Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1997
Randomized Controlled Trial Comparative Study Clinical Trial[Postoperative peridural analgesia. Continuous versus patient-controlled administration of a low-dose mixture of sufentanil, clonidine and bupivacaine].
The purpose of our study was to find out whether patient-controlled epidural administration (PCEA) of a mixture containing a low-dose local anaesthetic, opioid and alpha 2-agonist provides as good or better postoperative analgesia as continuous epidural administration of the same analgetic solution. ⋯ In patients at rest both continuous and patient-controlled epidural administration of analgesics provides excellent analgesia after major abdominal surgery. Contrariwise, patients on exercise who could use a PCA-device experienced more pain compared to those with a continuous epidural infusion technique. On the other hand the patients of the PCA-group consumed less epidural analgesics. We did not notice any severe side effects such as respiratory depression or cardiovascular instability during the study.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1997
Randomized Controlled Trial Comparative Study Clinical Trial[A comparison of the effect of propofol in 3 subhypnotic doses within the framework of tumor chemotherapy].
In anaesthesia and critical care propofol is often used as a hypnotic or sedative. There are some reports showing propofol as a mood-altering drug. The use of propofol in subanaesthetic doses, for example in antineoplastic chemotherapy, led to similar results. In previous studies it was hypothesised that these mood effects could also reduce chemotherapy-induced nausea and vomiting. The present prospective randomised double-blind study evaluated mood effects of different subanaesthetic doses of propofol in oncology patients who received antineoplastic chemotherapy. ⋯ Further studies are needed to specify the "anti-emetic" effects of subhypnotic propofol in antineoplastic chemotherapy. Especially a comparison with a standard drug for the prevention of nausea and vomiting, such as ondansetron, will have to be conducted. The results of this study showed that a dose of propofol of 1.0 mg/kgxh after an initial bolus of 0.1 mg/kg is a useful reference dose.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1997
Randomized Controlled Trial Clinical Trial[The dose-dependent effects of oral premedication with midazolam].
The aim of this study was to examine the psychological effects, well-being and side effects after various doses of oral midazolam medication. ⋯ Midazolam administered orally prior to surgical procedures showed marked interindividual variability. Sedation and amnesia were dose-dependent and were evaluated by the patients as acceptable. Anxiolysis was not significantly different from placebo. A dose of 7.5 mg midazolam showed the best relation between desirable and undesirable effects. Adequate attention given to the patient by the anaesthesiologist prior to surgery seems to be as important and beneficial as oral medication with midazolam.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1997
[The preparation for elective interventions--the spectrum and dissemination of somatic and psychological measures in Germany].
The positive effects of preoperative preparation on postoperative recovery in patients undergoing elective surgery have been demonstrated. On that account, we surveyed the practice procedures of preoperative preparation for elective surgery patients at German hospitals. ⋯ Existing possibilities for optimising preoperative preparation in patients undergoing elective surgery are not used regularly. Preoperative preparation needs to be improved, especially in patients undergoing major surgery. Standardisation of management procedures and integration of several professional groups and regular application of known procedures for preoperative preparation may lead to cost-saving optimisation of the duration of hospital stay.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1997
Biography Historical Article[Helmut Weese--an attempt at an appreciation of his importance for German-language anesthesia].
In addition to the two surgeons Hans Killian and Helmut Schmidt the pharmacologist Hellmut Weese was elected honorary member of the German Association of Anaesthesiology at the organisation's founding congress in 1953. Especially the younger colleagues are quite unfamiliar with his name, although a "Hellmut Weese commemorative" lecture is annually held at our national association's gathering. While it is widely known that his name is intimately connected with the introduction of evipan anaesthesia during the early thirties, only few people know about his extensive research on the therapy of shock that lead to the development of the plasma-expanding substance "Periston". ⋯ Thus he fought enthusiastically for the idea of producing specialists and as a member of a committee for questions concerning anaesthesia played in important part in founding the "Deutsche Arbeitsgemeinschaft für Anästhesiologie". He lived to see the association's name being changed to "Deutsche Gesellschaft für Anaesthesiologie" in 1953 but died before the textbook of anaesthesia (Die Narkose) he had written together with Hans Killian was published in 1954. The following text reports on Weese's medical career and on some of his most important contributions to the knowledge of anaesthesia.