Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1999
Review Historical Article[Würzburg in the history of anesthesia].
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1999
Review[Pharmacokinetics in newborns and infants].
Physiologic changes influence the pharmacokinetics of drugs relevant to anesthesia in neonates and infants. The neonatal phase is the phase of life with the most rapid and dramatic changes of organ-functions responsible for pharmacokinetics of most anesthetics. Changes in body composition and the content of plasma proteins influence volume of distribution, the drug distribution to different compartments and the amount of free fraction in plasma. ⋯ There are also pharmacodynamic changes like modified sensitivity to some drugs like volatile anesthetics or neuromuscular blocking agents. In summary neonates and infants are a highly heterogenous group with large interindividual differences. Therefore the dosage of anesthetic agents must be individualized to achieve optimal pharmacodynamic effects without toxicity in this age group.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1999
[Recent developments in obstetric regional anesthesia. A review of experiences at the Eppendorf University Hospital].
The study investigates changes of anaesthesia practice in obstetric patients of a University Hospital over a six years' period. ⋯ Epidural and subarachnoid application of sufentanil appears to enhance the success rate of obstetric regional anaesthesia. Subarachnoid techniques such as spinal or combined spinal-epidural anaesthesia showed a high effectiveness, low incidence of side effects and high degree of patients' satisfaction.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1999
Clinical Trial[Neuromuscular recovery following mivacurium is predictable in patients with severe systemic disease prognoses].
Fast recovery from mivacurium-induced neuromuscular blockade is impaired in patients with decreased plasma cholinesterase activity which is often associated with dysfunction of different organs. Nevertheless, predictability of neuromuscular recovery may be given. Thus, this study evaluates parameters to predict individual neuromuscular recovery in patients with uncommon diseases. ⋯ Prolonged neuromuscular recovery could be predicted from a reduced PChE, a prolonged duration of action of the initial mivacurium bolus and a decreased mivacurium-infusion rate required to maintain a 95% neuromuscular blockade. Measurement of plasma cholinesterase and monitoring of mivacurium induced neuromuscular blockade can avoid resting neuromuscular blockade postoperatively despite of prolonged neuromuscular recovery.