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.

Alprostadil↗

PubMedDate not supplied

The disturbances of object vision and spatial vision in Alzheimer's disease.

Thirty-one patients with mild-to-moderate Alzheimer's disease (AD) underwent a test battery of complex visual tasks. We assessed the scores using a principal-factor analysis to elucidate the underlying deficits. There were three independent factors: The first factor included the tasks of identifying and comparing forms of visual stimuli. The second factor consisted of digit span and digit symbol tasks, and the third factor consisted of a specified visual counting task. We considered these three factors as representing the dysfunctions of object recognition, general attention and spatial recognition, respectively. These results underline the disturbances of the two visual systems, object vision and spatial vision, in early-AD patients.

Aged↗

PubMedDate not supplied

[Nursing intervention for the patient whose death is imminent].

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Adult↗