Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Droperidol and dimenhydrinate alone or in combination for prevention of postoperative nausea and vomiting].
Droperidol and dimenhydrinate are inexpensive antiemetic drugs. Droperidol, especially, has been studied extensively in the past, but there are no studies that used the combination of both drugs for prevention of postoperative nausea and vomiting (PONV). Thus, the aim of this randomised controlled and double-blinded study was to evaluate the antiemetic efficacy and the side effects of such a combination therapy. ⋯ Dimenhydrinate failed to reduce the incidence and severity of PONV. The efficiency of droperidol given alone was within the ranges previously known from metaanalytic data. The combination of both drugs showed a moderate synergistic effect.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2001
Case Reports[Successful cardiopulmonary resuscitation with a high-dosage bolus injection of rt-PA after fulminant pulmonary embolism].
The fulminant pulmonary embolism is one of the most feared complications of hospitalized patients. A high percentage of those patients need resuscitation within a short period of time. In such cases, the thrombolysis is a quickly attained therapeutical alternative to pulmonary embolectomy. ⋯ After 20 min of cardiopulmonary resuscitation (CPR), the patient could be stabilized under high dosage of catecholamines. The patient survived after prolonged intensive care treatment without severe bleeding complications, neither did he present any neurological deficit. We conclude that in the case of massive pulmonary embolism with small chance of resuscitation, the high-dose bolus injection of rt-PA could enrich the therapeutical possibilities.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Ropivacaine 0.2% versus bupivacaine 0.125% plus sufentanil for continuous peridural analgesia following extended abdominal operations].
An improved opioid-free analgesia concept using thoracic epidural anlgesia with a low concentrated local anaesthetic alone could be of practical interest for hospitals which are unable to guarantee continuous monitoring on the wards. ⋯ The present study shows that continuous epidural infusion of 0.2% ropivacaine alone provides comparable analgesia at rest, but less profound pain relief during mobilisation within the first 24 hours after major abdominal surgery than bupivacaine 0.125% with sufentanil.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2001
Multicenter Study Clinical Trial[The ProSeal-LM, a new variant of the laryngeal mask: description and first clinical results].
The ProSeal-LMA is a modification of the laryngeal mask airway (LMA) invented by AIJ Brain. It differs from the known models in three major respects: An additional lumen extending into the tip of the cuff allows insertion of a gastric tube. A pocket immediately behind the cuff accommodates a finger or a siliconated metal introducer and thus facilitates insertion. ⋯ Both are equally well tolerated and handled. Most remarkable is a better seal for the ProSeal-LMA (pressure for a leak of 3 L/min: 31 mbar compared to 20 mbar (mean) for the Standard-LMA). Therefore the ProSeal-LMA seems suitable for anaesthesia procedures with IPPV, which up to now are a domain of endotracheal intubation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2001
Case Reports[Amniotic fluid embolism as an obstetric emergency--description of the syndrome and a case with fatal outcome].
Amnotic fluid embolism is an incompletely understood obstetric emergency presenting with the acute onset of hypoxia, hypotension and severe coagulopathy. Up to 86% of the cases are fatal, maternal death occurs within the first hour of symptom onset in 50% of the patients. This report describes the case of a 29-year-old, HIV-positive patient undergoing elective cesarean section who died despite immediate onset of cardiopulmonary resuscitation. The epidemiology of amniotic fluid embolism, clinical presentation, differential diagnosis, pathology and possible treatment are discussed.