Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2002
Multicenter Study Comparative Study Clinical Trial[A comparison of the Proseal laryngeal mask to the standard laryngeal mask on anesthesized, non-relaxed patients].
It was our goal to compare the Proseal-laryngeal mask airway (PLMA) with the classical laryngeal mask airway (LMA) in a german multicenter trial. Handling of the instruments and application criteria were to be tested. 7 anaesthesia departments were able to take part in this study. 280 patients could be investigated after approval of the ethics committee of the medical faculty of the university of Goettingen. 145 patients received the PLMA and 135 the LMA. The surgical interventions were small to moderate procedures with a duration of at least 20 minutes in the sections general surgery, trauma/orthopedic surgery, urology, vascular surgery, gynecology, ENT-surgery and ophthalmology. ⋯ The PLMA may be applied in laparoscopies and lower abdominal surgical interventions. Careful clinical observation will show, if the minimal invasiveness of the PLMA offers an advantage for these patients. The PLMA should not be applied in patients with increased aspiration risk.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2002
Historical Article[The centennial of oxygen-therapy (1902 - 2002)--reassessing its history. Part I: "The long way of oxygen"--from its discovery to its implementation as a rational therapy in anaesthesia and emergency-medicine].
This historical survey in two parts analyses the history of inhalative oxygen therapy and its interactions with the history of anaesthesiology. For this purpose, we will start with illustrating "the long way of oxygen" from its first isolation by Carl Wilhelm Scheele (1772) and Joseph Priestley (1774) to its breakthrough for therapeutic application in the 20th century. We will show that the two main factors delaying the successful implementation of a truly rational oxygen therapy were of technical nature: The complicated and costly production of the gas and insufficient means to apply it continuously and with reliable and sufficient dosages to the patients. ⋯ Here, a special significance is to be awarded to pressure reducing valves. These were first introduced into medical technology by Draeger Inc. (Lübeck/Germany) on a significant scale, proving particularly successful in anaesthesia and rescue-devices (e. g. in the "Roth-Draeger Anaesthesia Apparatus" [1902]). Critically discussing earlier research on the history of oxygen therapy, we therefore propose a historical reassessment, accepting the year 1902 as the internationally decisive "turning point" towards the development of modern oxygen therapy.