ABSTRACT
To investigate the changes in renal function during the halothane, enflurane and thalamonal anesthesia and elective surgery, the authors measured urine flow rate, creatinine clearance(Ccr, GFR), excreted amounts of sodium, potassium and chloride ions, fractional excretion of sodium (FeNa), free water clearnace (C H2O) at preanesthesia (control), 20 minute after the induction of anesthesia, during operation (3 times), 1 hour after surgery, respectively, and obtained the results as follows: 1) Changes in renal function was not significant after the induction of anesthesia compared to preanesthesia in halothane, enflurane and thalamonal anesthesia. 2) Renal function decreased signifi-cantly during the operation under anesthesia with halothane or enfiurane. 3) There was a tendency of renal function to be decreased compared to preanesthesia in the 1st postoperative day in patients anesthetized with halothane or enflurane, but tendency of it to be increased in thalamonal anesthesia. Therefore, it is suggested that thalamonal anesthesia is a good choice in patients with renal dysfunc-tion.
Subject(s)
Humans , Anesthesia , Creatinine , Enflurane , Halothane , Ions , Kidney , Potassium , Sodium , WaterABSTRACT
Signs and Symptoms consistent with the irritation of the cauda equina developed during epidural morphine therapy for the relief of pain from osteosarcoma in a 10-year-old female patient. This was considered to be due to a subarachnoid diffusion of the epidurally administrated morphine through the dural opening formed by a previous inadvertent dural puncture. The subarachnoid diffusion of the drug was confirmed by fluoroscopy following injection of the contrast media through the indwelling epidural catheter. The chemical inflammation of the cauda equina might be due to substances formed by chemical reactions with a certain preservative vehicle rather than the morphine itself. Spinal steroid therapy may be effective for the suppression of a chemical inflammatory reaction.