Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2000
Randomized Controlled Trial Comparative Study Clinical TrialA fibreoptic scoring system to assess the position of laryngeal mask airway devices. Interobserver variability and a comparison between the standard, flexible and intubating laryngeal mask airways.
We determined the interobserver reliability of a fibreoptic scoring system for assessing the position of the laryngeal mask airway (LMA), the flexible laryngeal mask airway (FLMA) and the intubating laryngeal mask airway (ILM). We also compare fibreoptic position between the devices. Thirty anaesthetised adult patients were studied in random order in a triple crossover manner. ⋯ We conclude that interobserver reliability for the fibreoptic scoring system is excellent for the LMA, FLMA and ILM. Fibreoptic position is better for the LMA and FLMA compared with the ILM. Fibreoptic scoring has potential utility for research and clinical practice with laryngeal mask devices.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial[Endocrine stress parameters during TIVA with remifentanil or sufentanil].
Increases of heart rate and blood pressure during anaesthesia are interpreted as a response to surgical stimulation, although the endocrine response and the cardiovascular reaction can differ markedly. We compared remifentanil and sufentanil as part of a TIVA for retinal surgery with respect to the endocrine stress responses and haemodynamic reactions. ⋯ The increase of prolactin concentrations could be interpreted as a result of the stimulation of mu 1-receptors. As all other measured stress hormones did not increase in both groups, remifentanil and sufentanil both provide an effective suppression of noxious stimulation induced endocrine response.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2000
Case Reports[Post-obstructive pulmonary edema as a complication of endotracheal tube obstruction].
Pulmonary edema following acute or chronic upper airway obstruction is a threatening complication. A case is presented in which a 15 year old boy developed a massive pulmonary edema after a acute endotracheal tube obstruction during emergence from anesthesia. ⋯ Sound knowledge of the disease increases the vigilance of the caring anaesthesiologist and helps to identify patients at risk. Preventing measures may further reduce the risk of occurrence of the postobstructive pulmonary edema.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2000
Case Reports[Blunt chest trauma with severe pulmonary contusion and traumatic myocardial infarction].
In the literature the incidence of cardiac involvement in blunt chest trauma varies considerably. This reflects the diagnostic problems encountered in polytraumatised patients. We report the case of an 18 year old man who suffered bilateral pulmonary contusion and traumatic myocardial infarction following a motorbike accident. ⋯ Left ventricular function was severely impaired (ejection fraction 26%). Due to the pulmonary contusion respiratory support was required for 14 days. The course was further complicated by left ventricular failure with low output.