<b>Fundamental Study on the Measurement of Blood Pressure by Kampo Pulse Examination</b> / 日本東洋医学雑誌

<p>In 57 consecutively enrolled outpatients, blood pressure as measured by the traditional cuff method and blood pressure measured by Kampo pulse examination were compared. As a result, a difference between the two methods was small, and blood pressure as measured by pulse examination appeared clinically acceptable. Considerably large differences between the two were observed in 4 patients, who tended to have hypofunctional constitutions.</p>

Relationship between noninvasive brachial artery blood pressure and radial artery blood pressure of the right arm of patients / 中华急诊医学杂志

Objective To investigate the relationship between noninvasive brachial artery blood pressure (B) and radial artery blood pressure (R) of the right arm.Methods Two hundred and ninetyfive patients with 149 males and age of (47 ± 16) years were studied.The height of patients was 163 ± 8 cm,and weight of patients was (61.2 ± 7.8) kg.The patients with peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were all excluded.Their B (with adult cuffs) and R (with infant cuffs) of the right arm were measured and analyzed after the patients under general anesthesia and stable hemodynamics.The relationships between B and R were analyzed by linear regression,the differences between B and R of each interval were compared using one-way ANOVA and then followed by SNK procedure.Results Right brachial artery blood pressure was significantly lower than radial artery blood pressure.The differences between the two varied from 13 to 18 mmHg in systolic BP (SBP),diastolic BP (DBP) and mean blood pressure (MAP).And linear regression was most applicable to describe their correlation [r=0.841 (SBP),0.808 (DBP),0.833 (MAP),all P＜0.01].Conclusions Radial artery blood pressure measured with infant cuffs can well reflect the variation of brachial artery blood pressure.

Rumpel-Leede phenomenon associated with noninvasive blood pressure monitoring: A case report / 대한마취과학회지

We report a case of Rumpel-Leede (RL) phenomenon, - acute dermis capillary rupture, secondary to noninvasive blood pressure (NIBP) monitoring in a patient with type 2 diabetes mellitus (DM) and hypertension. The first most likely cause is vascular fragility in microangiopathy as a result of DM and chronic steroid use. The second is the increased venous pressure during cycling of the blood pressure cuff in a hypertensive state. Anesthesiologists need to be aware that acute dermal capillary rupture, although rare, can occur in patients with long-standing DM, hypertension and chronic steroid use.

Effects of Blood Pressure Cuffs on the Circulatory and Respiratory Status of Infants with Persistent Pulonary Hypertension of the Newborn

PURPOSE: Vasodilator therapy in infants with persistent pulmonary hypertension of the newborn(PPHN) frequently causes systemic hypotension due to non-selectivity for pulmonary vessels. Blood pressure(BP) cuffs can increase systemic vascular resistance around which they are applied without affecting pulmonary vessels. We studied the effects of BP cuffs on the circulatory and respiratory status of infants with PPHN receiving vasodilator therapy. METHODS: Mechanically ventilated 16 term infants(gestational age of 39.9+ 1.3 weeks and birth weight of 3,533+/-318 gm with PPHN who had right to left shunt on echocardiogram and survived over 5 days were included for the study. All infants received vasodilator(tolazoline)therapy. We applied BP cuffs for neonatal use to four extremities of study infants(n=8) and inflated them to systolic pressure. Those who received vasodilator therapy alone served as control(n=8). We analyzed systolic and mean BP, respiratory parameters, presence of right to left shunt an clinical outcome at 1, 2, 6, 12, 24, 48, 72hr after initiation of vasodilator therapy. RESULTS: Systolic BP increased significantly in study group(from 37+/-11 to 46+/-13 mmHg) from 6 hours after BP cuff application compared to control group(from 39+/-8 to 40+/-13 mmHg), and this effect persisted up to 72 hour(52+/-18 vs. 46+/-16 mmHg)(P<0.05). Mean BP also increased significantly in study group(30 +/-10 to 38+/-12 mmHg) from 6 hours compared to control group(32+/-11 to 33 15 mmHg) and maintained up to 72 hour occurred(43+17 vs. 3715 mmHg)(P<0.05). Reversal of right to left shunt occurred significantly earlier in study group than control group(30+/-10 vs. 52+/-18 hr)(P<0.01). Respiratory parameters such as mean airway pressure, oxygenation index and duration of ventilator care and hospitalization were not different. Four of five infants in the study group and five of eight in control group survived. CONCLUSION: Application of BP cuffs to the infants with PPHN treated with vasodilator resulted in increase innd mean BP and early reversal of right to left shunt. We suggest that application of BP cuffs can play a useful role in the management of infants with PPHN.

Radial Nerve Paralysis due to Kent Retractor during Upper Abdominal Opertion / 대한마취과학회지

A 52 year old female patient was operated under the diagnosis of stomach cancer. She was very obese; her body weight and height were 95.5 kg and 161.5 cm, respectively. Radical subtotal gastrectomy was performed and the operation time was 4 hour and 40 minutes. The day following surgery, signs of right radial nerve palsy including wrist drop were noted. Neurologic examination revealed O-l/5 power of the wrist and finger extensor muscles of the right arm with reduced sensation in the radial aspects of the dorsum of the hand. The electromyography & nerve conduction test revealed incomplete right radial nerve injury above elbow level. During surgery, the patient was in the supine position, the right arm fully adducted to the lateral side of the trunk, and the left arm was 90 degree abducted from the trunk. The blood pressure cuff had been applied to the right upper arm and automated sequential blood pressure measurements performed every 5 minutes during the operation. Thirty minutes into the procedure, a Kent retractor had been applied, the side frame of which contacted the patients right upper arm. We hypothesize that firm pressure from the retractor frame against radial nerve where it passes superficially in the upper arm was responsible for the injury. No abnormalities in function of the automatic cuff were discovered. The patient was discharged 19 days after operation with partial recovery of the radial nerve palsy. Two months later the radial nerve palsy had completly resolved.