Der Anaesthesist
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Malignant hyperthermia (MH) is a rare, life-threatening pharmacogenetic disease. The genetic incidence is estimated to be 1:10,000. In predisposed individuals, MH is triggered by volatile anaesthetics and/or depolarizing muscle relaxants by an abnormal increase of intracellular calcium concentration in skeletal muscle cells. ⋯ In some MH families, a genetic alteration of the ryanodine receptor gene (a calcium channel of the sarcoplasmic reticulum) on chromosome 19 has been identified as the potential cause of MH susceptibility. Recent molecular biological findings support the view of MH being a heterogenetic disease. At present, the diagnosis in potentially MH-susceptible individuals is still made using the in vitro halothane and caffeine muscle contracture test.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Ondansetron versus droperidol. Postoperative treatment against nausea and vomiting. Comparison of action, adverse effects and acceptance by gynecologic inpatients].
Ondansetron is more effective than a placebo in treating postoperative nausea and vomiting (PONV), but it has not been proved to be superior to established antiemetics for prophylaxis or therapy. We compared ondansetron vs droperidol for the treatment of PONV. ⋯ Ondansetron (8 mg) and droperidol (1.25 mg) proved to be equally effective when used as a postoperative antiemetic. Both drugs showed similar side-effects. Due to differences in methods it was difficult to compare our results to those obtained in other studies.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Glucose-xylitol 35% (1:1) versus glucose 40%. Effectiveness and metabolic effects after major surgery].
Injury and stress are accompanied by a characteristic hormonal response and altered energy utilisation. Hyperglycaemia and negative nitrogen (N) balance are the leading symptoms of the metabolic changes in the post-operative state. In a prospective, randomised study the efficacy and metabolic effects of glucose-xylitol (GX) 35% (1:1) versus glucose (G) 40% were investigated in patients undergoing major surgery. ⋯ Similar blood G profiles were in accordance with comparable glucagon and insulin levels. Because of the high standard deviations of N balances, differences in efficacy could not be proven. A significantly lower level of pseudocholinesterase (PCHE) for G40% on day 7 might indicate enhanced hepatic protein synthesis in the GX group.
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Modern medicine has succeeded in achieving enormous technical developments. One recent highlight has been the introduction of postmortem organ transplantation. At the same time, serious objections have been raised concerning the radical changes in the cultural conception of the inviolable body. ⋯ The beneficiary of the treatment is not the donor, but another person, the recipient. The concept of human dignity does not allow the use of a person for purposes other than the ones he/she consents to, as Immanual Kant stated. Although the human corpse is not a person in the full sense, even if it is protected by the thought of respect for the former person, the life-interest of the organ recipient had to be considered legitimate.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
[Ondansetron as prophylaxis for postoperative nausea and vomiting. A prospective randomized double-blind comparative study with droperidol].
Ondansetron, a selective 5-HT3 receptor antagonist, has recently been shown, in a dose of 8 mg, to be superior to 1.25 mg droperidol in preventing postoperative vomiting. There are indications that a dose of 4 mg of ondansetron may be just as effective in reducing postoperative nausea and vomiting as a dose of 8 mg. The aim of this study was to evaluate the efficacy and the adverse effects of 4 mg ondansetron in the prevention of postoperative nausea and vomiting compared to droperidol in patients undergoing surgery with inhalation anaesthesia supplemented with alfentanil. ⋯ CONCLUSION. Our results show that for the prevention of postoperative nausea and vomiting 4 mg of Ondansetron was inferior to 1.25 mg of droperidol. The drugs were given intravenously prior to general anaesthesia for minor gynaecological surgery with nitrous oxide and enflurane in oxygen supplemented with small boluses of alfentanil.