Download e-book for kindle: Anesthetic Management of Endocrine Disease by Tsutomu Oyama M. D. (auth.)

By Tsutomu Oyama M. D. (auth.)

ISBN-10: 3540061819

ISBN-13: 9783540061816

ISBN-10: 3642655610

ISBN-13: 9783642655616

Endocrinology is a speedily constructing box with many new ideas. additionally, many new hormones were defined considering that 1960. The structural research and synthesis of numerous intestinal hormones corresponding to gastrin, secretin, glucagon and cholecystokinin were completed. a number of hypothalamic hormones controlling pituitary functionality were pointed out and often times synthesized. The life of hormonal peptides se­ creted from ectopic websites has been well-known. the improvement of latest thoughts of hormone assay has inspired reviews at the results of anesthetics at the endocrine procedure. even if the endocrine reaction to anesthesia is below its reaction to significant surgeries, the results of anesthesia on metabolism and at the autonomie fearful method are colossal. the first function of this e-book is to extend the protection of sufferers present process anesthesia by means of making to be had the newest advancements during this box. the foremost matters tested within the publication are endocrine responses to anesthesia and surgical procedure, the consequences of endocrine illness on anesthesia and sur­ gery, and pre-operative and post-operative administration of sufferers with endocrine disorder. The e-book is designed for college kids, citizens and practising physicians within the box of anesthesia and surgical procedure. Many tables and figures are empIoyed to enhance the presentation, particuIarly these with regards to pharmacology and to the sensible points of therapy.

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For induction, meperidine (5 %) 120 mg (50-250 mg) was administered intravenously supplemented with N 20 and 02' Subsequent doses of meperidine (25 mg) were injected intnvenously when needed, and an average total of 336 mg (120-615 mg) was used. HAN and BRowN [29] found that anesthetic doses of meperidine supplemented by nitrous oxide inhibited the adrenocortical response to operation. 3 Jlg/l00 ml). No further rise occurred during anesthesia alone or during the operation. But these data were not analysed statistically, and with surgieal intervention h'llf of the patients showed marked increase in the plasma cortisollevels.

B) Preoperative Preparation The preoperative preparation depends upon the nature of the condition for which hypophysectomy is being performed. Endocrinologic preparation is necessary in additon to the general preoperative evaluation and preparation for craniotomy [13, 29]. 1. Patients must be informed that they will have to take a corticosteroid preparation for the rest of their lives. Mention should also be made that, although they will recover from the effects of the craniotomy within a few days, they may suffer postoperatively from polyuria and excessive thirst which might last for an unknown length of time.

For induction hydroxydione (1 %) 500-1000 mg is injected intravenously in man, taking 10-15 min to complete the induction. It is given also by intravenous infusion (150 drops/min). This takes about 15-20 min for induction. The agent has several dis advantages - the dose is large, induction of anesthesia and recovery are slow, and it produces a high incidence of thrombophlebitis in the injected veins (ROBERTSON et al. [39], HOWLAND [16], GORDON [13], TAYLOR [36], STEDTFELD [33]). The tidal volume decreases during induction by approximately 30% (BRYCE-SMITH [37]).

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Anesthetic Management of Endocrine Disease by Tsutomu Oyama M. D. (auth.)

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