 47 kDa neutrophil cytoplasmic protein, a phosphorylated protein required for activation of NADPH oxidase. The inhibitory action of lidocaine on PKC activity may correlate with the inhibition of superoxide generation induced by PMA.

Animals↗
PubMed1992

[Troubled endotracheal intubation: an adult case of anomalous tracheal bronchus].

We experienced troubled endotracheal intubation in an adult patient with asymptomatic tracheal bronchus. The breath sounds of the right upper lobe were found to be absent right after the placement of a tracheal tube. An anomalous tracheal bronchus (displaced right upper lobar bronchus originating about 1 cm above carina) was found by fiberoptic bronchoscopy. The length of trachea of the patient was about 6 cm shorter than that of the normal value of adult male, which significantly reduced the safe range of positioning a tracheal tube. In a patient with this anomaly, who is otherwise healthy, a placement of a tracheal tube may cause pulmonary complications. Thus, as a diminished breath sound is found to be located at the upper right lobe after endotracheal intubation, we have to think of tracheal bronchus as one of the possible causes.

Aged↗
PubMed1991

Hemodynamic effect of the prone position during anesthesia.

We studied 21 patients undergoing lumbar spinal surgery under halothane anesthesia on a convex saddle frame, in order to determine the hemodynamic effect of the prone position. A thermodilution pulmonary arterial catheter was placed in 14 patients (Group PA-1: n = 8; and Group PA-2: n = 6), and an inferior vena caval catheter in the remaining seven patients (Group IVC). Group PA-1 and Group IVC patients were placed in the prone position on a convex saddle frame. In the prone position, the cardiac index (CI) decreased significantly from 3.1 +/- 0.5 to 2.5 +/- 0.3 (l.min-1.m-2, mean +/- s.d., P less than 0.01) without accompanying significant changes in the other hemodynamic variables in Group PA-1. The postural change in Group IVC did not exert a significant effect on the inferior vena caval pressure. Group PA-2 were initially placed in the flat prone position on a flat saddle frame, which produced no significant changes in the hemodynamic variables. Then the convex curvature of the frame was adjusted to the grade appropriate for surgery, which produced a significant reduction in CI (from 2.9 +/- 0.3 to 2.4 +/- 0.4, P less than 0.05). We conclude that the prone position itself may not interfere with the circulatory function. The prone position using a convex saddle frame causes significant reductions in CI, but little change in the other hemodynamic variables.

Anesthesia, Inhalation↗
PubMed1991

[Effect of lidocaine-epinephrine-dextran solution on the plasma epinephrine concentration during spinal surgery--how to avoid circulatory complications due to the use of epinephrine for hemostasis].

Epinephrine infiltrated for hemostasis may cause adverse effect on the circulatory system and the effect can be potentiated by surgical stimulation. Local infiltration of lidocaine-epinephrine-dextran solution (LED) at the surgical site is advantageous for this purpose since nerve blocking action of lidocaine attenuates surgical stimulation and dextran suppresses the transfer of injected epinephrine to the blood stream, thereby reducing the adverse effect of epinephrine. LED, however, could be injected accidentally into vessels. This is one of the important causes of raising the plasma epinephrine concentration to a dangerous level. The author believes that the following maneuvers are helpful to avoid the rise of plasma epinephrine concentration to a dangerous level; 1) injecting not more than 0.05 ml.kg-1 at a time, 2) monitoring the arterial pressure waves and ECG during the injection by use of a continuous recording device, and 3) halting the injection immediately whenever sudden changes in the arterial pressure and in the height of the T wave in ECG were observed. More importantly, surgeon's cooperation is essential for anesthesiologists to execute these maneuvers.

Adult↗
PubMed1991

[TDM (therapeutic drug monitoring) for dosing theophylline].

In order to maximize the effectiveness and safety of drug therapy, it is important to individualize the dosage of potent drugs. Some drugs can not be titrated against the intensity of the therapeutic or toxic actions. Determination of the blood concentration of such drugs can be a helpful guide in adjusting the dosage during their therapeutic use. The drug dosing guided by pharmacokinetics is called TDM or therapeutic drug monitoring. In conventional pharmacokinetics, a large number of blood samples are collected from one patient to determine the individual pharmacokinetic parameters. In TDM, the pharmacokinetic parameters obtained from a group of patients who belong to a certain category are used to guide estimation of the individual pharmacokinetic parameters and only a few blood samples from one patient are sufficient to determine the individual parameters. The blood concentration of a drug and the intensity of its pharmacodynamic action, however, is not necessarily correlated. Therapeutic decisions should never be based solely on the blood concentration of a drug.

Drug Monitoring↗
PubMed1991

[Effect of nitroglycerin and nicardipine on ICG excretion during halothane anesthesia].

We evaluated the effect of nitroglycerin and nicardipine on ICG excretion during halothane anesthesia in man. Induced hypotension with nitroglycerin during halothane anesthesia produced a significant prolongation in ICG excretion. No such significant prolongation occurred in the patients who received nicardipine. The results suggest that a reduction in hepatic blood flow during anesthesia may be much less in patients who receive halothane with nicardipine than in those who receive halothane with nitroglycerin.

Adult↗