Der Anaesthesist
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Heat loses during surgery occur mainly to the environment and due to infusions and irrigations. Infusions given at room temperature account for a great deal of the total heat deficit during major operations, e.g., the infusion of 53 ml/kg 20 degrees C fluid leads to a loss of 1 degree C in mean body temperature. Hence, heating i.v. fluids will add to the effect of other measures aimed at reducing heat loss to the environment. We investigated the efficacy of different warming methods for i.v. fluids in an experimental model by measuring the temperature at the end of the delivery line. ⋯ The importance of infusion warming increases with the amount of fluid given.(ABSTRACT TRUNCATED)
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Randomized Controlled Trial Clinical Trial
[Propofol and etomidate-Lipuro for induction of general anesthesia. Hemodynamics, vascular compatibility, subjective findings and postoperative nausea].
Etomidate has become an important induction agent in high-risk patients because of its cardiovascular stability. Its unwanted side-effects such as pain on injection and thrombophlebitis could be significantly reduced by a new (medium chain triglyceride and soya bean) emulsion formulation. Propofol is solved in a mixture of long chain triglyceride and soya bean emulsion. In this double-blind, randomized study we compared the haemodynamic effects, the patients' sensations, signs of thrombophlebitis and postoperative nausea and vomiting (PONV) following injection of both drugs. ⋯ Etomidate formulated in a medium chain lipid emulsion causes significant less discomfort for the patients than propofol, which is solved in a long chain formulation. Myocloni, however, occur significantly more frequently after etomidate than after propofol.
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Comparative Study Clinical Trial
[Measurement of human cerebrovascular circulation. Comparison of Kety-Schmidt technique with the intravenous 133-xenon clearance technique].
In this study cerebral blood flow (CBF) was simultaneously measured with the Kety-Schmidt method and the intravenous 133Xe clearance technique. CBF, cerebral metabolic rate of oxygen (CMRO2), and CO2 reactivity of CBF were compared under fentanyl-midazolam anaesthesia and varying paCO2 levels. ⋯ Most probably due to contamination with radioactivity from slowly perfused extracerebral tissues the intravenous 133Xe-clearance technique underestimates CBF, CMRO2, and cerebrovascular CO2 reactivity, at least when CBF15 values are used as flow parameters.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Cardiovascular effects after bolus administration of cisatracurium. A comparison with vecuronium].
Cisatracurium-one of the ten stereoisomers of atracurium-is an intermediate long-acting non-depolarizing neuromuscular blocking agent. Cardiovascular reactions have been described after administration of cisatracurium or vecuronium in surgical patients. ⋯ After the administration of cisatracurium in two different doses (3xED95 and 5xED95) or vecuronium (3xED90) only minor cardiovascular changes were observed. Both drugs proved to be safe for use during induction of anaesthesia in patients ASA I-II. With regard to its cardiovascular effects, cisatracurium shares with vecuronium the requirements of an ideal muscle relaxant.