Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1998
Randomized Controlled Trial Clinical Trial[Electrophysiologic arousal reactions during sufentanil-/isoflurane anesthesia].
There is controversy about relevant EEG signal changes indicating adequate or inadequate anaesthesia. Differences of drug-induced and nociceptive mediated signal changes have not been studied in detail. The present study investigates whether signal changes during decreases of depth of anaesthesia due to surgical stimulation depend on different isoflurane concentrations during sufentanil anaesthesia. ⋯ EEG recordings are useful in assessing pharmacodynamic drug effects. In contrast, intraoperative EEG recordings have a low correlation to clinical signs of changes in the anaesthetic state. Previous studies demonstrate paradoxical EEG-arousal reactions during isoflurane anaesthesia. The present data suggest that classical or even paradoxical EEG arousal due to nociceptive stimulation may depend on the isoflurane concentration. It seems reasonable that the ascending reticular formation is functionally blocked by isoflurane in a dose-dependent manner.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1998
Biography Historical Article[Aloys Martin and the Society of German Physicians in Paris].
The news about the discovery of the anaesthetic properties of ether swept rapidly from America to Europe. The first informations concerning this topic reached England in late fall of 1846 and after that came to France and especially Paris. ⋯ Controversial discussions concerning the anaesthetic properties of ether developed among the members of various scientific circles right after the news from America had reached the city--and many members of the "Verein Deutscher Aerzte in Paris" (Association of German Physicians in Paris) took part in them, Martin then was one of the club's most active members and repeatedly reported on the new method as a correspondent for the widely read "Augsburger Allgemeine Zeitung": Documents discovered recently at the archives of the "Leopoldinisch-Carolinischen Akademie" of Halle provide an interesting insight into this association, whose members tried to find out more about the anaesthetic properties and side effects of ether carrying out a series of well appreciated self-experiments in the spring of 1847. The following text reports on the history of the "Verein Deutscher Aerzte in Paris" which has largely fallen into oblivion and emphasizes the importance of Aloys Martin whose name is strongly attached to the spread of the use of ether throughout the German-speaking countries.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1998
[Successful resuscitation after bolus injection of tissue-type plasminogen activator in emergency admission].
We report on a 30-year old female patient with suspected fulminant pulmonary embolism and cardiac arrest following ambulatory arthroscopy nine days before the event. After 15 minutes of unsuccessful cardiopulmonary resuscitation (CPR) on the ambulance the patient was transferred to the emergency unit of a hospital and was treated with bolus injection of 50 mg t-PA initially and 50 mg over the next two hours. Five minutes after the initial bolus the circulation could be stabilised and the patient could be extubated the next morning. The patient did not present any neurological deficit on the day of discharge nor did she show any bleeding complications. The time elapsing from notice to emergency service to arrival at hospital was about 35 minutes. ⋯ In the light of an excellent outcome of this patient thrombolytic therapy with t-PA appears to be justified under continued CPR if fulminant pulmonary embolism is suspected.