Journal of clinical anesthesia
-
As of 1991, intensive care medicine in Germany is not an independent medical specialty but a part of other main medical specialities such as anesthesiology, internal medicine, surgery, and pediatrics. Accordingly, there is neither formal training nor a separate board examination in intensive care medicine. ⋯ Surgical (or operative) ICUs predominantly are operated by anesthesiology departments, as anesthesiologists' expertise in respiratory and hemodynamic support qualifies them for the management of the critically ill patient in the perioperative phase. This article gives a brief review of the development of intensive care medicine in Germany, thereby providing the historical background for its present national and regional organization, facilities, and education and training programs.
-
We describe a patient with the hypokalemic type of familial periodic paralysis (FPP) who received atracurium for muscle relaxation as required for diagnostic laparoscopy. Electrocardiographic (EKG) T-wave changes suggestive of hypokalemia were not supported by blood determinations. ⋯ At the conclusion of the surgical procedure, no reversal to the muscle relaxant was needed or given. The patient regained preoperative muscle strength, and her postoperative course was uneventful.
-
Randomized Controlled Trial Comparative Study Clinical Trial
The effectiveness of oral clonidine as a sedative/anxiolytic and as a drug to blunt the hemodynamic responses to laryngoscopy.
To determine the effects of oral clonidine premedication on sedative, anxiolytic, and hemodynamic responses during the immediate preoperative period, laryngoscopy/intubation, and postanesthetic recovery. ⋯ Oral clonidine 0.2 mg was effective in reducing the level of behavioral and hemodynamic responses preoperatively and in blunting systolic hypertension produced by prolonged laryngoscopy.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain management and respiratory depression after thoracotomy: a comparison of intramuscular piritramide and intravenous patient-controlled analgesia using fentanyl or buprenorphine.
To compare the analgesic efficacy of fentanyl, buprenorphine, and piritramide and to define the respiratory risk during conventional postoperative pain management and patient-controlled analgesia (PCA). ⋯ Opioid-induced respiratory depression occurred infrequently during postoperative pain management whether by conventional means or using PCA, even though high doses of opioid analgesics were required intermittently for adequate postoperative pain relief by either technique.