| Japanese |
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| Title | 心血管手術におけるfentanyl(<50γ/kg)麻酔時の血中カテコラミンの推移と血行動態 |
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| Subtitle | 原著 |
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| Authors | 白井希明*, 藤田昌雄*, 西山圭子*, 松本克平*, 福岡靖介*, 曽根衣子*, 横川すみれ*, 野村実*, 高田勝美* |
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| Authors(kana) | |
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| Organization | *東京女子医科大学麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 10 |
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| Number | 4 |
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| Page | 641-647 |
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| Year/Month | 1989/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」心疾患患者に対する麻酔法はfentanylが使用されるようになって従来より安全に行なえる様になった. Stanlayらによる大量fentanyl麻酔は重症の心血管手術の麻酔に適応され, これに関する報告も非常に多くみられる. しかし, fentanylの使用量は報告によっても差があり, その結果に対する評価も微妙な違いを認めるが, 血行動態の安定性から見るfentanyl麻酔の有用性は十分に評価されている. 我々は従来よりfentanylの使用量は50μg/kgを最大使用量として心血管手術の麻酔を行なって来た. この方法の有効性を検討する為に現在おこなっている麻酔導入時より胸骨切開時までに使用するfentanyl 30μg/kg投与時の血行動態と血中カテコールアミン濃度の推移を見た麻酔導入時のfentanyl 30μg/kgは冠動脈再建術群で多少のRate Pressure Product(RPP)の増加が認められたが臨床的に危険性は認めなかった. 血中カテコールアミン濃度の推移から見ても外科的ストレスに対して交感神経系の緊張は十分に制御されていたると判断された. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | fentanyl, 心血管手術, 血中カテコールアミン, 液体高速クロマトグラフィー法 |
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| English |
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| Title | Plasma Catecholamine Levels during moderate-dose Fentanyl A nesthesia for Cardiac Surgery |
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| Authors | Kimei Shirai, Masao Fujita, Keiko Nishiyama, Kappei Matsumoto, Keisuke Fukuoka, Yoriko Sone, Sumire Yokokawa, Minoru Nomura, Katsumi Takada |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology Tokyo Women's Medical College |
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| Journal | Circulation Control |
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| Volume | 10 |
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| Number | 4 |
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| Page | 641-647 |
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| Year/Month | 1989/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Changes in release of plasma catecholamines (pCA) in response to induction of anesthesia and surgical stimulation, which might remarkably affect cardiovascular functions, were studied to evaluate differences in patients with ischemic disease and valvular heart disease. Infusion of fentanyl 30 μg/kg continued up to sternotomy. Total 38 patients consisted of 14 patiens for mitral valve replacement, 14 patients for coronary-aorto bypass grafting and 10 patients for aortic valve replacement were randomly sized to the this study. pCA were measured by high performance liquid chromatography=electro chemical detector methode (HPLC=ECD), and investigated of collerations during hemodynamic changes and pCA levels. There were no collerations between pCA and hemodynamic changes. Stimulations, such as endtracheal intubation and sternotomy under this moderate does fentanyl anesthesia did not increase pCA. In patients for coronary-aorto grafiting bypass, Rate Pressure Product (RPP) was increased during sternotomy However, this was able to treated by increasing dose of fentanyl up to 50μg/kg. It is conculuted that moderate fentanyl in this study was suiificient to controlled changes in hemodynamics during cardiovascular surgery. |
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| Practice | Basic medicine |
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