Takao Tanaka

Usefulness of Nerve Block Therapy for Patients with Herpetic Pain

A retrospective study was performed on 230 patients with Herpes zoster. Among these patients, 156 patients (67.8%) were over 50 years old. Ninety-four percent of the patients who received the nerve block therapy within a month from the onset became ultimately free from pain while only seventy-nine percent of the patients upon whom this therapy was started after 2 months or more were relieved of pain. It was suggested that the earlier the therapy and the younger the patients, the more easily herpetic pain could be controlled. In conclusion, it became apparent that early treatment of Herpes zoster with nerve block therapy, is extremely important for prevention of post-herpetic neuralgia.

Clinical study of glucose metabolism during partial gastrectomy--comparison between epidural and general anesthesia.

Plasma glucose, insulin, glucagon, growth hormone (GH) and cyclic-AMP (C-AMP) were measured in 14 patients undergoing partial gastrectomy under 5 g/hr glucose loading. Seven patients received general anesthesia (GOF; Group G) and the other seven, GO + epidural anesthesia (analgesia Th4 t-L1 ; Group E). Blood glucose increased in both groups, although it remained consistently lower in Group E than in Group G. Serum IRI and IRI/glucose ratio appeared consistently higher in Group E than in Group G and a significant difference was found between the two groups at the early period of surgery. The changes in plasma glucagon and GH were found independent of those in glucose. Cyclic-AMP was also consistently higher in Group G than in Group E and a significant difference was observed at the end of anesthesia. These results suggest that epidural anesthesia with 5 g/hr glucose loading may facilitate insulin release from the islet and peripheral blood uptake particularly during the early period of surgery while many other factors such as GH, cortisol and vagal stimulation seemed to be involved in the later period of surgery.

Clinical study on hypotensive anesthesia with nitroglycerin

Deliberate hypotension was induced by using nitroglycerin (NG) during anesthesia in 13 patients with intracranial aneurysm, who underwent clipping surgery. The following results were obtained: Changes in blood pressure were rapid and smooth, before, during and after administration of NG. No patients showed resistance to the drug in this study. Heart rate increased significantly during induced hypotension while a significant reduction was observed in the rate-pressure product (RPP), which correlates with the myocardial oxygen demand. No significant changes were found in pH, PaO2, PaCO2 and base excess (B. E.) while the respiratory index (PaO2/FIO2) as an indicator of pulmonary oxygenation appeared to be significantly reduced.