Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1996
Review[What significance to genotype changes have in diagnosis of malignant hyperthermia?].
Malignant hyperthermia (MH) is a potentially fatal, inherited pharmacogenetic disorder characterised by a dysfunction of the intracellular calcium regulation. Linkage to DNA markers from the chromosome 19q12-13.2 region and the MHS-phenotype (MH susceptible) has been shown in about 50% of families with a history of MH. The ryanodine receptor gene encoding the human skeletal muscle ryanodine receptor has been localised to the chromosome 19q13.1-13.2 region. ⋯ However, the relevance of this observation is so far unknown. At present, unambiguous preoperative screening of MH disposition based on molecular genetic characteristics is not available because of the enormous heterogeneity of the human MH syndrome. Thus, the halothane-caffeine in-vitro contracture test according to the standard protocol of the "European MH Group" must be performed in order to discover MH susceptibility.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Blood supply to the liver in the human after 1 MAC desflurane in comparison with isoflurane and halothane].
Objective of this investigation was to compare the effects of the new inhalation agent desflurane with equipotent doses of isoflurane and halothane on hepatic blood flow (tHBF). ⋯ The results of this study suggest that all inhalation agents included in the study significantly decreased tHBF during anaesthesia with the concentration of 1 MAC.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1996
Case Reports[Are monamine oxidase inhibitors in disposition to malignant hyperthermia contraindicated? Discussion based on a case report].
We report on a young patient with a positive family history for malignant hyperthermia (MH), who was diagnosed as susceptible to MH in our malignant hyperthermia laboratory by the in vitro-contracture test. Prior to the investigation of MH-susceptibility, the patient had been on medication with moclobemide, a monoamine oxidase (MAO) inhibitor, over a period of 13 months for treatment of a hyperactivity disorder. ⋯ However, some authors regard MAO-inhibitors as MH-triggering agents. The risk of MH-patients due to the therapy with MAO-inhibitors and the association between MH and the neuroleptic malignant syndrome is discussed in this case report.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1996
[Peridural catheter for postoperative long-term analgesia in children].
Continuous epidural anaesthesia is a well established procedure for postoperative analgesia as well as sympathicolysis in adult patients. It is, however, much less frequently reported in infants and children. ⋯ The results of continuous epidural anaesthesia and sympathicolysis in infants and children are encouraging. This technique is readily employable and complications seem to be rare. Satisfactory analgesia and sympathicolysis were achieved. Based on the results of our bacteriological studies we recommend that caudal catheters are tunnelled subcutaneously in cranio-lateral direction.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1996
[Acute effects of complete blood exchange with ultra-purified hemoglobin solution or hydroxyethyl starch on liver and kidney in the animal model].
The present animal study investigates the influence of an acute and almost complete isovolaemic haemodilution with a new ultrapurified polymerized bovine haemoglobin (UPBH) on hepatic and renal function and histology in comparison to hydroxyethylstarch (HES). ⋯ The high degree of purification and polymerization of bovine haemoglobin associated with adequate tissue oxygenation by increased oxygen extraction resulted in normal histological and functional findings after acute and almost complete blood exchange with UPBH. In contrast, HES-treated animals showed severe histological changes of renal tubuli caused by isovolaemic anaemia.