Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 1996
Biography Historical Article[Priority conflict concerning the discovery of lumbar anesthesia between August Bier and August Hildebrandt].
The history of anaesthesiology like that of other medical branches has not been free of quarrels concerning priority. International disputes between the surgeon August Bier from Kiel and his former colleague August Hildebrandt concerning the question of who was the actual inventor of spinal anesthesia have almost fallen into oblivion. While Hildebrandt and numerous other colleagues frequently stated that the New York neurologist James Leonhardt Corning was the inventor of spinal anesthesia, Bier insisted on having described and developed this method first and without any knowledge of Corning's experiments. ⋯ Only recently, American scientists emphasized the fact that this is not true. There will, unfortunately, not be an answer to the Question why Hildebrandt started this quarrel about priority. His reason might have been hurt feelings as he had not been mentioned as co-author in Bier's epoch-making survey.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 1996
Editorial Historical Article[150 years ether narcosis (1846-1996)].
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1996
Review Historical Article[History and definition of sepsis--do we need new terminology?].
The history of sepsis demonstrates that despite current knowledge about its pathogenesis the definition of sepsis is more contested than ever. However, a definite terminology is necessary to define the entrance criteria for future clinical studies concerning patients with sepsis or septic shock. For this purpose, in 1991 a consensus conference was held in the US, but its recommendations have not found unequivocal acceptance. These recommendations and their historical background are presented and their consequences discussed.
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Mivacurium is a short-acting nondepolarising muscle relaxant of the benzylisoquinoline type undergoing rapid breakdown by plasma cholinesterase. With 2.5 fold ED95, tracheal intubation can be accomplished within 2-3 min following injection. The ensuing DUR 25% (i.e. time from injection to 25% recovery of control twitch tension) is three times as long as with succinylcholine and about half as long as with equipotent doses of atracurium and vecuronium. ⋯ One of them, cis-atracurium, is five times as potent as the chiral mixture while having a similar pharmacodynamic and kinetic profile. It does not cause significant histamine release or clinically relevant cardiovascular effects at doses up to 8 times the ED95. Laudanosine release seems to be less with cis-atracurium than with atracurium.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1996
[Neuromuscular and cardiovascular effect of mivacurium in anesthesia induction in patients with renal failure].
Mivacurium produces a prolonged neuromuscular block (NMB) in anuric patients (13), in spite of its rapid hydrolysis by pseudocholinesterase (PChE) which is independent of renal function (17). In the present study the pharmacodynamics and the cardiovascular effects of a bolus dose of mivacurium (0.15 mg/kg) in relation to impairment of renal function were evaluated. ⋯ Our findings suggest that 0.15 mg/kg mivacurium is an effective and safe intubation dose in healthy patients as well as in patients with renal impairment, inspite of a prolonged duration in patients with renal impairment. Low PChE in some, but not in all patients with a renal dysfunction indicates involvement of impaired hepatic function. There was a close correlation between the PChEd and dur 5. Therefore mivacurium dosage should be reduced in patients with compromised renal function, mainly if there are additional systemic, especially hepatic diseases. Thus, in patients with impaired renal function, relaxometry may be of high valu