Der Anaesthesist
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Comparative Study
[Economic aspects of modern inhalation anesthetics with sevoflurane as an example].
The economic impact of the new German health care laws requires an awareness of cost-effectiveness when using newer drugs. The main goal in patient care, i.e., effective treatment, must be achieved by the rational use of restricted resources at a maximum degree of effectiveness. Economic aspects of the new inhalational anaesthetics such as sevoflurane are discussed in this article. ⋯ We conclude that volatile anaesthetics account for only a minor portion of the anaesthesia department budget and the cost of anaesthesia delivery. The higher market price of the new agents may be compensated for by the economic impact of fewer side effects and a shorter post-anaesthesia stay in the hospital. In analysing data for sevoflurane, this agent may be cost-effective, for example, for outpatient anaesthesia.
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We report a case of irreversible unilateral hypoglossal nerve palsy in connection with nasal septum surgery in intubation anaesthesia. On account of the spatial distance, there is no danger of injuring the hypoglossal nerve during nasal surgery. However, in the otorhinolaryngological and anaesthesiological literature, some cases of hypoglossal palsy following endotracheal intubation, use of the laryngeal mask airway, bronchoscopy and laryngoscopy are reported. ⋯ According to the available publications, it must be assumed that in the process of intubation pressure from the MacIntosh blade was the cause of the hypoglossal palsy. This complication is extremely rare, so that routine preoperative briefing of the patient does not appear necessary.
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Deferoxamine is known to reduce the iron-dependent generation of toxic oxygen-derived radicals during reperfusion of ischaemic tissue. The present study investigates the antioxidative properties of a deferoxamine-conjugated hydroxyethyl starch solution and its effects on the hepatic microcirculation in a haemorrhagic-shock rat model. ⋯ DFO significantly attenuates shock-induced oxidative stress, thereby reducing the early inflammatory reaction and improving the hepatic microcirculation.