Biomedical subjects

M Fujimori

Publications and source records attributed to M Fujimori.

255 records · Page 15Linked to original sources

PubMedDate not supplied

Self-assessment of the cephalad analgesia level after spinal or epidural anesthesia.

BACKGROUND AND OBJECTIVES: To determine the accuracy of self-assessment of the cephalad analgesia level after spinal or epidural anesthesia using skin pinch. METHODS: The assessment of the cephalad analgesia level of anesthetic block made using self-assessment was compared to that of the pinprick method with a short bevel needle in 40 patients who received spinal or epidural anesthesia. RESULTS: A good correlation was found between the assessments of the cephalad analgesia level of anesthetic block made using pinprick and self-assessment (spinal anesthesia group: r = 0.883, p less than 0.0001; epidural anesthesia group: r = 0.802, p less than 0.0001). Among 14 patients who had received sedatives and analgesics intravenously during surgery, a good correlation was found between the assessments of analgesia level made using the two methods in the spinal group (r = 0.921, p less than 0.0001); the corresponding correlation was poor in the epidural group (r = 0.617, p less than 0.05). CONCLUSIONS: Self-assessment seems to be a method useful for testing recovery from spinal and epidural anesthesia in the recovery room and in the surgical ward, although it may be unreliable when used by patients who have been sedated.

Adult↗

PubMedDate not supplied

Effects of intravenous mepivacaine on renal sympathetic nerve activity in the cat during nitrous oxide and nitrous oxide-halothane anesthesia.

BACKGROUND AND OBJECTIVES: Because hemodynamic responses to systemic mepivacaine may be influenced by sympathetic change and concurrent general anesthesia, the authors directly measured renal sympathetic nerve activity (RSNA) during intravenous administration of mepivacaine in subseizure through seizure doses under N2O-O2 and N2O-O2-halothane anesthesia. METHODS: Thirty-four cats were randomly assigned to five groups. Groups I-A, I-B, and I-C received incremental subseizure doses of intravenous mepivacaine (2 mg/kg, 5 mg/kg, and 10 mg/kg). Groups II-A and II-B received intravenous infusion of mepivacaine (4 mg/kg/min). Anesthesia was maintained with N2O(70%)-O2 in groups I-A, I-C, and II-A, and with N2O(70%)-O2-halothane (1%) in groups I-B and II-B. Cats in group I-C had undergone total baroreceptor denervation. Heart rate (HR), mean arterial pressure (MAP), and RSNA were measured. RESULTS: In group I-A, MAP did not significantly change with intravenous mepivacaine, though RSNA and HR significantly decreased (P < .05) respectively with 5 mg/kg i.v. and 10 mg/kg i.v. mepivacaine. In group I-C, HR, MAP, and RSNA did not change significantly. In group I-B, HR and MAP decreased with bolus intravenous doses of mepivacaine in a dose-dependent fashion, but RSNA did not change significantly. All cats in group II-A developed seizure by mepivacaine infusion at mean total dose of 28.9 +/- 4.2 mg/kg without significant changes in HR, MAP, or RSNA. In group II-B, mepivacaine infusion resulted in circulatory collapse at mean total dose of 34.3 +/- 4.6 mg/kg without seizure or significant RSNA change. CONCLUSIONS: The authors conclude that intravenous mepivacaine induces occasional depression in HR and RSNA during N2O-O2 anesthesia, but in addition induces dose-related circulatory depression during N2O-O2-halothane anesthesia via nonsympathetic mechanism(s).

Anesthesia, Inhalation↗

PubMedDate not supplied

Effects of lidocaine on pulmonary circulation during hyperoxia and hypoxia in the dog.

BACKGROUND AND OBJECTIVES: High concentrations of lidocaine have been found to cause pulmonary vasoconstriction and low concentrations (0.5-0.9 microgram/mL) to cause reversal of nitrous oxide-induced depression of hypoxic pulmonary vasoconstriction. This study was undertaken to examine the effects of high concentrations of lidocaine on pulmonary circulation during hyperoxic and hypoxic ventilation. METHODS: With use of cross-circulation consisting of ventilation and constant-flow perfusion of the left lower lobe (LLL) independently of all other lobes of the dog lung under nitrous oxide and halothane anesthesia, lidocaine was infused into the inflow system, so that plasma lidocaine concentrations in the inflow blood were maintained at either 5, 10, 20, 40, 70, or 140 micrograms/mL during ventilation with 50% oxygen or 3% oxygen. Mean arterial and venous pressures in the LLL (PAPLLL and PVPLLL), airway pressure of the LLL, and blood gas in LLL inflow and outflow were measured. RESULTS: High plasma concentration of lidocaine (140 micrograms/mL) in the LLL inflow produced a significant increase in PAPLLL during hyperoxia, while PAPLLL did not change significantly at the 5-70-micrograms/mL lidocaine concentration. In LLL outflow blood, PO2 increased significantly following a 140 micrograms/mL lidocaine infusion during hyperoxia, while in LLL inflow blood, PO2 did not change. The airway pressure of LLL also did not change. During hypoxia, hypoxic pulmonary vasoconstriction did not occur, and lower plasma concentrations of lidocaine (40-70 micrograms/mL) significantly constricted the lobar vessels. In addition, lidocaine at the 140-micrograms/mL concentration constricted the upstream vessels (presumably the lobar arteries) more strongly than the lobar veins during hypoxia. CONCLUSIONS: Extremely high concentrations (140 micrograms/mL) but not low concentrations (5-70 micrograms/mL) of lidocaine produced pulmonary vasoconstriction and reduced shunt. Lower concentrations of lidocaine constricted the hypoxic lobar vessels.

Anesthetics, Local↗