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Biomedical subjects

A Matsuki

Publications and source records attributed to A Matsuki.

At least 271 records · Page 15Linked to original sources
PubMed1990

[Effect of continuous epidural infusion of morphine on postoperative glucose metabolism].

Plasma growth hormone (GH), insulin, prolactin and blood glucose levels were measured to evaluate postoperative pain relief either with epidural morphine or systemic analgesics in 16 patients who underwent gastrectomy. Continuous epidural morphine with a pump (CADD-PCA, Model 5200P, Pharmacia) was given to eight (epidural morphine group) patients. A bolus of epidural morphine was administered through an indwelling thoracic (Th8.9) catheter at 3 hrs prior to the expected end of surgery, which was followed with continuous epidural infusion of morphine at a rate of 0.167-0.042 mg.hr-1 with the pump during and after anesthesia and surgery with gradually decreasing dose until the third postoperative day. The remaining eight patients (systemic analgesics group) repeatedly received intravenous or intramuscular pentazocine and buprenorphine when needed. Plasma GH levels increased significantly only on the first postoperative day in both groups. Plasma insulin levels increased significantly on the first postoperative day in both groups. Blood glucose levels increased significantly at the end of surgery and during the following three postoperative days in both groups. There are no statistical differences in plasma GH, insulin and blood glucose levels between the two groups. Plasma prolactin concentrations increased significantly at the end of surgery and they were significantly higher in the systemic analgesic group than in the epidural morphine group. They, however, returned to the previous day's levels on the first postoperative day in both groups. Our study suggests that continuous epidural infusion of morphine has no suppressing effect on postoperative changes in plasma GH, insulin, prolactin and blood glucose levels as compared with systemic analgesic regimen.

Adult↗
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↗
PubMed1990

[Endocrine and hemodynamic responses to total body hyperthermia in humans].

We investigated effects of total body hyperthermia (TBH) on endocrine and hemodynamic responses. A total of five treatments were performed in five patients with gastric cancer under neuroleptanesthesia with morphine followed by 0.2 to 0.4% enflurane. TBH was extracorporeally induced with veno-venous shunt incorporating with heat exchanger to keep their temperature between 41.5 degrees C and 42.0 degrees C for three hours. The patients were administered angiotensin to maintain tumor blood flow. Lactated Ringer's solution was administered at the rate of 10 to 15 ml.kg-1.hr-1 for five hours. Plasma cortisol levels decreased significantly to about one third of the control value after heating and the levels recovered to the control value after cooling. Plasma norepinephrine level increased significantly to about 7 to 9 times the control value following TBH, but this hormonal response was insufficient to reveal marked direct hemodynamic effects. The magnitude of fall in SVR was more significant in spite of the administration of angiotensin. Cardiac index increased significantly to about 2.0 to 2.6 fold of control value, but mean arterial blood pressure (MAP) decreased significantly to about two thirds to four fifths of the control value. Morphine relieved the hormonal response in ACTH and cortisol strongly, but morphine suppressed hemodynamics by decreasing SVR. Neither norepinephrine released from sympathetic nerve endings nor even 50 to 200 ng.kg-1.min-1 of angiotensin administered failed to restore SVR or MAP during hyperthermia.

Adult↗
PubMed1990

[Anesthetic experience of a patient with blue rubber bleb nevus syndrome].

We report an anesthetic experience of a 63-year-old female patient with blue rubber bleb nevus syndrome who underwent an open reduction of the fracture of the right femur. The syndrome is characterized by bluish nevus scattered throughout the skin of the whole body and angiomas of the gastrointestional tract causing serious bleeding. Anesthesia was induced with thiopental followed by intravenous injection of succinylcholine chloride and maintained with neuroleptanesthesia in nitorous oxide and oxygen. The course of anesthesia and emergence from anesthesia were uneventful. Anesthetic management of patients with blue rubber bleb nevus syndrome was also discussed.

Female↗
PubMed1990

[Changes in plasma superoxide dismutase like activity during general anesthesia and surgery in man].

Superoxide radicals are highly reactive products that are known to induce various pathological changes in man. Superoxide dismutase is an enzyme that scavanges superoxide radicals. We measured plasma superoxide dismutase (SOD) like activity according to electron spin resonance using DMPO as a trap. The subjects of the study were 48 surgical patients who underwent various elective surgery. They ranged from 10 to 74 years in age. Anesthetic agents employed were enflurane in 50% O2 + 50% N2O, modified NLA with pentazocine, original NLA and fentanyl + ketamine (FK). In NLA group, 70% N2O and 30% O2 were given and 70% air and 30% O2 were administered to the patients of FK group. The mean plasma SOD like activity before the anesthetic induction in surgical patients of all groups was 5.70 +/- 0.41 U.ml-1. There is no significant difference compared with the value of normal persons. A marked reduction in plasma SOD like activity was obtained during surgery in any type of anesthesia in this study. Neither anesthetic agents used in this study nor the extent of surgery contributed to the degree of SOD like activity reduction. Surgical duration over two hours was the most contributing factor to reduce the SOD like activity. There was no correlation between plasma SOD like activity and age or serum total protein.

Adolescent↗
PubMed1990

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--1. Introduction].

We have developed a new method of total intravenous anesthesia with droperidol, fentanyl and ketamine and have administered it to more than 400 surgical patients, ranging in ages from 4 to 80 years. Cardiac and neurosurgical patients were excluded. After establishing a routine monitoring, droperidol 0.06-0.1 ml.kg-1 was slowly given. After 5 minutes, fentanyl 1-2 micrograms.kg-1 and ketamine 1.0-1.5 mg.kg-1 were slowly administered intravenously. Trachea was intubated following intravenous succinylcholine. A total dose of 5-15 micrograms.kg-1 of fentanyl was given intravenously with a continuous infusion of ketamine 2 mg.kg-1.hr-1 during surgical procedure. Air and O2 (FIO2 0.30-0.35) were given and muscle relaxation was achieved with necessary dose of intravenous pancuronium or vecuronium and no inhaled anesthetic was given. Total intravenous anesthesia has many advantages such as no air pollution in the operating theatre, empty bowels, no organ (hepato-renal) toxicity, good peripheral perfusion and low cost, while this method has several disadvantages to overcome such as hypertension. There are many anesthetic agents for total intravenous anesthesia. However, sufentanil, alfentanil and propofol are not available. Droperidol, fentanyl and ketamine are the best combination for this purpose in Japan so far.

Adolescent↗
PubMed1990

[Anesthetic management of a patient with Sjögren's syndrome and pulmonary fibrosis].

We described an anesthetic management of a 63 year old man complicated with Sjögren's syndrome and pulmonary fibrosis. Sjögren's syndrome is characterized by pathological dryness of the mouth, cornea and other exocrine glands. Anesthesia was induced with thiopental and the trachea was intubated smoothly following intravenous succinylcholine. Anesthesia was maintained with enflurane in nitrous oxide and oxygen. Intraoperative muscle relaxation was adequately obtained by pancuronium. Before and during anesthesia, atropine and other drying agents were avoided. Physiological saline solution was instilled on the eyes every ten minutes against dryness. A heat and moisture exchanger (Humi-Vent) was used to maintain high moisture of the respiratory tract. Anesthesia was carried out successfully.

Anesthesia, Inhalation↗
PubMed1990

[The changes in total body water in patients with prolonged anesthesia and surgery].

We studied the influence of prolonged anesthesia and surgery on total body water (TBW) with tetrapolar bioelectrical impedance analysis (BIA). Eight patients who underwent prolonged anesthesia were selected as the subjects of the study and were compared with nine patients who underwent surgery of less than 3 hours. Plasma hormone concentrations were also examined. In the prolonged anesthesia patients, TBW increased significantly as compared with those of the patients who underwent short surgery (P less than 0.05). TBW showed the most remarkable increase on the first post operative day. Plasma ADH and aldosterone concentrations increased in the patients of both groups. However, we could not find a significant relationship between TBW and plasma hormone concentrations. BIA seems to be a useful method to estimate TBW during perioperative periods. However, further detailed investigation would be necessary to obtain a reliable technique in such an unstable condition.

Adult↗
PubMed1990

[Anesthetic experience of a patient with essential thrombocythemia].

We reported a 54-year-old male with essential thrombocythemia, who underwent coronary artery bypass grafting. Anesthesia was maintained with enflurane in nitrous oxide and oxygen supplemented with fentanyl. Heparin 7mg. kg-1 was administered intravenously to obtain adequate anticoagulant effect during 89 minutes of extracorporeal circulation. Aspirin and dipyridamole were also administered as anti-platelet therapy. No complications were observed during and after anesthesia. It is advocated that administration of anticoagulants such as heparin, aspirin and dipyridamole is effective to prevent thrombus formation.

Anesthesia, Inhalation↗
PubMed1990

[Reaction products of sevoflurane with components of sodalime under various conditions].

Sevoflurane is reported to react with sodalime to resolve into several products. We examined the reaction products of sevoflurane when this anesthetic reacted with components of sodalime under various conditions. Analysis of reaction products was performed by gas chromatography using a 2m column packed with DOP. Six peaks including sevoflurane were detected on the gas chromatogram of sevoflurane after reaction with sodalime and five reaction products were obtained. These peaks were from P1 with the shortest retention time to P5 with the longest retention time. When sevoflurane was sealed with sodalime in a test tube at room temperature, only P1 was detected and all reaction products of P1 to P5 were identified when the test tube was heated at 50 degree C for 3 hours. Sodalime contains Ca (OH)2, NaOH, KOH and silicon dioxide. Reaction of sevoflurane with KOH produced P1 to P5 products even at room temperature. After the reaction of sevoflurane with NaOH or Ca (OH)2 at 50 degrees C, P1 to P5 or P1 only were detected on the chromatogram respectively. No peak of any reaction products was obtained after the reaction with silicon dioxide under various conditions. These results suggest that hydroxy group of sodalime component would increase reaction products of sevoflurane.

Anesthetics↗
PubMed1990

[Accurate and simplified determination of ketamine in plasma by gas chromatography mass spectrometry].

An accurate and simplified method has been developed for determination of ketamine in human plasma using gas chromatography and electron impact mode mass spectrometry with selected ion recording from 0.5ml of plasma. Standards and samples of plasma underwent the same procedure of two step extraction by methanol. Ketamine concentrations in the plasma were determined from the peak in the selected ion profile of ketamine (m/e: 237). Standard curve was linear with the increasing amount of ketamine (0.63-5.0 micrograms.ml-1) in plasma with mean CV = 5.2% mean RR = 63.8% and r = 0.998. The concentration of ketamine in plasma ranged from 1.6 micrograms.ml-1 to 2.5 micrograms.ml-1 during ketamine anesthesia (2mg.kg-1.h-1) in a surgical patient.

Gas Chromatography-Mass Spectrometry↗
PubMed1990

[Sevoflurane anesthesia for a patient with cerebral palsy].

We report anesthetic management of a 20-year-old male patient with cerebral palsy who underwent an operation for retinal detachment of the left eye. Induction and maintenance of anesthesia were smoothly done with inhalation of 1-5% sevoflurane with nitrous oxide and oxygen. Emergence of anesthesia was also smooth except for slight and transient excitement. Anesthetic management of a patient with cerebral palsy was also discussed.

Adult↗
PubMed1990

[Reaction products of sevoflurane with new soda lime-A under various conditions].

Sevoflurane is reported to react with sodalime, a common carbon dioxide absorber which resolves into several products. We measured the reaction products of sevoflurane when this anesthetic reacted with sodalime-A, a new carbon dioxide absorber under various conditions. Analysis of reaction products was done by gas chromatography using a 2 m column packed with DOP. Six peaks including sevoflurane were detected on the gas chromatogram of sevoflurane after reaction with sodalime-A and five reaction products were obtained. These peaks were from P1 with the shortest retention time to P5 with the longest retention time. When sevoflurane was sealed with sodalime-A in a test tube at room temperature, 40 degrees C and 45 degrees C, only P1 was detected and two reaction products of P3 and P5 were identified when the test tube was heated at 50 degrees C. Sodalime contains Ca(OH)2, NaOH, KOH and silicon dioxide, and sodalime-A contains Ca(OH)2 and NaOH only. We reported previously that sevoflurane reacted with KOH to produce P1 to P5 even at room temperature and KOH was the most contributing factor to produce these reaction compounds. Reaction products of sevoflurane with two types of carbon dioxide absorber were checked with gas chromatography. Degradation products except P1 with sodalime-A was less than with conventional sodalime at any conditions. P1 production was about twice to three times more than that with sodalime.

Anesthetics↗
PubMed1990

[Plasma cortisol levels during abdominal surgery under sevoflurane anesthesia: comparison between gastrointestinal and gynecological surgery].

Plasma cortisol levels during abdominal surgery under sevoflurane anesthesia were evaluated in 22 patients who ranged in ages from 37 to 65. They underwent either gastrointestinal or gynecological abdominal surgery. Anesthesia was induced and maintained with sevoflurane (1-5%) in nitrous oxide (4 l.min-1) and oxygen (2 l.min-1). Succinylcholine was administered intravenously to facilitate tracheal intubation and pancuronium was given intravenously during surgery. Lactated Ringer's solution at a speed of 10-15 ml.kg-1.hr-1 was also administered intravenously throughout the surgical procedures. Plasma cortisol levels were unchanged with the induction of sevoflurane anesthesia alone, but they increased significantly 2-3 times of the preanesthetic levels during and after surgery in both groups. However, the concentrations of plasma cortisol after recovery from anesthesia were significantly higher in the gastrointestinal group than in the gynecological group. The findings suggest that plasma cortisol levels after surgery reflect the difference in magnitude of stress response between gastrointestinal and gynecological surgery.

Abdomen↗
PubMed1990

[Plasma catecholamine levels following continuous epidural infusion of morphine for postoperative analgesia in surgical patients].

Plasma catecholamine levels were measured to evaluate postoperative pain relief either with epidural morphine or systemic analgesics in sixteen patients who underwent gastrectomy. Eight patients (epidural morphine group) obtained postoperative analgesia with continuous epidural morphine with a pump (CADD-PCA, Model 5200P, Pharmacia). A bolus of morphine was administered through an indwelling thoracic (Th8 X 9) epidural catheter 3 hrs prior to the proposed end of the surgery, which was followed with continuous epidural infusion of morphine at a rate of 0.167-0.042mg.hr-1 by the pump during and after anesthesia and surgery with gradual decrease in dose until the third postoperative day. The remaining eight patients (systemic analgesics group) received repeatedly intravenous or intramuscular pentazocine and buprenorphine when needed. Plasma epinephrine levels increased significantly at the end of surgery in both groups, and were higher in the systemic analgesics group than those in the epidural morphine group. In the epidural morphine group, the catecholamine levels decreased to the previous day's levels on the first postoperative day and afterward, but remained high during three postoperative days in the systemic analgesics group. Plasma norepinephrine levels increased significantly at the end of surgery and afterward in both groups. However, they were significantly higher in the systemic analgesics group than in the epidural morphine group. Plasma dopamine levels were unchanged in the epidural morphine group during the surgical procedures, but they increased significantly on the first postoperative day and thereafter in the systemic analgesics group. Our study suggests that continuous epidural infusion of morphine is adequate for postoperative pain relief and exerts a suppressing effect on plasma catecholamine levels as compared with systemic analgesics regimen.

Adult↗
PubMed1990

[Effect of nafamostat mesilate on serum activities of pancreatic enzymes and plasma hormone levels].

To evaluate the effect of nafamostat mesilate, a potent protease inhibitor, on the pancreatic enzymes and the endocrine system in patients undergoing open-heart surgery with extracorporeal circulation, serum activities of amylase, trypsin, alpha 1-antitrypsin (alpha 1AT) and pancreatic secretory trypsin inhibitor (PSTI), and plasma levels of cortisol and catecholamines were measured. Seven patients (nafamostat group) received intravenous nafamostat mesilate 0.5 mg.kg-1.hr-1 during cardiopulmonary bypass (CPB). The remaining seven patients (non-nafamostat group) did not receive any protease inhibitor. Both groups showed the same changes in serum activities of pancreatic enzymes during CPB. In sera, the levels of amylase, trypsin and alpha 1AT decreased during CPB. Amylase and trypsin activities returned toward the preanesthetic levels after CPB, while alpha 1AT remained at lower levels. PSTI was unchanged during CPB. Plasma cortisol levels markedly increased during and after CPB, but there was no difference between nafamostat group and non-nafamostat group. Nafamostat group showed lower plasma dopamine levels and higher epinephrine levels compared with non-nafamostat group. The result suggests that nafamostat mesilate administered during CPB could not influence the changes in the activities of pancreatic enzymes. Further studies are needed to clarify the effect of this protease inhibitor on the endocrine system.

Adult↗