Anaesthesiologie und Reanimation
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Anaesthesiol Reanim · Jan 1997
Randomized Controlled Trial Comparative Study Clinical Trial[Drug onset time of atracurium after pancuronium priming in elderly patients].
Synergism occurs between some combinations of non-depolarising muscle relaxants. To test the effect of pancuronium as a priming dose of atracurium, 45 adults were anaesthetised with 25 micrograms/kg alfentanil. 75 micrograms/kg midazolam, and 0.25 mg/kg edomidate, O2/N2O and enflurane, and were randomised to one of three groups. After induction, 15 patients received 0.5 mg/kg atracurium, 15 were primed with 0.075 mg/kg atracurium and another 15 with 0.0125 mg/kg pancuronium and three minutes later 0.45 mg/kg atracurium. ⋯ The pancuronium priming group showed a significantly faster onset of neuromuscular blockade (tI = 0%: control group I: 76.3 +/- 15.4 sec vs. pancuronium group III: 64.3 +/- 11.3 sec) and a prolonged recovery. Pancuronium priming can shorten the onset time of atracurium while atracurium priming alone showed no shortening. This suggests a synergism for pancuronium priming in combination with atracurium.
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Anaesthesiol Reanim · Jan 1997
Review Case Reports[Epiduritis after long-term pain therapy with an epidural catheter--review of the literature with a current case report].
Patients suffering from vascular disease are often a challenge for the acute pain service. Ischaemia, impaired wound healing, stump and phantom limb pain often require a complex analgesic regimen. Invasive measures such as spinal or epidural catheters can be very helpful but carry the risk of infection, as shown by this case report. ⋯ A little necrotic material and residues of an old haematoma were removed and the epidural space was lavaged. Specimens taken from the epidural material revealed colonisation with staphylococcus epidermidis, which was sensitive to the broad spectrum antibiotics formerly given to the patient to treat the infection in the left stump. By the next day, all signs of epiduritis had disappeared and the patient recovered completely.
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Anaesthesiol Reanim · Jan 1997
Biography Historical Article[Professor Fritz Lotsch--a wrongfully forgotten German pioneer in anesthesia].
Like many of the contributors to the early development of anaesthesia in Germany. Prof. Fritz Lotsch (1879-1958) was a surgeon. ⋯ As early as 1903 Lotsch reported on clinical experience with the recently developed barbiturate "Veronal". Later he reported on advantages and disadvantages of combined anaesthesia using inhalation anaesthetics, opiates and barbiturates. In 1913 he recommended a special double cannula for intravenous infusion purposes which was only rediscovered decades later.