Akira Okuaki

Responses to Exogenous Adenosine 3', 5'-monophosphate of Cardiac Output and Blood Flow in the Renal, Superior Mesenteric and Carotid Arteries in Anesthetized Dogs

Changes in the cardiac output and blood flow in the renal, superior mesenteric and carotid arteries in anesthetized dogs were observed, using the non-cannulating electromagnetic flow meter. Dibutyryl cyclic-AMP, 5 mg/kg body weight, was given intravenously and the following results were obtained: 1) Dibutyryl cyclic-AMP increased the stroke volume and the cardiac output, and slightly increased the heart rate. These effects appeared 3 to 5 min after administration of dibutyryl cyclic-AMP. 2) The mean systemic blood pressure as well as the central venous pressure fell slightly. 3) The renal and the superior mesenteric artery blood flow increased markedly, but the carotid artery blood flow did not change. 4) Distribution of the cardiac output to the renal and superior mesenteric arteries did not change but distribution to the carotid artery decreased. 5) Total peripheral resistance, renal artery vascular resistance and superior mesenteric artery vascular resistance decreased, and carotid artery vascular resistance decreased slightly. 6) The cardiac output and blood flow were enhanced by aminophylline (3 mg/kg), and were not blocked by propranolol (0.3 mg/kg).

Comparison of sevoflurane and other volatile anesthetics for cesarean section

Low-concentration halothane or enflurane is generally used for a cesarean section. Sevoflurane is a new volatile anesthetic and its blood/gas partition coefficient is very low. It seems to be suitable for anesthesia that requires rapid induction and emergence, such as cesarean section. In this study sevoflurane was evaluated during anesthesia for cesarean section and compared with halothane, enflurane, and isoflurane.

Interabdominal analgesia in pain management after cholecystectomy: A preliminary report

In recent years, recognition of the importance of adequate postoperative pain relief has been increasing [13]. We usually perform epidural anesthesia for upper abdominal surgery. However, it is occasionally either impossible or too risky to place a catheter into the epidural space because of hemorrhagic diathesis, adhesion, or synostosis. Thus, we have developed a new technique as the sole treatment for postoperative pain in cholecytectomy patients which involves the insertion of an epidural catheter into the omental sac and the adminstration of local anesthetics. The results so far have been encouraging, and we feel that the method is worthy of description. We have termed this technique interabdominal analgesia (IAA).

The Troubles of Anesthetic Machines with Oxygen Failure Protection Devices

最近低酸素防止装置が装備されている2つの機種の麻酔器で危険な故障を経験した. 1つは流量計の故障で, 笑気流量調節バルブに異物が迷入し, バルブを完全に閉めたつもりでも, 実際には間隙を生じ, 酸素を流しただけで笑気回路が開放され笑気が流れた. この麻酔器では, この種の事故においては低酸素防止装置は作動しない.もう1つは, 低酸素防止装置自体の故障で, 流量調節システムと酸素濃度調節システムの故障であった. いずれも麻酔科医が気付き大事には至らなかった.機械を過信することなく, 麻酔科医の注意深い観察が最も重要だと思われた.

A newly designed flexible fiberoptic bronchoscope for use in intensive care units.

AbstractA newly designed flexible fibroptic bronchoscope has been manufactured for use in intensive care units (ICU). It has an inside channel of large caliber, diameter 2.5 mm, through which pulmonary secretions can be aspirated directly via the suction tube. Furthermore, prompt bedside use is possible since handle type batteries can easily be attached to the bronchofibroscope. This new instrument is now employed in our ICU for:1.The diagnosis and treatment of atelectasis.2.Suction of retained secretions.3.Detection of tracheal obstruction.4.Evaluation of endotracheal and tracheostomy tubes whilst in position.5.Observation of tracheal and bronchial changes.6.Help in endotracheal intubation. It was used most frequently for the diagnosis and treatment of atelectasis and suction of retained secretions.