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Biomedical subjects

T Asai

Publications and source records attributed to T Asai.

At least 271 records · Page 15Linked to original sources
PubMed1997

Effect of clonidine on gastric emptying of liquids.

We have investigated the effects of clonidine on gastric emptying of liquids in 30 patients. In a double-blind, randomized design, clonidine 150 micrograms, morphine 10 mg or saline in 1 ml was given i.m. One hour later, the patient drank a paracetamol solution (1.5 g in 50 ml water). Venous blood samples were obtained every 15 min for 90 min thereafter. Plasma paracetamol concentrations were measured using high-pressure liquid chromatography and the area under the concentration-time curve was calculated. The degree of sedation and complications were recorded. The area under the curve for 0-60 min was significantly smaller in the morphine group than in the saline group (P = 0.002; 95% confidence interval (CI) for difference -1237 to -502 micrograms min ml-1), whereas it was greater in the clonidine group compared with the saline group, although this was not significant (95% CI for difference -423 to 1264 micrograms min ml-1). Arterial pressure was significantly lower in the clonidine group compared with the saline group. Both clonidine and morphine appeared to cause mild sedation. We conclude that clonidine 150 micrograms i.m. does not delay gastric emptying of liquids in a similar manner to morphine.

Acetaminophen↗
PubMed1997

Low-dose rocuronium improves conditions for tracheal intubation after induction of anaesthesia with propofol and alfentanil.

We studied 60 adult patients to assess if low doses of rocuronium improved conditions for tracheal intubation during induction of anaesthesia with propofol 2.5 mg kg-1 and alfentanil 10 micrograms kg-1. In a double-blind, randomized design, patients were allocated to one of three groups: group P = saline; group R1 = rocuronium 0.1 mg kg-1; and group R3 = rocuronium 0.3 mg kg-1. Intubation conditions were judged as optimal, suboptimal or failure, based on the scoring of ease of jaw opening and laryngoscopy, position of the vocal cords and degree of straining after tracheal intubation. Intubation conditions were judged as optimal in one patient in group P, in six patients in group R1 and in 18 patients in group R3. Conditions were judged as a failure in seven patients in group P, in one patient in group R1 and in none in group R3. No laryngospasm or other complications were observed in any patient. The addition of low doses of rocuronium significantly improved intubation conditions (P < < 0.001). Ventilation was controlled during surgery, and in no patient was any problem encountered with antagonism of neuromuscular block with neostigmine. Injection of rocuronium 0.3 mg kg-1 (ED95) with propofol and alfentanil provided a high proportion of optimal intubation conditions.

Adolescent↗
PubMed1997

Differential effects of clonidine and dexmedetomidine on gastric emptying and gastrointestinal transit in the rat.

We have studied the effect of clonidine, dexmedetomidine and morphine on gastric emptying and gastrointestinal transit in the rat. In one group, each agonist was injected i.p. in 6-12 male Wistar rats. In another group of rats, yohimbine, naloxone or saline was injected with an agonist. At 30 min, radiolabelled saline 1 ml was infused into the stomach. At 1 h, gastric emptying and gastrointestinal transit were calculated by measuring the radioactivity in the gastrointestinal tract. We found that clonidine and dexmedetomidine strongly inhibited gastrointestinal transit (ED50 0.08 and 0.04 mg kg-1, respectively). They also significantly inhibited gastric emptying (P < 0.05), but the effect was weak (95% confidence intervals for difference from saline 8.2-34.9% with clonidine 1 mg kg-1 and 3.4-15.4% with dexmedetomidine 0.03 mg kg-1). Morphine strongly inhibited both gastric emptying and gastrointestinal transit (ED50 2.8 and 1.2 mg kg-1, respectively). Yohimbine significantly antagonized the inhibitory effects of clonidine and dexmedetomidine (P < 0.05), whereas naloxone, which significantly antagonized the effect of morphine (P < 0.01), did not antagonize the effect of either of the other agonists.

Adrenergic alpha-Agonists↗
PubMed1997

Damage to the laryngeal mask by residual fluid in the cuff.

It has been suggested that, in some situations, the cuff of the laryngeal mask should be filled with fluid. We speculated that this practice might damage the device during sterilisation in an autoclave. We studied whether injection of a small volume of water into the cuff of the laryngeal mask and subsequent sterilisation affected the integrity of the cuff. First, a pressure-volume relationship for each of 20 new masks was obtained by inflating the cuff with increasing volumes of air (5-45 ml). The masks were then randomly allocated into four groups (W0, W0.25, W0.5 or W1.0), 0, 0.25, 0.5 or 1.0 ml of water was injected into the cuff and the mask was then sterilised in an autoclave. After sterilisation, the shape of the cuff was examined and pressure-volume relationships were obtained again. The baseline intracuff pressures were similar in the four groups. After sterilisation, the pressure was significantly lower in groups W0.25, W0.5 and W1.0 than in group W0 (p < 0.05). Two masks in group W1.0 lost their integrity, resulting in herniation of and rupture of the cuff. We conclude that the cuff of the laryngeal mask should not be inflated with fluid unless the device is discarded afterwards.

Equipment Failure↗
PubMed1997

Effect of the size of a tracheal tube and the efficacy of the use of the laryngeal mask for fibrescope-aided tracheal intubation.

We randomly allocated 60 patients with normal airways into three groups to compare the ease of fibrescope-aided tracheal intubation using 8.0-mm internal diameter (group F8) and 6.0-mm (group F6) reinforced tracheal tubes and to evaluate the efficacy of the laryngeal mask as an aid for fibreoptic tracheal intubation (group L). In group F8 tracheal intubation was optimal in 2 of 20 patients and in two patients in whom intubation over the fibrescope was difficult the attempts resulted in inadvertent oesophageal intubation. In group F6 intubation was always successful and significantly easier than in group F8 (p < 0.005; 95% confidence interval for the difference in the proportion of the optimal intubation grade: 20-70%). In group L tracheal intubation was optimal in 18 of 20 patients and easier than in group F6 (p = 0.014; 95% confidence interval for difference: 10-60%). In both groups F6 and L tracheal intubation was completed within less than about 1 min. We conclude that conventional fibrescope-aided tracheal intubation with a 6.0-mm tracheal tube is easier than with an 8.0-mm tube and that the laryngeal mask facilitates fibrescope-aided tracheal intubation.

Adult↗
PubMed1997

[Institution and significance of the new guidelines for prevention of transfusion associated graft versus host disease].

The Japanese Society of Blood Transfusion (JSBT) has produced guidelines three times for preventing transfusion associated graft versus host disease (TA-GVHD). On January 1, 1992, the first guidelines from JSBT were issued after the recognition that immunocompetent patients had suffered from TA-GVHD after surgery. These guidelines were established to provide protective irradiation for transfusion with cardiosurgery, the same as for transfusions with congenital immunodeficiency, infants, and other immunocompromised patients, as well as exchange transfusions of newborn. In 1993, the Japanese Red Cross analysed the data from questionnaires about TA-GVHD from hospitals in Japan, and it was revealed that the majority of the patients were transfused for cardiac surgery and surgery for cancers. On May 12, 1995, the second set of guidelines was issued, indicating that transfusions accompanying cancer surgery should be protected by irradiation, and that blood for transfusion should be irradiated within 72 hours after donation. In April 1996, the Japanese Ministry of Health and Welfare issued an urgent warning about TA-GVHD, because a report from the Japan Red Cross Blood Center stated that about ten patients still died yearly from TA-GVHD in the last few years. JSBT organized a subcommittee for preventing TA-GVHD, and issued the third version of guidelines for blood irradiation for its prevention in Japan.

Aged↗
PubMed1997

[A case of lung carcinoid].

A 78-year-old female was pointed out an abnormal shadow in left lung field. For 4 years this shadow was followed up as benign tumor. Chest CT scan revealed growing tumor and new tumor in right lung. Tumor resection was performed. Until operation time carcinoid syndrome was not found. This case was diagnosed histopathologically typical carcinoid of peripheral lung.

Aged↗