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NEW BALANCED ANESTHESIA
New Balanced AnesthesiaProceedings of the First Congress of the Asian and Oceanic Society for Intravenous Anesthesia, Kyoto, Japan, 25-27 February 1998

Edited by
K. Mori, Kyoto University, Department of Anesthesia, Japan
A. Ohmura, Teikyo University School of Medicine, Department of Anesthesiology, University Hospital at Mizonokuchi, Kawasaki, Japan
H. Toyooka, Tsukuba University, Research Institute of Clinical Medicine, Department of Anesthesiology, Tsukuba, Japan
Y. Hatano, Wakayama Medical College, Department of Anesthesiology, Wakayama, Japan
K. Shingu, Kansai Medical University, Department of Anesthesiology, Osaka, Japan
K. Fukuda, Kyoto University Hospital, Department of Anesthesia, Kyoto, Japan

Included in series
International Congress, 1164

Description
International Congress Series 1164

This book proposes a New Balanced Anesthesia based on the molecule oriented pin-point targeted drugs. Recent advances in the neurosciences are heralding the advent of new neuroscience- and molecular and cellular biology-based drugs. The Asian and Oceanic Society for Intravenous Anesthesia (AOSIVA), established in 1996, invited lectures that were selected based on the concept of the historical developments of volatile anesthetics that are related to the adverse responses provoked by surgical insults.

Audience
Anesthesiologists, Pharmacologists.

Contents


Lectures.


President lecture.
Why TIVA now (K. Mori, H. Segawa).

Keynote lecture.
Do intravenous and inhalational anesthetics have the same molecular sites of action? (R.A. Harris).

Opioids
Pharmacokinetics and pharmacodynamics of remifentanil (C. Rosow). The effects of different concentration of fentanyl on maintenance, recovery and postoperative pain relief in propofol-fentanyl-N2O anesthesia (H.-Y. Kil).

Drug delivery and pharmacokinetics.
Target controlled infusions: Advance or gimmick? (S.L. Shafer). Anesthesia induction and recovery with predicted effect site concentration (T. Kazama).

Phosphodiesterase inhibitor.
Clinical implications of phosphodiesterase inhibitors in anesthesia (C.C. Hug, Jr.). The effects of milrinone on splanchnic blood flow and tissue oxygen metabolism after cardiopulmonary bypass (K. Yamaura et al.).

Muscle relaxants.
Steroidal neuromuscular blocking agents (J.M.K.H. Wierda). New insights: Benzylisoquinoline neuromuscular blocking drugs (J.J. Savarese).

Sedatives.
Monitored anesthesia care - Use of intravenous adjuvants (P.F. White). Effects of midazolam and ketamine on heart rate variability as an indicator of dynamics of cardiovascular system (T. Komatsu et al.). Power spectral analysis of heart rate variability during propofol sedation under spinal anesthesia (M. Kawamoto, S. Hidaka, O. Yuge). Propofol as a sedative drug during surgery (T. Kazama).

Symposia.


What really predicts "depth of anesthesia"?
Changing concept of depth of anesthesia (K. Suwa). What really predicts "depth of anesthesia"? - Bispectral index (P.S.A. Glass). Clinical signs and drug concentrations: What really predicts depth of anesthesia? (S.L. Shafer).

A role of alpha2 adrenoreceptor agonists in clinical anesthesia.
The role of alpha-2-adrenoceptor agonists in clinical anaesthesia: Clinical implications in anaesthesia practice (R.M. Grounds, Y.-M. Lam). A role of alpha-2 adrenoceptor agonist in clinical anesthesia: Spinal antinociception (S. Dohi). Interaction of α2 adrenoceptor agonists and various drugs (Y. Hayashi et al.).

International Forum.


Anesthesia Practice at the Turn of the Century - Current Status and Future Direction in A/O Countries.
From Seishu Hanaoka to sevofulrane and propofol (O. Yuge). Anesthesia in Thailand at the turn of the century (T. Tritrakarn). Intravenous anesthesia in Korea - Current status and future direction (S.-W. Baik). Anesthesia practice in the turn of the century, Hong Kong special administrative region, China (D.C. Chung). Anaesthesia practice in Taiwan (P.P.C. Tan). Anaesthetic practice at the turn of the century - Australia (D.P. Crankshaw). Anaesthesia practice at the turn of the century - Current status in Singapore and future directions in A/O countries (T.L. Lee).

Posters.


Intravenous anesthetics (clinical).
Clinical endpoints versus processed EEG variables during propofol – ketamine intravenous anesthesia (H. Singh et al.). Clinical endpoints versus processed EEG variables during propofol – fentanyl intravenous anesthesia (H. Singh et al.). Nitrous oxide attenuates the requirement dose of propofol for fentanyl-propofol anesthesia (M. Ozaki et al.). Propofol induced muscular relaxation in a patient of myasthenia gravis (S. Fukumoto et al.). Diazepam premedication does not attenuate coughing during spinal anesthesia sedated with propofol (S. Yamamoto, K. Motokawa, H. Toyooka). Effect of propofol on the incidence of postoperative emesis after minor orthopedic surgery (S.I. Kim, S.C. Kim). Slow vs rapid infusion of propofol for induction: Haemodynamic changes and the effect of fentanyl on induction dose of propofol (S. Kiyama, T. Yoshikawa). The cardiovascular responses and recovery patterns according to the anesthetic methods during laryngoscopic microsurgery (J.H. Song, S.W. Shin, S.W. Baik). Effects of anesthetics on cerebral blood flow in Moyamoya disease: Comparison between total intravenous and inhalational anesthesia (K. Sato et al.). Not only clonidine but also midazolam as premedications provides the better conditions for insertion of the laryngeal mask airway wtih propofol (M. Kodaka et al.). Effects of pneumoperitoneum on cardiac autonomic nervous activity evaluated by heart rate variability analysis during propofol anesthesia (N. Sato et al.). Power spectral density and correlation dimension of heart rate variability during propofol-fentanyl anesthesia in cardiac surgery (N. Kimura, T. Komatsu, Y. Shimada). Propofol can provoke the intrinsic epileptogenicity in the patient with cortical dysplasia (D.-C. Kim et al.). The effect of propofol on the electrocorticogram (ECoG) in the patients with intractable epilepsy (D.-C. Kim et al.). Prediction of "conscious" sedation using the spectral edge frequency 90% during propofol/epidural anesthesia (T. Yamashiro et al.). The processed EEG during cardiac surgery. A comparison of propofol/fentanyl and isoflurane/fentanyl anesthesia (T.L. Kobayashi et al.). Bispectral index (BIS) guided propofol and low dose fentanyl anesthesia for cardiac surgery (M. Kosaka et al.). The effects of the changes in PaCO2 on bispectral index, 95% spectral edge frequency and median frequency during propofol + fentanyl intravenous anesthesia (T. Sakai et al.). Correlation between bispectral index and blood propofol concentration during recovery from anesthesia (S. Fujioka et al.). Effects of propofol anesthesia on the bilateral intracerebral oxygen saturation and on the hemoglobin index. Comparison with awake volunteers (Y. Kasuya, S. Dohi). New technique for sedation with propofol prior to performing spinal anesthesia (K. Torigoe et al.). High spinal anesthesia increases the sensitivity to the soporific effects of propofol in humans (J. Kurata et al.). Propofol sedation during spinal anesthesia (Y. Shibazaki, H. Nasuhara, K. Yokoyama). Sedative effect and plasma concentration of propofol on spinal anesthesia (S. Iwahata et al.). Propofol sedation for fiberoptic bronchoscopy in intensive care unit (N. Uetsuki et al.). Comparative evaluation of TIVA with propofol-fentanyl and thiopental-sevoflurane anesthesia using laryngeal mask airway for diagnostic bronchoscopy (S. Yamaguchi et al.). Propofol anesthesia in pediatric patients undergoing cardiac catheterization (M. Miura et al.). General anesthesia with propofol and fentanyl for adult cardiac surgery (M. Sugahara et al.). Peripheral vascular dilatation by propofol during cardiac surgery (S. Hidaka et al.). Retrospective comparison of propofol-fentanyl with midazolam-fentanyl in open heart surgery (S. Kaneko et al.). Propofol infusion provides excellent sedation in postoperative cardiac patients (H. Yoshida et al.). Outcome of the long-term sedation by intravenous anesthetics in 9 cases with severe tetanus (M. Nakashima, T. Totoki). Clinical experiment of total intravenous anesthesia with propofol-ketamine for obstetric ambulatory surgery (C. Ho et al.). Additional dose of thiamylal versus propofol: A comparison of circulatory changes at the time of the induction and endotracheal intubation (M. Igarashi et al.). A simple induction technique for total intravenous anesthesia (TIVA) with relatively low doses of propofol, ketamine and fentanyl (N. Kanamitsu, T. Ochiai). Propofol and vecuronium for crash induction (N. Matsuda, T. Mayumi, O. Kemmotsu). Effect of lidocaine mixture on propofol-induced pain on injection and induction (H.-W. Lee et al.). Reduction of pain on injection of propofol: A comparison of fentanyl with lidocaine (R. Naganuma et al.). Prevention of injection pain by prior continuous infusion of low-dose propofol (H. Terada, S. Ohta, T. Nishikawa). Injection pain with propofol: The effectiveness of thiopentone on induction (Y.I. Cheng et al.). Effects of premedicated oral midazolam on propofol requirement and on cardiovascular changes during propofol anesthesia (A. Yoshino et al.). Euphoria in propofol-ketamine technique - Two cases report (C. Ho et al.). Antegrade amnesia after propofol and isoflurane anesthesia (K. Ono, K. Maeshima, Y. Nishimura). Perioperative mood alterations and dreaming: Propofol versus sevoflurane-nitrous oxide (K. Mukaida et al.). The effect of dose of propofol on the emergence time from general anesthesia (N. Kobayashi et al.). A review of prolonged emergence under total intravenous anesthesia (TIVA) with propofol infusion - 25 cases in ASA grade I and II patients (H. Sato et al.). Evaluation of total intravenous anesthesia (TIVA) versus inhalation anesthesia (IA) in mastectomy (S. Tamagawa, K. Harada, T. Ozawa). Total intravenous anesthesia in a patient with chronic nephritis and dilated cardiomyopathy undergoing gastrectomy (S. Amagasa et al.). Propofol anesthesia for awake craniotomy (S. Oku et al.). Middle ear pressure variations during total intravenous anesthesia with propofol, fentanyl and ketamine (T. Kubota et al.). Comparison of propofol and sevoflurane anesthesia in pediatric patients - Plasma glutathione S-transferase as a sensitive index of hepatocellular integrity (A. Mizushima, Y. Kawauchi, T. Kugimiya). TIVA, a portable anaesthetic technique for remote mountainous terrain (P.P. Joshi). Anesthesia for pediatric herniotomy or hydroceletomy: Comparison of propofol/ketamine and thiopentone/halothane (C.S. Tang et al.). How propofol was accepted for total intravenous anesthesia in a city hospital in Japan? - Analysis of the early period (S. Fukumoto et al.). Effect of combined epidural and general anesthesia with propofol or sevoflurane on interleukin-6 and E-selectin levels in patients during hysterectomy (A. Mizutani et al.). The electroencephalographic changes upon tetanic electric stimulation during propofol anesthesia with and without nitrous oxide (T. Inada et al.). Intravenous anesthetics (experimental). Intravenous anesthetics affect signaling downstream of GABAA receptors in growth cones (H. Fukura et al.). Neuroprotective action of I.V. anesthetics on brain ischemia induced cell injury in mongolian gerbil: Related to GABA receptor subtypes (H. Ito et al.). Single injection of haloperidol increases the activity and phosphorylation of the rate-limiting enzyme for catecholamine (CA)-biosynthesis in rat brain (K. Harada, T. Kashimoto, R. Wakusawa). Attenuation of the baroreflex sensitivity by propofol infusion: Comparison with sevoflurane (M. Ogawa et al.). The effects of intravenous propofol on somato-sympathetic reflex potentials (S. Saeki et al.). The effect of intravenous anesthetics and volatile anesthetics on fatigue-induced change of hamster diaphragmatic contractility (T. Kagawa et al.). Effects of thiamylal on receptor-operated Ca2+ channels in rat aorta (V.H. Vinh, T. Enoki, K. Mori). Vasodilating actions of propofol in the isolated pulmonary arteries of rats (H. Tanaka, O. Yuge). Vasoconstrictive properties of propofol on the human venous smooth muscle (M. Kawanishi, H. Akita, K. Onoue). Enhancement of platelet aggregability by thiopental is due to increased intracellular Ca2+ concentration and consequent activation of phospholipase A2 (R. Kitamura et al.). Inhibition of catecholamine biosynthesis in cultured neuronal cell lines by propofol (R. Saito et al.). The anesthetic efficacy of propofol in the sevoflurane anesthetized rats (Y. Fujii, Y. Ishizawa, S. Dohi). Propofol inhibits KCl-induced activation of mitogen-activated protein kinases in PC12 cells (M. Kansha, K. Irita, S. Takahashi). Anticonvulsant actions of intravenous anesthetics on the bicuculline-induced seizure model in rats (H. Matsumoto, K. Mura, K. Shingu). Effects of intravenous anesthetics on in vivo release of acetylcholine in the rat cerebral cortex (T. Shichino et al.). Effects of pentobarbital, propofol and ketamine on acetylcholine release from the rat frontal cortex, hippocampus and striatum (T. Kikuchi et al.). Propofol anesthesia increases dopamine and serotonin activities at the somatosensory cortex in rats: A microdialysis study (M.-H. Shyr, P.P.C. Tan). Formalin-induced activity in the spinal dorsal horn of the transected cat: Differences in responses to intravenous thiamylal administered before and after formalin (Y. Mizumoto et al.). Propofol inhibits ketamine-induced c-Fos expression in the rat cingulate cortex (S. Nakao et al.). The correlation between intravenous anaesthetics attenuating ischaemic neuronal damage and their actions on NMDA receptors in rat hippocampus in vitro (R.-Z. Zhan et al.). Inhibitory effects of ketamine and barbiturates on isolated rabbit lower esophageal sphincter (A. Kohjitani et al.). Ketamine alters sleep in rabbits (S. Takahashi et al.). Reduced ketamine sensitivities in mice lacking NMDA receptor g1 subunit (T. Yamakura, K. Sakimura, K. Shimoji).

Muscle relaxants.
The neuromuscular effects of mivacurium in adults wBh priming technique during nBrous oxide-fentanyl anesthesia: A randomized comparative study wBh succinylcholine (Y.C. Chu et al.). The mechanism of fading responses induced by non-depolarizing muscle relaxants in cat's evoked EMG (.T. Suzuki et al.). Neuromuscular blocking action of the aminoglycoside antibiotics in the rabbit (Y. Hashimoto et al.). Weak muscle relaxants are faster in their onset: Analysis in a transfer and chemical equilibration model (K. Suwa et al.). Action duration of atracurium in the elderly patients (Y.M. Lee et al.). Action duration of atracurium and vecuronium in patients with renal failure (H.S. Yang et al.). Maintenance of the muscle relaxation after edrophonium administration during coronary artery bypass graft surgery (Y. Masuda et al.). The effects of peritoneal CO2 on neuromuscular blockades and pharmacokinetics of vecuronium during laparoscopic cholecystectomy (M. Kuwahara et al.). Long-term use of pipecuronium in esophagectomy patients (T. Aoki et al.). Monitoring of neuromuscular blockade on foot: Comparison between tibial and deep peroneal nerves (K. Suzuki et al.). Effect of atracurium in thymectomy for myasthenia gravis (J.A. Lim et al.). Neuromuscular effects of propofol in a patient with myasthenia gravis (T. Ikemoto et al.). Response of muscle tension to propofol in patients with myasthenia gravis (H. Hino et al.). Propofol potentiates the neuromuscular blocking effect of mivacurium in the rat hemidiaphragm (T.G. Ryu et al.). Vecuronium infusion rate required to maintain surgical muscle relaxation: Comparison between propofol/N2O and isoflurane/N2O anesthesia (O. Nagata et al.).

Analgesics and local anesthetics.
Quality assurance of improvement of patient's pain relief and workload reduction of medical persons with postoperative intravenous patient-controlled analgesia assessed by questionnaire (Y.-S. Oh et al.). Clonidine premedication enhances pressor response to ephedrine in patients anesthetized with propofol (Y. Fujii et al.). Effects of oral clonidine premedication on side effects of intravenous ketamine (F. Handa et al.). Na+ pump inhibitor potentiates spinal antinociception with clonidine in rats (W.A. Zeng et al.). The effects of dexmedetomidine on central nervous system electrical activity and seizure threshold in cats (Y. Miyazaki et al.). Fentanyl promotes survival of serum-deprived PC12 cells by :-opioid receptor-mediated mechanism (M. Yoshikawa et al.). Adaptive cellular responses induced by chronic agonist treatment of the nociceptin receptor-expressing Chinese hamster ovary cells (T. Shoda et al.). Respiratory and cardiovascular effects of fentanyl during propofol-induced sedation under regional anesthesia (S. Tanaka et al.). Cough response of fentanyl bolus administered through a peripheral venous catheter (J.Y. Hong et al.). The postoperative outcome comparison of coronary artery bypass grafting using two different postoperative pain control methods (Y.-S. Tsai, W.-M. Ho). PONV after ketorolac versus fentanyl in patients undergoing minor gynecologic laparoscopy (M.T.V. Chan et al.). Supplementary anesthesia to propofol during induction and endotracheal intubation - Fentanyl vs. nitrous oxide/sevoflurane (H. Tsuchida et al.). The effects of preemptive epidural anesthesia and postoperative analgesia on immunomodulation and neuroendocrine response in stomach cancer surgery (T.H. Han et al.). Rectal absorption of morphine using a hollow-type suppository (Y. Matsumoto et al.). Comparison of epidural administration technique of local anesthetics for stable patient circulatory management (K. Onoue, H. Akita, M. Kawanishi). The efficacy of adding morphine to bupivacaine in dorsal penile nerve block for post-circumcision analgesia (K.H. Leung et al.). High dose fentanyl anesthesia and laparoscopic resection of pheochromocytoma (M. Nakano, S. Yokono, K. Ogli). Reemptive analgesia with epidural and intravenous ketamine in combination with epidural blockade in abdominal surgery (S. Aida, K. Shimoji).

Cardiovascular drugs.
The hemodynamic effects of adding ephedrine to propofol and alfentanil during induction and intubation (M.Y.-H. Chow et al.). Effect of clonidine on heart rate variability in children (Y. Kimura, M. Ishida, H. Obara). Comparison of three phosphodiesterase (PDE) III inhibitors for hemodynamics in patients with heart failure by acute myocardial infarction (H. Kita et al.). Continuous infusion of synthetic atrial natriuretic peptide for the management of urine output in open heart surgery of children (Y. Kimoto, T. Kakutani, Y. Hatano). Continuous infusion of low dose synthetic atrial natriuretic peptide provides sufficient urine output during thoracic surgery (T. Kakutani et al.). The vasorelaxant response to amrinone in aortic and pulmonary arterial strips isolated from newborn rabbits (M. Mori, S. Hassan, H. Obara). Endothelin systems in porcine pulmonary vasculature: Evidence for autocrine and/or paracrine regulation (C. Sakihara, S. Takahashi). Lidocaine reduces the oxidants-provoked cytotoxicity in endothelial cells by inhibiting calcium influx, but not by scavenging oxygen free radicals (T. Az-ma, N. Saeki, O. Yuge). The effect of the various agents related to anesthesia on the Ca-induced Ca release of the sarcoplasmic reticulum in the skinned skeletal muscle from the guinea pig (J. Sasaki et al.).

Infusion technology and pharmacokinetics.
Spectral edge frequency of the processed EEG to monitor the depth of anesthesia in target controlled propofol infusion (T. Wagatsuma et al.). Midazolam pharmacokinetics in patients undergoing lung surgery (S.I. Lee et al.). Whole blood propofol concentrations during epidural/propofol anesthesia at a propofol infusion rate of 5mg/kg/hr after Roberts' step-down infusion (K. Moriwaki et al.). Change in plasma concentration of propofol during cardiac surgery (T. Nishida, Y. Kaminoh, C. Tashiro) Can the lean body mass be a factor of the pharmacokinetics of propofol? (N. Tanaka et al.). Experience of target-controlled infusion using propofol in Japan (N. Takahashi, Y. Kinefuchi, M. Takiguchi). Development of a three-pump computer-controlled-infusion system for total intravenous anesthesia with propofol, fentanyl, and vecuronium (O. Nagata et al.).

Index of authors.


Bibliographic & ordering Information
Hardbound, 402 pages, publication date: SEP-1998
ISBN-13: 978-0-444-50009-0
ISBN-10: 0-444-50009-X
Imprint: EXCERPTA MEDICA
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