Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 1999
Case Reports[Diagnosis, procedures and conservative therapy of a bronchial rupture after intubation with double-lumen tube].
Bronchial rupture is a rare but severe complication of intubation with a double-lumen tube. Cardinal symptoms are mediastinal and subcutaneous emphysema as well as pneumothorax. Larger injuries result in an air leak and the endtidal carbon dioxide decreases. ⋯ To identify the minimum occlusive pressure of the endobronchial cuff for lung isolation different methods are described and should be used. The cuff has to be deflated when the patient is repositioned and when one-lung-ventilation is not required. Tumours of the tracheobronchial tree and weakness of the bronchial wall caused by steroid hormone therapy or COPD may increase the risk of tracheobronchial laceration.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 1999
[Experiences fo three year's routine operation of an anesthesia information management system (AIMS) at a university clinic in Giessin].
In 1994, the Department of Anaesthesiology and Intensive Care Medicine of the Justus Liebig University at Giessen decided to install an Anaesthesia Information Management System (AIMS). Individual aspects and results from routine operation are presented, demonstrating the quality of the documentation and the value of information at the anaesthesiological workstation. The paper discusses which adaptations are necessary according to the experience gathered. ⋯ The implementation of the AIMS and an effective user support have been able to increase significantly the quality of documentation, the flow of information at the anaesthesia workplace and the number of recorded Anaesthesia procedures. All recorded data can be analysed immediately The expansion of the automatic data transfer from the patient monitoring, interfaces to other computer subsystems of the hospital and a practicable evaluation programme are necessary for further enhancing the efficiency of the AIMS.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 1998
Randomized Controlled Trial Clinical Trial[Prophylactic nefopam administration for post-anesthetic shivering].
Shivering is a frequent postanaesthetic complication. Its definite reason is unknown. Patients with cardiovascular or pulmonary diseases are endangered by postanaesthetic shivering. The aim of this study was to assess the efficacy of nefopam in prophylaxis of shivering. Additionally we investigated the influence of nefopam on haemodynamic parameters and on the time until extubation. ⋯ The data indicate that prophylactic administration of nefopam can suppress postanaesthetic shivering. Prolonged awakening was not observed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 1998
Comparative Study Clinical Trial[The importance of the laryngeal mask in the difficult intubation and early experience with the intubating laryngeal mask airway--ILMA--Fastrach].
The conventional laryngeal mask airway ("Standard" laryngeal mask airway SLMA is of outstanding importance in the management of the difficult airway. The intubating laryngeal mask airway (ILMA, commercial name Fastrach) has become available recently. First results indicate that the excellent ventilation characteristics of SLMA are maintained, but in addition blind intubation is successful in more than 90% of patients with normal anatomy as well as with difficult intubation. ⋯ The ILMA maintains the superb ventilation potential of a SLMA in difficult intubation but doubles the success rate of blind intubation irrespective of anatomical difficulties, with a 50% success rate during the first intubation attempt. Possible uses of the ILMA may be in difficult intubation situations including immobile spine, in cannot ventilate--cannot intubate situations comparable to a SLMA with an improved chance of successful intubation, and perhaps as a device for ventilation and intubation for untrained people. The use of the ILMA can be trained during everyday practice. Expert assessment of successful endotracheal tube position is mandatory.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study of propofol emulsions for anesthesia in varicose vein operations].
It is commonly known that propofol-based anaesthesia is easily controlled and well tolerated. These advantages of propofol are partly offset by the comparably high costs of the anaesthetic. The present prospective randomised double-blind cross-over study compared two propofol emulsions with regard to their efficacy and drug safety. ⋯ The results clearly demonstrate that both propofol emulsions are comparably well suited for vascular surgery anaesthesia. This study demonstrates a methodological clinical approach to compare the same medication supplied by different manufacturers.