Biomedical subjects

H Mitsuhata

Publications and source records attributed to H Mitsuhata.

133 records · Page 8Linked to original sources

PubMed1991

[Skin-epidural distance in human lumbar region].

To clarify factors that determine the distance between skin and epidural space we analyzed the relationship between distance and factors such as age, sex, height, weight and Broca index using multivariate analysis. Epidural tap was performed in 100 adult patients. Distance was estimated by subtracting the length of needle outside the body from the total length of a Touhy needle. The distance at L3-L4 was significantly longer than that at Th12-L1 and at L1-L2 (P less than 0.05). The distance in male was significantly longer than that in nonpregnant female (P less than 0.05). There was no significantly different distance between pregnant and nonpregnant female. There were good correlations between the distance versus height, weight and Broca index, respectively r = 0.343, r = 0.599, r = 0.328 (P less than 0.05). In this multivariate analysis the first principal component was the site, the second one was the Broca index, the third one was age and the fourth one was height. The distance tended to increase in proportion to aging in this analysis. We conclude that the skin-epidural distance is strongly influenced by the site of puncture and Broca index, but not influenced by pregnancy.

Adult↗

PubMed1991

[A case of delirium which occurred during otorhinolaryngological treatment under local anesthesia--the importance of close communication between practitioners and local general hospitals].

We experienced a case of delirium which occurred during treatment of chronic sinusitis under local anesthesia in a ENT practitioner, which took an unique course. We were able to treat the patient immediately after occurrence of the complication because we have emergency hot-line between anesthesiologists in our hospital and the practitioners in our area. Fortunately the patient recovered without severe sequelae due to immediate therapy. We consider that in emergency cases, a close communication between practitioners and local general hospitals is important for exact diagnosis and suitable treatments as well as for life-saving procedures.

Anesthesia, Local↗

PubMed1991

[Evaluation of the efficacy of continuous epidural block with low concentration of local anesthetics in patients with ureterolithiasis].

Forty patients with ureterolithiasis were studied to evaluate the efficacy of a continuous epidural block with local anesthetics. The patients were randomly allocated into 3 groups: first group (n = 7) received continuous epidural administration of 1% mepivacaine at a rate of 2 ml.hr-1; second group (n = 19) received intermittent bolus administration of the same anesthetic 4-5 times daily; and third group (control group, n = 14) was treated by conventional therapy including infusion of Ringer's solution and diuretics. Among 3 groups, a comparison of the rate of abortion of ureter stone, the rate of mobilization of stone, and the frequency of operation was performed. The rate of abortion in group 1 was significantly higher than those of group 2 and control. The rate of mobilization of stone in group 1 tended to be higher than group 2 and control. Also the frequency of operation in group 1 tended to be lower than group 2. Effect of continuous administration with 1% mepivacaine in patient with ureterolithiasis was comparable to that of intermittent bolus administration of 2% mepivacaine or 0.5% bupivacaine reported. We conclude that the continuous block with 1% mepivacaine is effective and safe for treating the patient with ureterolithiasis.

Adult↗

PubMed1990

[Changes in plasma granulocyte elastase, myeloperoxidase and fibronectin during and after open heart surgery].

Arterial and pulmonary arterial levels of plasma granulocyte elastase, myeloperoxidase and fibronectin were measured during and after cardiac surgery by using a bubble oxygenator. Granulocyte elastase-proteinase inhibitor and myeloperoxidase increased significantly from the end of cardiopulmonary bypass to the first postoperative day. The levels of granulocyte elastase-proteinase inhibitor and myeloperoxidase correlated with the perfusion time with cardiopulmonary bypass, but did not correlate with respiratory index except correlation of the level of arterial myeloperoxidase with respiratory index on the first postoperative day. We speculate that microvascular leukostasis occurs after cardiopulmonary bypass on account of the differences of the level of myeloperoxidase between arterial and pulmonary arterial blood. Plasma fibronectin decreased slightly during operation and on the first postoperative day.

Adult↗

PubMed1990

[Effects of ulinastatin on changes of plasma granulocyte elastase, myeloperoxidase and fibronectin during and after open heart surgery].

We investigated effects of ulinastatin on plasma levels of granulocyte elastase in alpha 1-proteinase inhibitor complex, myeloperoxidase and fibronectin in 20 patients during and after open heart surgery. Ulinastatin, 300,000 units were given immediately after the induction of anesthesia. Plasma fibronectin increased significantly after cardiopulmonary bypass (CPB) in ulinastatin group (group U) compared with control (group C) group. Regression coefficients between CPB time and changes of plasma fibronectin in group U were significantly different from those in group C after CPB. Plasma levels of granulocyte elastase in alpha 1-proteinase inhibitor complex were not different between the two groups. Regression coefficients of group U were smaller than those of group C after CPB. Plasma levels of myeloperoxidase were not different between the two groups. Regression coefficients of group U were significantly smaller than those of group C. Ulinastatin suppressed significantly the decrease of plasma fibronectin after CPB. Ulinastatin had no effects on plasma granulocyte elastase in alpha 1-proteinase inhibitor complex during and after CPB. Ulinastatin inhibited the increase of plasma myeloperoxidase in proportion to CPB time.

Aged↗

PubMed1990

[Evaluation of the safety of a new portable pump for continuous epidural infusion of local anesthetics].

The safety of a new portable pump (Baxter Infusor), was evaluated for continuous epidural infusion of local anesthetics. The experimental flows at different temperatures were 1.87 ml.hr-1 at 28 degrees C and 2.14-2.15 ml.hr-1 at 33 degrees C. The average temperature of local anesthetics in this pump attached to patients was 29 degrees C. Concentration of mepivacaine reached the maximal value (1.129 +/- 0.439 micrograms.ml-1) at 12 hours after the application of the infusor. The concentration of mepivacaine was maintained at a constant level from 6th hour to 24th hour. The result indicates that Infusor is a safe device for continuous infusion of local anesthetics because of constant flow and low level of local anesthetics.

Anesthetics, Local↗

PubMed1990

[Transfusion for operation: reduction and proper preparation of blood for transfusion].

In order to minimize preoperative transfusion requirements and to order proper preoperative transfusion blood, we induced deliberate hypotension and analyzed preoperative preparation of blood with C/T (cross-match/transfusion) ratio. We tried to establish a maximum surgical blood order schedule (MSBOS) based on the surgical transfusion experience of about 10 operations at our hospital. Deliberate hypotension was induced with prostaglandin E1 (PGE1) in 14 patients with mastectomy. Bleeding volume in PGE1 group (n = 7) was reduced to approximately 50% of control group (n = 7) at average dose of 35 +/- 25 ng.kg-1.min-1 with enough urine output. The dose of PGE1 was smaller than other reports because of the application of continuous epidural block to general anesthesia in all cases. Average C/T ratio was 4.6 and it was 3.6-24 in the 10 operations, which are higher than recommended value of the Ministry of Health and Welfare as well as ASA committee. We confirmed deliberate hypotension with PGE1 and continuous epidural block under general anesthesia were useful to minimize blood loss during mastectomy and clarified the improvement of the present preoperative blood ordering.

Alprostadil↗