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Medical economics affected by anesthetic methods in liver surgery from the points of view of hepatic hypoxia and bacterial infection.

Research Project

Project/Area Number 16591571
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Anesthesiology/Resuscitation studies
Research InstitutionFujita Health University

Principal Investigator

KAINUMA Motoshi  Fujita Health University, School of Medicine, Professor, 医学部, 教授 (90135335)

Co-Investigator(Kenkyū-buntansha) KAWASE Kyo  Fujita Health University, School of Medicine, Assistant, 医学部, 助手 (30322548)
Project Period (FY) 2004 – 2005
Project Status Completed (Fiscal Year 2005)
Budget Amount *help
¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 2005: ¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 2004: ¥1,600,000 (Direct Cost: ¥1,600,000)
Keywordsamesthetic method / hepatic hypoxia / hepatic venous oxygen saturation / epidural anesthesia / general anesthesia / post operative hospital day / medical economics / bacterial infection / 肝静脈血酸素飽和度 / PCR / 細菌DNA / フェンタニール麻酔
Research Abstract

We anesthetized 90 patients undergoing liver surgery. Anesthetic method was general anesthesia with (46 patients) or without (44 patients) epidural anesthesia using ropivacaine. In patients with epidural anesthesia, mean postoperative hospital days were 41 days in 38 patients anesthetized with nitours oxide, isoflurane and ropivacaine, 37.0 days hi 4 patients with isoflurane and ropivacine, 34.0 days in 3 patients with nitrous oxide, sevoflurane and ropivacaine, and 28.0 days in one patients with sevoflurane and ropiovacaine. In patients without epidural anesthesia, mean postoperative hospital days were 64.3 days in 36 patients anesthetized with nitours oxide, isoflurane and fentanyl, 29.5 days in 4 patients with nitrous oxide, sevoflurane and fentanyl, 48.3 days in 3 patients with isoflurane and fentanyl, and 26.0 days in one patients with nitrous oxide and isoflurane. There was no statistical difference in mean postoperative hospital days among anesthetic methods. However, there was a tendency of shortening in mean postoperative hospital days in patients with epidural anesthesia.
There were also no differences in hepatic hypoxic insult by monitoring hepatic venous hemoglobin oxygen saturation among anesthetic methods.
We made a model to detect bacterial DNA by PCR in the laboratory level, however, found several disadvantages in clinical application. There were also no differences in the frequency of postoperative infection anesthetic methods, however there remains to be the establishment of PCR method for early detection of bacterial DNA in the future.
In conclusion, There was no statistical difference in mean postoperative hospital days among anesthetic methods. However, there was a tendency of shortening in mean postoperative hospital days in patients with epidural anesthesia. Epidual anesthesia together with general anesthesia has possibly some advantages of reducing medical cost, comparing with general anesthesia alone in liver surgery.

Report

(3 results)
  • 2005 Annual Research Report   Final Research Report Summary
  • 2004 Annual Research Report
  • Research Products

    (10 results)

All 2006 2004

All Journal Article (7 results) Book (3 results)

  • [Journal Article] Appleby手術における肝静脈酸素飽和度モニタリングの決定的役割2004

    • Author(s)
      貝沼関志
    • Journal Title

      日本臨床麻酔学会雑誌 24・9

      Pages: 424-431

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 腹部手術における血清Glutathione-S-Transferase (GST-α) と肝静脈酸素飽和度の相関に関する研究2004

    • Author(s)
      大原義隆, 貝沼関志, 竹田 清
    • Journal Title

      藤田学園医学会誌 28・1

      Pages: 29-35

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] An pivotal role of hepatic vanous hemoglobin oxygen saturation monitoring in anesthetic management during an Appleby operation.2004

    • Author(s)
      Motoshi Kainuma, M.D.
    • Journal Title

      The journal of Japan Society for Clinical Anesthesia 24-9

      Pages: 424-431

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] The relationship between Glutathione-S=Transferase and hepatic venous hemoglobin oxygen saturation in the abdominal surgery.2004

    • Author(s)
      Ohara Y, Kainuma M, Takeda K
    • Journal Title

      Bulletin of The Fujita Medical Society 28-1

      Pages: 29-35

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Hepatic venous catheter, monitoring2004

    • Author(s)
      Motoshi Kainuma
    • Journal Title

      Clinical Practice of Anesthesia

      Pages: 235-237

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Appleby手術の麻酔における肝静脈血酸素飽和度モニタリングの決定的役割2004

    • Author(s)
      貝沼 関志
    • Journal Title

      日本臨床麻酔学会雑誌 24・9

      Pages: 424-431

    • NAID

      10014043477

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 腹部手術における血清Glutathione-S-Transferase(GST-α)と肝静脈血酸素飽和度の相関に関する研究2004

    • Author(s)
      大原義隆, 貝沼関志, 竹田 清
    • Journal Title

      藤田学園医学会誌 28・1

      Pages: 29-35

    • Related Report
      2004 Annual Research Report
  • [Book] 麻酔と腎機能、専門医のための麻酔科学レビュー2006,2006

    • Author(s)
      貝沼関志
    • Publisher
      総合医学社
    • Related Report
      2005 Annual Research Report
  • [Book] 麻酔科診療プラクティス第13巻 モニタリングのすべて、肝静脈カテーテル2004

    • Author(s)
      貝沼関志
    • Publisher
      文光堂
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Book] 麻酔診療プラクティス第13巻 モニタリングのすべて 肝静脈カテーテル2004

    • Author(s)
      貝沼 関志
    • Publisher
      文光堂
    • Related Report
      2004 Annual Research Report

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Published: 2004-04-01   Modified: 2016-04-21  

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