Der Anaesthesist
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Mivacurium is a short-acting, nondepolarising muscle relaxant of the benzylisoquinoline type that undergoes rapid breakdown by plasma cholinesterase. After 2.5 times the ED95 (0.2 mg/kg), tracheal intubation can be accomplished within 2-3 min following injection. ⋯ The principal side effects of mivacurium are facial flushing and a transient fall in blood pressure due to moderate histamine release following doses 3-4 times the ED95. In patients with end-stage liver or renal disease as well as those with atypical plasma cholinesterase, the duration of action of mivacurium is prolonged.
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We performed a prospective multi-center study in order to determine the causes of 30-day perioperative mortality. ⋯ In order to further reduce perioperative mortality in critically ill patients, every hospital should aim to optimize the structure of the surgical and anaesthesiological departments. A delay due to logistical or personnel problems may be a co-factor in perioperative mortality. Recovery rooms with experienced personnel should be the standard in postoperative anaesthesiological care. (ABSTRACT TRUNCATED)
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Clinical Trial
[The Mallampati Score. Prediction of difficult intubation in otolaryngologic laser surgery by Mallampati Score].
The Mallampati score (MS), later modified by Samsoon and Young, is a common method used to predict difficult intubation. We tested its predictive value in otolaryngologic (ENT) laser surgery. ⋯ Difficult intubation was significantly more common in patients with MS > or = 3. Low sensitivity (60%) and specificity (72%) limit the clinical value of this test, however.
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The mucociliary escalator of the lung is an important protective transport system by means of which inhaled particles and microorganisms are removed from the tracheobronchial system. In general, it is assumed that anaesthetics inhibit mucociliary clearance [3,5,6,19,27]. In the present prospective study the effect of combination anaesthesia with isoflurane, fentanyl, vecuronium, and nitrous oxide-oxygen mixture on bronchial mucus transport velocity (BTV) was investigated. ⋯ Combination anaesthesia with isoflurane, fentanyl, vecuronium, and O2:N2O does not influence BTV in patients with healthy lungs.