Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1993
[Neurolytic block of the lumbar sympathetic trunk in advanced stages of peripheral arterial occlusive disease].
Neurolytic blocks of the lumbar sympathetic trunk enable a less invasive sympathetic denervation if compared to standard surgical procedures. ⋯ Considering the relatively short follow-up period, the results of this study support evidence of the therapeutic efficacy of CLS for rest pain and ischaemic ulcers in patients with advanced arterial disease. The prognostic value of standard variables for estimation of sympathetic reactivity and skin blood flow, however, could not be confirmed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative effectiveness and tolerance study of a new galenic etomidate formula].
One of the major disadvantages of etomidate is the high frequency of pain on injection. A new galenic formulation based on a lipid emulsion for etomidate (Etomidat-Lipuro) was compared with the commercial standard (etomidate in propylene glycol, Hypnomidate) in a prospective, randomised, double-blind clinical evaluation in 232 patients undergoing elective surgery in general anaesthesia. The patients were premedicated with flunitrazepam 2 hours before the investigation. Two intravenous cannulas were inserted in veins of forearm or back of the hand. One cannula was only used for the application of etomidate and removed immediately after injection. General anaesthesia was induced with 0.3 mg/kg etomidate at an injection rate of 20 mg/30 s. If the patient did not complain of pain or other sensations during injection spontaneously, he was questioned for 15 s after beginning of injection. The arm used for application of etomidate was kept free of any manipulation during the operation and the following five postoperative days. ⋯ There were marked differences between the two etomidate preparations concerning venous irritation. About 20% of the patients receiving the hypnotic in propylene glycol complained spontaneously of pain on injection, whereas none with the lipid emulsion. No difference was found in the incidence of myoclonic movements. The time interval between the beginning of injection and loss of eyelid closure reflex was about 50 s and not different for the two galenic formulations. Blood pressure during and after induction of anaesthesia did not differ. The heart rate in the group of patients with etomidate in lipid emulsion was slightly increased before and immediately after intubation compared to the propylene glycol group. 4% of the patients in the propylene glycol group suffered from postoperative venous complications as reddening, swelling, induration or pain. These complications could not be seen in the lipid emulsion group.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1993
[Connector for double-lumen tubes in thoracic surgery interventions].
The junction between double-lumen endotracheal tube (DLT) and anaesthetic circuit is of crucial importance to modern anaesthesiological management in thoracic surgery. We present a connector which allows for all the essential procedures, such as clinical control of DLT position, use of fiberoptic bronchoscope (FOB) to control or correct DLT position, application of differential lung ventilation patterns or simple suction manoeuvres by easy handling, minimal interference, and avoidance of disconnection or clamping.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1993
Biography Historical Article[Heinrich Braun (1862-1934)--a pioneer in anesthesiology in Germany].
Heinrich Braun was born on January, 1, 1862. He attended school in Dresden and was a student of Medicine at the Universities of Strassburg, Greifswald and Leipzig between 1881 and 1887. In 1887 he acquired his doctorate degree. ⋯ Famous representatives of his school are Läwen, Peuckert, Kulenkampff, Härtel and Kappis. In Zwickau he extensively dealt with problems of hospital organisation and -construction. In 1921 the new "Krankenstift Zwickau" constructed on the basis of his plans and recommendations was inaugurated.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1993
Comparative Study[High purity ryanodine for in vitro diagnosis of malignant hyperthermia].
The identification of disposition for malignant hyperthermia (MH) is performed by the halothane-caffeine contracture test in skeletal muscle. However, testing currently renders about 14% of the patients MH equivocal (MHE). To reduce this number the "ryanodine contracture test" has been proposed in addition to the established procedure. As all ryanodine preparations used until now are combinations of ryanodine and dehydroryanodine, we investigate in this study the effects of the now available high-purity ryanodine (HPR) in concentrations of 2,5 and 10 mumol/l. ⋯ The ryanodine contracture test should be added to the current diagnostics of malignant hyperthermia.