Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1996
Randomized Controlled Trial Clinical Trial[Changes in coagulation physiology and rheology after preoperative normovolemic hemodilution].
In a prospective randomised controlled trial the effect of preoperative normovolaemic haemodilution on coagulation, plasma viscosity and plasma protein levels was examined. ⋯ Haemodilution induced decreases in plasma coagulation, platelet count and plasma proteins did not cause any functional impairement and may just reflect dilution of these parameters. It seems that infusion of 6% hydroxyethyl starch 200/0.5 in an amount of 10-20 ml/kgKM/d does not result in a relevant decrease in coagulation parameters.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1996
Case Reports[N2O-induced acute funicular myelosis in latent vitamin B 12 deficiency].
The neurotoxicity of nitrous oxide ("laughing gas") had already been observed in 1956 when using N2O in the long-term sedation of tetanus patients. In 1967 Parbrook described leukopenic effects during long-term exposure to N2O. It was only in 1978 that further studies were conducted on myeloneuropathies and myelodepression under the influence of N2O. ⋯ Two observations must be emphasised when assessing the 10 patients mentioned above: 1. There was no long-term exposure to N2O (> 6 hrs); the periods of anaesthesia were between 1.5 and 3.5 hrs. 2. Vitamin B12 deficiency was not known preoperatively, and there was no marked pernicious anaemia, so that the only pointers to the risk patients were supplied by the mean corpuscular haemoglobin (MCH) and the mean corpuscular volume (MCV) of the blood picture.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Does propofol have advantages over isoflurane for sufentanil supplemented anesthesia in children for strabismus surgery?].
The present study investigates the effectivity and the incidence of side effects of sufentanil-supplemented propofol versus isoflurane anaesthesia in children undergoing elective strabismus surgery. ⋯ Propofol as an induction agent of balanced anaesthesia fails to show advantages over thiopentone. During total intravenous anaesthesia propofol increases the risk of bradycardia especially in younger children. However, a significantly lower incidence of postoperative nausea and vomiting after TIVA with propofol and sufentanil, irrespective of N2O administration, may be an advantage over isoflurane anaesthesia in paediatric patients after strabismus surgery.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 1996
[Behm's T-piece for reducing anesthesia gas pollution at the anesthesia work site].
The safety standards demanded for performing anaesthesia and the increasing burden of work to be handled by OP personnel entail continuous supervision and elimination of hazards and leaks. One example illustrates this necessity: Anaesthetic agents in the circular system of the induction are pollute the atmosphere after disconnection of one patient and transport into the OP suite and are a potential risk to personnel and next patient. ⋯ Behm developed a T-piece which connects the Y-piece with the scavenging system leading to elimination of residual anaesthetics from the circular system. A useful byproduct is the longer life of the galvanic O2 sensor.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 1996
Review[Mucociliary clearance function and medicamentous modification].
Mucociliary clearance represents a complex self-cleaning mechanism of the lung and is based on the functional unity of ciliated columnar cells and the special viscoelastic properties of the secretion produced in the tracheobronchial system. It has been known for a long time that intubation and mechanical ventilation can impair mucous transport and lead to morphological damage to the tracheobronchial mucosa. Recent studies made it clear, however, that mechanical ventilation during anaesthesia using an appropriate anaesthesiological technique has no deleterious effect on mucus transport in patients with healthy lungs. ⋯ In these patients a number of factors combine to form a formidable potential insult to the mucociliary transport mechanism. Numerous drugs can affect mucociliary transport. Beta-mimetics and theophylline, in particular, have a favourable effect on mucociliary transport, whereas the effect of mucolytic agents is controversial.