Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1993
Case Reports[Ambulatory epidural morphine analgesia via a transcutaneous implanted spinal catheter].
This report deals with a patient suffering from recurring rectum carcinoma infiltrating the lumbosacral plexus who received ambulant treatment with spinal opiate supply by a pump device, using a transcutaneous spinal catheter over a period of 12 weeks. The catheter turned out to be simple to implant. During the whole period no malfunctions occurred. This form of spinal analgesic treatment allowed the patient a relatively pain-free life outside the hospital.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1993
Case Reports[An anaphylactic shock reaction caused by latex from medical protective gloves].
In case of IgE-mediated latex allergy, the person wearing medical rubber gloves as well as the patient getting in contact with the gloves' outside may be affected. This is illustrated by the present case reports on two atopic young women. The first patient repeatedly underwent laparotomies and finally, 50 minutes after the onset of another operation, suffered an anaphylactic shock reaction due to transperitoneal latex resorption. ⋯ Latex prick testing in this patient resulted in an anaphylactic shock reaction. With regard to these observations the general aspects of intraoperative allergen exposition and safety of latex skin testing are discussed. Recommendations are given for a) the latex test procedure in case of anamnestic suspicion of high-degree sensitisation, b) the issuing of a latex allergy pass, and c) the use of latex-free synthetic gloves.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1993
Randomized Controlled Trial Comparative Study Clinical Trial[The hemodynamic effects of atracurium in geriatric patients during intravenous anesthesia using propofol].
Neuromuscular blocking drugs may produce cardiovascular effects by virtue of drug-induced release of histamine or other vasoactive substances from circulating mast cells, effects at cardiac muscarinic receptors or effects at nicotinic receptors at autonomic ganglia. These haemodynamic reactions may be more pronounced in elderly patients, since cardiovascular compensating mechanisms are attenuated with advancing age. The present study was designed to investigate the cardiovascular effects of atracurium with special regard to the reactions in younger adults and in elderly patients. ⋯ Since the results of the present study suggest that haemodynamic reactions in younger adults and in the elderly are rare, atracurium can be recommended for neuromuscular blockade in elderly patients under propofol anaesthesia.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Single-shot spinal anesthesia versus continuous spinal anesthesia using the CoSPAN catheter].
We compared conventional single-shot spinal anaesthesia (SS) with continuous spinal anaesthesia (CS) in a randomised prospective study. ⋯ Fractionated injection of the local anesthetic via a spinal catheter was more precise in achieving the desired maximum cephalad spread than SS. The CS group revealed a significantly more stable blood pressure than the SS group. The use of a short-acting local anesthetic for CS provided an earlier postoperative return of motor function of the legs. Postspinal headache appears not to be a clinically relevant problem when 28-gauge spinal catheters are used.