Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1997
Randomized Controlled Trial Clinical Trial[Intraoperative pain stimuli change somatosensory evoked potentials, but not auditory evoked potentials during isoflurane/nitrous oxide anesthesia].
Evoked potentials are used for intraoperative monitoring to assess changes of cerebral function. This prospective randomised study assesses the influence of surgical stimulation on midlatency components of somatosensory (SEPs) and auditory evoked potentials (AEPs) in anaesthetised patients. ⋯ During steady state isoflurane anaesthesia surgical stimulation (SURG2) resulted in significant increases of N20 P25 amplitudes compared with BL (BL: 1.4 +/- 0.7 microV; SURG2: 2.0 +/- 0.8 microV; p < 0.05). Latencies of SEPs and midlatency components of AEPs did not change over time. There were no differences in autonomic parameters between SEP and AEP groups. MAP increased from 76 +/- 6 mmHg at BL to 93 +/- 16 mmHg at SURG1 and 96 +/- 17 mmHg at SURG2 (n = 36; p < 0.05). HR increased from BL (60 +/- 8 beats/min) to SURG2 (76 +/- 12 beats/min). Increases of amplitudes of midlatency SEP amplitudes indicate increased nociceptive signal transmission which is not blunted by isoflurane-nitrous oxide anaesthesia. In contrast, unchanged AEPs indicate adequate levels of the hypnotic components of anaesthesia.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1997
Case Reports[Malignant hyperthermia and sevoflurane--a case report].
The authors report on a course of malignant hyperthermia (MH) in an almost 5-years old boy. In the past, he had been anaesthetized two times with halothane without complications. The causative triggering agent was sevoflurane, a new user-friendly substance for paediatric anaesthesia. ⋯ The timely administration of dantrolene rapidly reversed the life-threatening signs and prevent progression of the disease. It is apparent that monitoring of endtidal carbon dioxide by means of capnometry is of crucial importance in detecting MH at an early stage, and appropriate treatment is being instituted more promptly. By such early recognition, and treatment with dantrolene, we can reasonably except a further decrease in mortality and morbidity of this enigmatic disorder.