Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2000
Randomized Controlled Trial Clinical Trial[The effects of perioperative continuous administration of mivazerol on early postoperative hemodynamics and plasma catecholamines after major surgery].
During and after surgical procedures a strong activation of the sympatho-adrenergic system is common with correlation to adverse cardiac outcome. Several drugs (alpha 2-adrenoceptor-agonists, beta blockers) are discussed to prevent this reaction. The new alpha 2-adrenoceptor-agonist mivazerol with marked specificity for alpha 2-adrenergic receptors may be suitable for this indication. The aim of the present study was to investigate the effects of perioperative continuous administration of mivazerol on plasma catecholamines, body temperature and calculated haemodynamic parameters in the early postoperative period in cardiac risk patients undergoing non-cardiac surgery. ⋯ Continuous, perioperative administration of mivazerol decreased the heart rate and the plasma catecholamines in the early postoperative period, but did not affect blood pressure, body temperature and the incidence of shivering. There were also no effects of mivazerol on calculated haemodynamic parameters (CO, SVR, PVR, VO2). These findings show a selective decrease in heart rate by Mivazerol without markedly cardiorespiratory side effects.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2000
Clinical Trial[Clinical experiences with the double jet technique superimposed HFJV (high frequency jet ventilation) during larygotracheal surgery].
Single-frequency high-frequency jet ventilation (HFJV) is an established ventilatory technique during laryngotracheal surgery. This study describes the clinical use of combined HFJV, characterised by the simultaneous application of a low-frequent (LF) and a high-frequent (HF) jet stream. ⋯ Tubeless supraglottic HFJV utilizing two jet streams with low and high frequency was effective in patients during laryngotracheal surgery. The application of two jet streams results in phasic changes of airway pressures between an inspiratory and expiratory pressure level, and facilitates application of enlarged tidal volumes. As demonstrated, oxigenation and ventilation is compromised by increased body weight. Superimposed HFJV (double-jet technique) enables the supraglottic ventilation of heavy patients and/or in the presence of airway stenoses during laryngotracheal surgery without need to use maximum driving pressures.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2000
Case Reports[Continuous intrathecal administration of baclofen in severe tetanus].
This is a case report involving a 71 year old man with generalized tetanus. The patient was initially treated conservatively with sedatives and muscle relaxants, which necessitated intubation and mechanical ventilation. After intrathecal administration of baclofen all cramps and spasms subsided and the patient could be weaned from the respirator and subsequently discharged from the intensive care unit.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2000
[The new German resuscitation guidelines in the context of international recommendations].
The German Guidelines for Cardiopulmonary Resuscitation were adapted to match the revised International Guidelines. The revised German edition was based both on the guidelines issued by the American Heart Association (AHA) in 1992 and on those of the European Resuscitation Council (ERC) of 1998, as well as on those released by the International Liaison Committee on Resuscitation (ILCOR) in 1997. Due to the diverging instructions for action the emergency physicians felt considerably unsafe as to what they should really do to achieve maximum results. ⋯ Sodium bicarbonate is recommended only after more than 20 minutes of reanimation and if so, only in a reduced dose of 0.5 mval/kg body weight. In accordance with the international recommendations there is now a universal algorithm that decides on application only between ventricular fibrillation and nonfibrillation. The new german recommendations have adapted the reanimation procedure in agreement with ERC to national usage without abandoning any principles of the international guidelines.