| Japanese |
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| Title | 3. A-C bypass術の麻酔 I. Rate Pressure Product(RPP)よりみたモルフィンおよび大量フェンタニール麻酔の比較 |
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| Subtitle | 第4回循環制御研究会記録 シンポジウム「心血管手術の麻酔」 |
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| Authors | 神山洋一郎*, 鹿倉公雅*, 里吉光子* |
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| Organization | *順天堂大学医学部麻酔科 |
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| Journal | 循環制御 |
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| Volume | 4 |
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| Number | 3 |
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| Page | 420-427 |
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| Year/Month | 1983/ |
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| Article | 報告 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | 「要旨」A-C bypass術の麻酔の注意点は, 麻酔導入から人工心肺までの血行動態をいかに安定に保ち, 心筋の酸素需給のバランスを維持するかにある. 過去約7年間に同一術者によって行われたA-C bypass術417例の麻酔法は, より安定した血行動態をうるためにmorphine(1〜1.5mg/kg, 2mg/kg)-diazepam-笑気, 大量fentanyl(75μg/kg)-酸素麻酔と変遷した. これらの症例のうち, 同年齢, 同程度の病変およびリスクを有するmorphine麻酔50例(M群)とfentanyl麻酔50例(F群)を選び, 麻酔前から人工心肺開始前までの心拍数, 収縮期血圧, RPP(Rate Pressure Product)を比較した. M群, F群とも麻酔開始前の平均心拍数はそれぞれ78±14, 78±15/分, 血圧138±24, 137±21mmHg, RPP11,488.7±2,956, 11,532.4±3,162と, 有意差がなかった. M群では血圧は導入時に下降し, 心拍数は挿管後, 胸骨切開, 心外膜切開, カニュレーション時に漸次増加して, RPPは平均値14,000と麻酔前にくらべ有意に上昇した. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Anesthesia for aortocoronary bypass operation 1.Comparative studies on RPP (Rate Pressure Product) between morphine and fentanyl anesthesia |
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| Authors | Yoichiro Kamiyama, Kimimasa Shikakura, Mitsuko Satoyoshi |
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| Authors(kana) | |
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| Organization | Dept. of Anesthesiology, Juntendo University |
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| Journal | Circulation Control |
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| Volume | 4 |
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| Number | 3 |
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| Page | 420-427 |
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| Year/Month | 1983/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Comparative studies on RPP between morphine (1-1. 5mg/kg) and fentanyl (75μg/kg) anesthesia for aortocoronary bypass operation were carried in 50 cases each randomly selected of 417 cases. Patient's age, class of coronary disease, risk, associated complication and operative course were similar and mean preanesthetic RPP was 11,500 in both groups. In morphine group, RPP increased significantly after endotracheal intubation followed by a decrease at skin incision. Then it increased gradually during sternotomy, pericardotomy and cannulation where RPP exceeded 11,400 mainly due to an increase in heart rate. In fentanyl group, heart rate, systolic blood pressure and RPP seemed to be stabilized until sternotomy, though RPP suddenly increased to 14,000 during pericardotomy due to both increased heart rate and raised blood pressure in 32 of 50 cases. This increase in RPP was probably provoked by sympathosympathetic reflex during the procedure which suggested to use the additional means such as epidural block of Th1-4 or potent inhalation anesthetics in fentanyl anesthesia. |
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| Practice | Basic medicine |
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| Keywords | aortocoronary bypass operation, anesthesia, morphine, fentanyl, RPP (Rate Pressure Product) |
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