ABSTRACT
Thirty two patients undergoing cardiac thoracic surgery were randomly assigned into two groups: Patients of the first group received high dose fentanyl (50 micrograms/kg) at the induction and patients of the second group received halothane for the maintenance of anesthesia. All patients received N2O:O2 and pancuronium for muscle relaxation. Surgical stress, as evaluated by changes in blood pressure, heart rate, plasma cortisol and glucose levels, appeared in the halothane group but not in the fentanyl group. Postoperative respiratory depression was expressed usually by mild elevation of pCO2 in the fentanyl group. Nevertheless two of these patients presented hypoventilation requiring intubation and naloxone administration. High dose fentanyl anesthesia may prove to be very useful in non cardiac thoracic surgery as it protects the patient from the stress of the operation and assures prolonged postoperative analgesia. When this technique is used one must always anticipate postoperative mechanical ventilation.
Subject(s)
Anesthesia, General , Fentanyl/administration & dosage , Halothane/pharmacology , Hydrocortisone/blood , Thoracic Surgery , Adolescent , Adult , Aged , Anesthesia, Inhalation , Blood Glucose/analysis , Blood Pressure/drug effects , Carbon Dioxide/blood , Clinical Trials as Topic , Fentanyl/pharmacology , Heart Rate/drug effects , Humans , Middle Aged , Oxygen/blood , Random AllocationABSTRACT
A total of 128 patients were examined using three tumor localizing agents, 99mTc-citrate, 111In-bleomycin and 67Ga-citrate. All these patients had clinical symptoms of pulmonary disease and chest x-rays. Twenty-two patients were excluded from the original number. From the 106 remaining patients, 14 were benign cases and 92 malignant. A scan with a gamma-camera was performed 3 to 4 h following an intravenous injection of 15 mCi of 99mTc-citrate. Upon completion of this examination, the patient was given 2.5 mCi of 67Ga-citrate and 72 h later, scans were obtained using a 5in. rectilinear scanner. Fifteen days later 2.5 mCi of 111In-bleomycin was given and a similar examination to that of gallium was performed. In evaluating benign lesions, 99mTc-citrate gave no false positive results, while 111In-bleomycin gave 5% and 67Ga-citrate 20%. In the case of malignant lesions, 67Ga-citrate gave 79% true positive diagnosis, 111In-bleomycin 65% and 99Tc-citrate (of 57 evaluated patients) 46%.