Takashi Kobayashi

Publications (2)0 Total impact

• Article: [Case of traumatically bleeding shock patient rescued by using an aortic occlusion balloon catheter during surgery].

  Takashi Kobayashi, Hirofumi Nagata, Masahiro Kojika, Yasushi Suzuki, Nobuhiro Satoh, Kenji Suzuki
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  ABSTRACT: A 55-year-old (163 cm, 70 kg) man with traumatic intra-abdominal bleeding underwent emergency operation. The patient was in a state of hemorrhagic shock with 82 mmHg of systolic blood pressure (SBP) at hospital arrival. His condition became severer within about 1 hr, and tracheal intubation and mechanical ventilation were consequently started in the ambulatory emergency room. SBP decreased to 60 mmHg when he was transferred to the operating room. Anesthesia was induced with intravenous fentanyl and vecuronium, and was maintained with inhalation of sevoflurane in 50% oxygen. After laparotomy, it was impossible to detect the bleeding source because of a large quantity of hemorrhage. To reduce the blood loss, aortic occlusion balloon catheter (AOBC) was inserted into the upper abdominal aorta via the right femoral artery. Aortic occlusion was performed twice each for twenty minutes. The evelation of SBP and decrease of bleeding dose were secured by aortic occlusion. Thereby the source of bleeding could be detected and surgical procedure could be finished with survival of the patient. The insertion of AOBC for the surgical patient with intra-abdominal hemorrhagic shock may be advantageous for uncontrollable bleeding.
  Masui. The Japanese journal of anesthesiology 09/2006; 55(8):1011-3.
• Article: [Changes in cardio-pulmonary function during laparoscopic colectomy and postoperative quality of life--comparison with laparotomy].

  Takashi Kobayashi, Hirofumi Nagata, Mamoru Kadosaki, Kouki Ohtsuka
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  ABSTRACT: We investigated whether laparoscopic colectomy would affect the degree of respiratory and circulatory changes during surgery and could improve postoperative quality of life (QOL) as compared with laparotomy. Fifty-one patients (ASA 1-3) scheduled for elective colectomy under general anesthesia with epidural anesthesia were enrolled in the study. All patients were divided into two groups (laparoscopic group: n = 33 and laparotomy group: n = 18) by surgical indication. Respiratory functions and hemodynamic changes were measured during surgery. Postoperative complications, pain scores, the time to start of walking and the period of hospital stay were examined. The serum concentrations of inflammatory cytokines (IL-6, IL-1 ra) and KL-6 were measured perioperatively. It was demonstrated that pneumoperitoneum and postural tilt had a bad influence on respiratory functions especially on pulmonary compliance and a-ET(D)co2 in laparoscopic group. The serum concentrations of inflammatory cytokines were significantly lower and the number of rescue for postoperative pain were less in laparoscopic group. The patients in laparoscopic group could begin to walk and leave hospital earlier after surgery. Severe complication did not occurr in both groups during the perioperative period. Laparoscopic surgery could improve postoperative QOL.
  Masui. The Japanese journal of anesthesiology 06/2006; 55(5):579-89.