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Biomedical subjects

K Samii

Publications and source records attributed to K Samii.

At least 163 records · Page 9Linked to original sources
PubMed1981

Plasma morphine concentration after intrathecal administration of low doses of morphine.

Plasma morphine concentration was measured in eight patients who received morphine 0.02 mg kg-1 intrathecally. The concentration was less than 0.5 ng ml-1 at 2 min and 10 min, 2 +/- 1 ng ml-1 at 30 min, 3 +/- 2 ng ml-1 at 1 h, 6 +/- 4 ng ml-1 at 3 h, 5 +/- 3 ng ml-1 at 12 h, 0.8 +/- 0.2 ng ml-1 at 24 h and less than 0.5 ng ml-1 at 36 h. The small plasma morphine concentrations we observed after intrathecal administration of morphine indicated that analgesia is a result of an action of morphine on opiate receptors, either spinal or cerebral.

Humans↗
PubMed1981

Postoperative spinal analgesia with morphine.

Patients with pain after operation received morphine hydrochloride intrathecally in doses of 0.02 mg kg-1 (n = 30) and 0.2 mg kg-1 (n = 30). The high-dose group showed slightly longer-lasting and more potent analgesia than the low-dose group. Sedation, decreases in heart rate and systolic arterial pressure, oliguria, nausea and urinary retention were more frequent in the high-dose group. Two patients of the high-dose group showed evidence of respiratory depression which appeared after a late change in posture (7 and 11 h). We conclude that postoperative analgesia with intrathecal morphine 0.02 mg kg-1 must be followed by a prolonged head-up posture and be performed in hospital units where the treatment of respiratory depression is competent.

Clinical Trials as Topic↗
PubMed1981

Plasma concentration of morphine after i.m., extradural and intrathecal administration.

Seventeen patients received morphine 0.2 mgkg-1 in a 10% dextrose solution i.m. (n = 5), extradurally (n = 6) and intrathecally (n = 6) for pain after operation. Morphine was measured in plasma by radioimmunoassay. Plasma immunoreactive morphine concentration was significantly less after intrathecal administration after i.m. and extradural administration (P less than 0.05) at 2, 10, 15 and 30 min. We conclude that morphine given extradurally has a greater initial rate of vascular absorption than morphine given intrathecally and is similar to that observed after i.m. administration.

Absorption↗
PubMed1980

[Treatment of isolated postoperative respiratory complications by constant positive pressure in spontaneous ventilation].

Positive pressure at the end of expiration (PEEP) applied in spontaneous ventilation (CPAP) has the same ventilatory effects as in controlled ventilation without the harmful actions. Few studies have described the use of CPAP in severe isolated postoperative respiratory insufficiency. CPAP was applied in 16 patients free of chronic bronchopulmonary disease, aged between 22 and 82 years, and suffering after major thoracic and/or abdominal surgery from isolated acute respiratory insufficiency as defined by clinical, blood gas and rediological criteria. CPAP was applied with mask alone (n = 5) or by nasotracheal intubation followed by mask (n = 11). PEEP was regulated at +1.7 to +2.94 KPa (+ 12 to 30 cm H2O) in order to obtain a PaO2/FIO2 greater than or equal to 300. Alveolar ventilation was assessed by capnography. Improvement was marked in six days : the PaO2/FIO2 ratio at nil PEEP fell from 129 +/- 3.2 to 3.73 +/- 6.5 (mean +/- SD), the score of interstitial and alveolar opacities from 25 to 4 and the atelectasis score from 10 to 1. These results show the efficacy of CPAP in the early treatment of isolated postoperative acute respiratory insufficiency.

Humans↗
PubMed1980

[Droperidol. Action on hemodynamic and oxygen consumption changes (author's transl)].

Hemodynamic and oxygen consumption changes following general anesthesia were studied in 11 patients who did and in 11 patients who did not received droperidol at the end of operation. Both group were similar with respect to age, duration of anesthesia, doses of anesthetic drugs, and hemodynamic and oxygen consumption values immediately at the end of operation. The highest oxygen consumption measurements which were selected as representative of the maximal metabolism of the recovery period showed that the following parameters were lower in the droperidol group than in the non-droperidol group: oxygen consumption (162 +/- 12 and 238 +/- 19 ml/min/m2 respectively), cardiac index (3.0 +/- 0.2 and 4.4 +/- 0.4 l/min/m2), mean arterial pressure (11 +/- 6 and 129 +/- 5 torr), stroke index (27 +/- 3 and 46 +/- 4 ml/m2) left ventricular stroke work index (38 +/- 5 and 77 +/- 8 gm/m2) and PaCO2 (39 +/- 2 and 49 +/- 2 torr). The measurements performed after extubation were similar in both groups. These data show a metabolic and hemodynamic stabilizing effect of droperidol during recovery which may be useful in high-risk patients.

Anesthesia↗
PubMed1979

[Factors responsible for post-operative infection].

Post-operative infection is often due to a combination of several factors. A decrease in immune defence processes represents the first factor. This is seen in situations such as malnutrition (undernourishment or obesity), alcoholism, diabetes, neoplasms, infections and old age. It may also be induced by therapy such as immunodepressants, antimitotic chemotherapy, corticosteroids and radiotherapy. Finally, certain antibiotics have been accused of reducing immune defences. The second factor responsible for infection is bacterial flora. Errors such as broad spectrum antibiotic therapy prescribed in the presence of unexplored fever, or changed repeatedly, are responsible for imbalance in the bacterial flora and the acquisition of resistance to antibiotics. These errors firstly increased the prevalence of infections and, secondly their severity and the difficulty of their treatment. The last factor responsible for infection is rupture of the natural barriers formed by the skin and mucosae. This is related on the one hand to surgery itself and, secondly, to the intensive care techniques surrounding the surgical act: venous catheterization above all, but also bladder catheterization, tracheal intubation, etc.

Anesthetics↗
PubMed1978

Hemodynamic effects of dopamine in septic shock with and without acute renal failure.

Hemodynamic response to dopamine hydrochloride in septic shock with myocardial dysfunction was studied in ten patients with normal renal function (group 1) and in ten patients with acute renal failure (group 2). The control hemodynamic data were similar in the two groups. Dopamine in groups 1 and 2 induced significant (P less than .01) and similar increases in cardiac index and mean aortic pressure. Group 1 had a smaller increase in heart rate (+ 16%), than group 2 (+ 24%), but this difference was not significant. Stroke volume index had a significant increase in group 1 (+ 18%), whereas it did not increase significantly in group 2 (+ 4%); this difference of changes in stroke volume index between the two groups was significant (P less than .01). This phenomenon suggests an increased chronotropic effect and/or a reduced inotropic effect of dopamine in patients with septic shock and acute renal failure.

Acute Kidney Injury↗
PubMed1978

Haemodynamic study of patients with severe sepsis during haemodialysis.

A study was performed in order to observe haemodynamic changes induced by haemodialysis in 14 patients with acute renal failure and severe sepsis. Left ventricular function, as assessed by changes in pulmonary wedge pressure and left ventricular stroke work index through plasma volume expansion, did not change during haemodialysis. Ultrafiltration-induced decreases in cardiac index provoked in 8 patients, with nearly normal initial systemic arteriolar resistance, had adequate and constant increase in their resistance (p less than 0.001), whereas 6 patients with low initial systemic arteriolar resistance did not increase their resistance and had a frequent (9/13 measurements) and significant (p less than 0.001) fall in mean aortic pressure. This abnormality of vascular tone is probably due to severe sepsis and explains why hypotension is a frequent occurrence during haemodialysis in such patients.

Acute Kidney Injury↗