title: [Epidural anesthesia with high dose fentanyl for thoracic surgeries].
abstract: Twenty-two elective thoracic surgeries were performed under epidural high dose fentanyl anesthesia. These included 11 mastectomies, 3 lung lobectomies, and 8 operations for esophageal carcinoma. Through an epidural catheter, 10 micrograms.kg-1 fentanyl with [E (+)] or without [E (-)] epinephrine (1: 100,000) was given. N2O (66%) and enflurane (0.2-0.8%) were also administered, and muscle relaxants were given as needed. The onset and duration of the action were approximately 20 minutes and 3 hours, respectively. Anesthesia was maintained with enflurane (up to 0.4%) in 17 patients (77.3%). There were no differences between the E (+) group and the E (-) group. Systolic pressure, diastolic pressure and heart rate during operations were about 30% lower than those observed before the operations. Patients recovered from anesthesia rapidly. Naloxone was administered intravenously in 6 patients after mastectomies or lung lobectomies (42.9%), whose respiratory rate was below 10.min-1. The patients with short operating time (shorter than 2 hours) needed more naloxone. Troubles did not occur either in the recovery room or in the ward with both naloxone and non-naloxone groups.
authors.affiliation: Department of Anesthesiology, Yamanashi Medical College.
authors.forename: T
authors.initials: T
authors.lastname: Matsukawa
authors.forename: T
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: T
authors.initials: T
authors.lastname: Kumazawa
authors.forename: M
authors.initials: M
authors.lastname: Manabe
authors.forename: T
authors.initials: T
authors.lastname: Oguchi
authors.forename: M
authors.initials: M
authors.lastname: Kume
authors.forename: A
authors.initials: A
authors.lastname: Nonaka
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
authors.forename: K
authors.initials: K
authors.lastname: Hanagata
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000379:methods*; D004938:Esophageal Neoplasms / Q000601:surgery; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D011013:Pneumonectomy; D013903:Thoracic Surgery
chemical_list: D005283:Fentanyl