Abstract:
STUDY OBJECTIVE:To determine the effect of intravenous administration of prostaglandin E1 (PGE1) in inducing controlled hypotension during general anesthesia. DESIGN:Randomized, prospective study. SETTING:Inpatient surgery at a university hospital. PATIENTS:57 ASA physical status I and II patients scheduled for total hip replacement. INTERVENTIONS:In 29 patients undergoing total hip replacement, PGE1 (0.11 +/- 0.03 micrograms/kg/min) was infused to induce hypotension during general anesthesia with enflurane, isoflurane, or sevoflurane in nitrous oxide and oxygen. In another 28 patients, the control group, normotensive anesthesia was performed for the same procedure. MEASUREMENTS AND MAIN RESULTS:Systolic blood pressure decreased significantly (p < 0.01) from 136 +/- 22 mmHg to 93 +/- 10 mmHg during PGE1 infusion, although heart rate did not change significantly. Arterial hemoglobin oxygen saturation showed a mild but significant decrease (p < 0.05) during PGE1 infusion. Blood loss (480 +/- 132 ml) and blood transfusion (280 +/- 260 ml) during surgery were significantly less in patients with hypotensive anesthesia (p < 0.01 and p < 0.05, respectively) than in patients with normotensive anesthesia (667 +/- 326 ml and 468 +/- 395 ml, respectively). Blood loss and blood transfusion after surgery were similar in both groups. In the recovery room or surgical ward, 3 of 29 patients with hypotensive anesthesia needed rapid blood transfusion because of moderate hypotension. The volume of urine during surgery was significantly less (p < 0.05) in the control group. Two patients developed mild phlebitis at the site of the PGE1 infusion, but there were no serious side effects. CONCLUSION:These data suggest that PGE1 can be used safely to induce hypotension, thereby reducing blood loss during total hip replacement with general anesthesia.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Yukioka H,Asada K,Fujimori M,Shimazu Adoi
10.1016/0952-8180(93)90125-xsubject
Has Abstractpub_date
1993-07-01 00:00:00pages
310-4issue
4eissn
0952-8180issn
1873-4529pii
0952-8180(93)90125-Xjournal_volume
5pub_type
临床试验,杂志文章,随机对照试验abstract::Horner syndrome is considered a common finding after epidural analgesia or anesthesia in obstetric patients. Conversely, Horner syndrome is very uncommon in nonobstetric patients. We report 2 cases of Horner syndrome after attempted epidural lumbar anesthesia in 2 patients undergoing peripheral vascular surgery. Spina...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2004.09.010
更新日期:2005-09-01 00:00:00
abstract:STUDY OBJECTIVES:To determine whether the first-attempt tracheal intubation incidence using the GlideScope videolaryngoscope is higher in patients with predicted increased risk of difficult laryngoscopy, and to assess the ability of other a priori defined standard risk factors to predict first-attempt intubation succes...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2011.03.006
更新日期:2011-12-01 00:00:00
abstract::A parturient presented at 35 weeks' gestation with worsening neurological symptoms caused by syringomyelia. She underwent urgent cesarean delivery. The etiology and anesthetic considerations for an obstetrical patient with syringomyelia are discussed. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2011.03.007
更新日期:2011-12-01 00:00:00
abstract::Turner syndrome is a complex and common genetic disorder that affects women and is associated with a wide variety of anatomic and physiological disorders. These abnormalities, especially those relating to the airway and cardiovascular system, pose a challenge to the anesthesiologist. We report a case of Turner syndrom...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2004.06.010
更新日期:2005-03-01 00:00:00
abstract::We anesthesized a patient susceptible to malignant hyperthermia (MH) three different times by epidural anesthesia with different types of local anesthetics. His skinned fiber test showed a marked acceleration of calcium (Ca2+)-induced Ca2+ release (CICR). When ester type local anesthetic was used for ankle contracture...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(95)00204-9
更新日期:1996-03-01 00:00:00
abstract::The anesthetic management of a parturient with a circulating lupus anticoagulant and an anticardiolipin antibody presenting to the obstetric suite taking heparin and aspirin is discussed. Issues concerning placement of a regional anesthetic with recent aspirin ingestion and heparin therapy are discussed. Documentation...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(95)00175-1
更新日期:1996-02-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate and compare cardiovascular responses to a new method of orotracheal intubation incorporating TV monitoring, with conventional orotracheal intubation via rigid blade laryngoscopy. DESIGN:Prospective single-blind study. SETTING:Operating room of a medical college hospital. PATIENTS:90 ASA p...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(00)00196-3
更新日期:2000-11-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the incidence and impact on clinical outcome of complications observed during high-frequency jet ventilation (HFJV) at interventional bronchoscopy and to identify the perioperative factors that may be associated to an increased incidence of such complications. DESIGN:Observational retrospec...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.jclinane.2005.12.011
更新日期:2006-08-01 00:00:00
abstract:STUDY OBJECTIVES:To test the effect of stellate ganglion block on tympanic membrane temperatures. DESIGN:Prospective, observational study. SETTING:Department of Anesthesia, Yamanashi Medical University, Yamanashi, Japan. SUBJECTS:7 healthy male volunteers. INTERVENTIONS:Stellate ganglion block, 6 ml of 1% mepivacai...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(98)00092-0
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Cardiac arrest is associated with very high mortality and causes neurological dysfunction in the survivors. Therapeutic hypothermia is one of the recommended modality in the postarrest management. However, recent findings question its benefit in postarrest management. This meta-analysis has been conceptualiz...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jclinane.2016.03.001
更新日期:2016-09-01 00:00:00
abstract::The development of acute respiratory failure (ARF) secondary to respiratory tract infection is a common event in patients affected with osteogenesis imperfecta type III. Noninvasive positive pressure ventilation (NPPV) is increasingly administered to treat severe ARF of various origin. The use of NPPV in two patients ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2011.04.011
更新日期:2012-02-01 00:00:00
abstract:STUDY OBJECTIVE:Medical residents working overnight call shifts experience sleep deprivation and circadian clock disruption. This leads to deficits in sensorimotor function and increases in workplace accidents. Using quick tablet-based tasks, we investigate whether measureable executive function differences exist follo...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2017.04.002
更新日期:2017-08-01 00:00:00
abstract::Horner's syndrome is a complication of epidural analgesia and anesthesia, encountered more commonly in pregnant women than in other patients. Previous reports described the appearance of Horner's syndrome following epidural injection of concentrated local anesthetic solutions. We report unilateral Horner's syndrome oc...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(03)00017-5
更新日期:2003-05-01 00:00:00
abstract::With the advent of safety needles to prevent inadvertent needle sticks in the operating room (OR), a potentially new issue has arisen. These needles may result in coring, or the shaving off of fragments of the rubber stopper, when the needle is pierced through the rubber stopper of the medication vial. These fragments...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.10.007
更新日期:2014-03-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether a 300 micrograms dose of oral clonidine given 90 minutes prior to laryngoscopy and intubation provides hemodynamic protection from the stress of a brief (15-second) and/or a prolonged (45-second) laryngoscopy. DESIGN:Randomized, double-blind, placebo-controlled study. SETTING:Inpa...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(93)90089-w
更新日期:1993-01-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluated a department's long-term (6.5-year) success of achieving an overall and individual incidence of anesthesiologists working late of approximately 20% of days when not on call to work late, if necessary, and providing care in operating rooms. DESIGN:Historical cohort study, January 2014 throu...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.110151
更新日期:2020-12-02 00:00:00
abstract:BACKGROUND:Childhood and adolescent obesity increased in recent decades, and caregivers face an increasing number of obese pediatric surgical patients. Some clinical and pharmacogenetic data suggest that obese patients have altered pain sensitivity and analgesic requirements. OBJECTIVE:To test the primary hypothesis t...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.109729
更新日期:2020-06-01 00:00:00
abstract::This is a case of systemic ropivacaine toxicity from a sciatic nerve catheter. A 20-year-old patient after heart transplant with poor systemic perfusion on hemodialysis and multiple medications experienced local anesthetic systemic toxicity 72 hours after placement of a peripheral nerve catheter. The case demonstrates...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.03.021
更新日期:2015-06-01 00:00:00
abstract:STUDY OBJECTIVE:To examine perioperative management and complications in patients undergoing pneumonectomy. DESIGN:Observational cohort study. SETTING:University-affiliated city hospital. MEASUREMENTS:65 patients who underwent unilateral pneumonectomy for resection of lung cancer between March 1997 and October 2007 ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2009.02.013
更新日期:2010-02-01 00:00:00
abstract::This case report details the intraoperative course of a patient, in her early pregnancy, who had a cardiac arrest during transvaginal insufflation of carbon dioxide (CO2) for laparoscopic tubal ligation. Modern monitoring methods and their ability to detect gas embolism and aid in the diagnosis and treatment of this r...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(90)90068-e
更新日期:1990-03-01 00:00:00
abstract::Propofol, a phenol compound with a short elimination half-life, was compared with thiopental and isoflurane for induction and maintenance of general anesthesia in 60 consenting ASA I, II, and III patients. The study was randomized and open label in design. Hemodynamically, the propofol patients showed a mean +/- SEM d...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(89)90026-3
更新日期:1989-01-01 00:00:00
abstract::Insertion of drug-eluting stents is one of the strategies for treating patients with coronary artery disease. These patients can be a perioperative challenge in management as they need to be maintained on antiplatelet therapy to prevent stent thrombosis, which puts them at an increased risk for surgical bleeding. Rece...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.11.013
更新日期:2009-11-01 00:00:00
abstract::Patients with severely impaired left ventricular function, an uncorrectable coronary artery disease, and a recent myocardial infarction are at high risk of cardiac complications after major noncardiac surgery. We present two patients with extensive three-vessel coronary artery disease who underwent intraperitoneal sur...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(99)00048-3
更新日期:1999-06-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the effect of clonidine when added to local anesthetics on duration of postoperative analgesia during retrobulbar block. DESIGN:Prospective, randomized controlled trial. SETTING:Operating room and Postanesthesia Care Unit of a university-affiliated hospital. SUBJECTS:80 ASA physical statu...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2010.12.014
更新日期:2011-08-01 00:00:00
abstract:STUDY OBJECTIVE:To study patients' requirement for propofol dosages during the course of repeated deep sedation for electroconvulsive therapy (ECT). DESIGN:Prospective study. SETTING:Outpatient psychiatric clinic in a tertiary-care, university-affiliated, 1100-bed metropolitan hospital. PATIENTS:30 patients undergoi...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.jclinane.2003.09.009
更新日期:2004-06-01 00:00:00
abstract::Obstructive sleep apnea (OSA) is associated with postoperative airway obstruction, hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, and death. Three cases highlighting important issues in patients with OSA are presented that occurred prior to and after implementation of an OSA protocol...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.08.023
更新日期:2009-06-01 00:00:00
abstract::This study examines whether epidural anesthesia is more effective than general anesthesia using an inhalation agent in controlling cardiovascular responses during femoral-popliteal bypass surgery. Nineteen patients were randomized into two groups: general anesthesia (n = 10) and epidural anesthesia (n = 9). The patien...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(90)90056-9
更新日期:1990-03-01 00:00:00
abstract:STUDY OBJECTIVE:To determine risk factors associated with reintubations in adult patients with soft tissue infections. DESIGN:A retrospective case-control design. SETTING:Operating room and postoperative recovery area. PATIENTS:There were 39 patients who presented for surgical intervention of their soft tissue infec...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.03.073
更新日期:2016-11-01 00:00:00
abstract:STUDY OBJECTIVE:To compare a total intravenous (IV) anesthetic technique based on propofol and alfentanil with a commonly used anesthetic technique for craniotomy. DESIGN:Open-label, randomized, clinical study. SETTING:Neurosurgical clinic at a university hospital. PATIENTS:Forty patients, aged 18 to 55 years, sched...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(91)90010-k
更新日期:1991-03-01 00:00:00
abstract:STUDY OBJECTIVE:To ascertain patients' recall of the risks of labor epidural analgesia from a discussion of informed consent during active labor. DESIGN:Survey analysis following an intervention. SETTING:Labor and delivery unit of a tertiary-care teaching hospital. PATIENTS:101 ASA physical status I and II parturien...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(97)00258-4
更新日期:1998-03-01 00:00:00