Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1995
The influence of the double burst stimulation (DBS) pattern on the DBS-train-of-four ratio relationship.
The double-burst-stimulation (DBS) is a new stimulation pattern developed to facilitate tactile evaluation of residual neuromuscular blockade. DBS consists of two bursts of high frequency stimulations separated by a short time interval. ⋯ At any chosen level of reversal defined by a TOF ratio, it should therefore be possible to construct a DBS ratio, where fade just can be detected by tactile evaluation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1995
Review[Cardiovascular morbidity and anesthesia].
One of every four persons in the Western industrialised nations has cardiovascular disease. The perioperative setting in those patients is associated with the risk of myocardial ischaemia (PMI) and myocardial infarction, and also with the risk of perioperative stroke and dysfunction of the central nervous system (CNS). Perioperative cardiovascular morbidity represents a major healthcare challenge. ⋯ In fact, only one recent study has established that perioperative stroke is preventable with the use of an adenosine-regulating agent. Thus, it appears that it may be possible to prevent stroke, even though these results require confirmation. Because of the aging of our population, and the medical, financial and social impact of cardiovascular disease, the development of anti-ischaemic therapy, particularly in the surgical patient, will be a critical area of medical research for the next several decades.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1995
Randomized Controlled Trial Clinical Trial[Stellate ganglion block with transcutaneous electric nerve stimulation (TENS): a double-blind study with healthy probands].
Blockade of the stellate ganglion is an established and highly effective diagnostic and therapeutic procedure for management of certain acute and chronic pain syndromes or other disorders. The paratracheal injection of a local anaesthetic is the simplest and most frequently used approach for blocking the cervicothoracic sympathetic nerves (ganglion stellate). However, since serious complications can occur during or following the anterior paratracheal technique including accidental intravenous or intraarterial injection, non-invasive methods for blockade of the stellate ganglion have been suggested. In 1980 Jenkner (15) reported the successful interruption of the sympathetic outflow from the stellate ganglion together with the relief of pain by transcutaneous electrical nerve stimulation (TENS), followed by the development of an "optimal wave form" in 1981 (14). Since we were unable to reproduce Jenkner's results of sympathetic blockade in our patients, this study was designed to investigate the effects of TENS on the sympathetic activity of the stellate ganglion in healthy volunteers. ⋯ No signs and symptoms of sympathetic blockade could be demonstrated in any of the groups, neither by TENS of the stellate ganglion as described by Jenkner nor by unspecific TENS. Thus, pain relief by TENS of the stellate ganglion as reported in the literature must involve other mechanisms than sympathetic blockade. In addition, TENS may not replace traditional blockade of the stellate ganglion by local anesthetics, if sympathetic blockade is required for diagnostic and therapeutic purposes.