Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 1997
[4-chloro-m-cresol-induced contractures of skeletal muscle specimen from patients at risk for malignant hyperthermia].
4-chloro-m-cresol (4-CmC), commonly used as preservative, has been shown to induce contractures in skeletal muscle specimens from individuals susceptible to malignant hyperthermia (MH). It has been suggested that a defect of the calcium release channel of the skeletal muscle sarcoplasmic reticulum (ryanodine receptor) in MH susceptible (MHS) patients could be responsible for this phenomenon. 4-CmC was found to be a potent activator of ryanodine receptor-mediated Ca2+ release. The aim of this study was to determine the in vitro effects of 4-CmC on muscle specimens from MHS and normal (MHN) patients, and whether contracture testing with different concentrations of 4-CmC could result in a more precise discrimination between MHS and MHN. ⋯ In vitro contracture testing with 4-CmC seems to be a specific method to distinguish between MHS and MHN patients. However, the question whether 4-CmC is an MH-triggering agent is not completely solved. 4-CmC is a preservative within a large number of commercially available preparations (e.g. insulin, hormones, etc.). Regarding the results of contracture testing with 4-CmC it has been suggested that 4-CmC possibly represents a high-risk agent for MHS individuals. To reduce the risk of MH in susceptible patients due to administration of chlorocresols, we recommend avoiding preparations containing the preservative 4-CmC.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 1997
[Pollution of the work environment by volatile anesthetics and nitrous oxide].
Anaesthetic personnel is exposed to different workload conditions. The individual impact is influenced by external factors and human stress stability. Different symptoms reported to be present in anaesthetic personnel are comparable to symptoms of the sick building syndrome, defined by the WHO in the 90's. ⋯ All reviewers do not discuss the fact, that all of these co-factors are present in the reality of the anaesthetic workplace. Thus, the studies by Corbett, enthusiastically criticized by different reviewers, simulate the all-day reality of the anaesthetic workplace more precisely than controlled experiments conducted, for example, by Eger and co-workers. The results of animal experiments and retrospective studies therefore do not justify realization of large controlled prospective studies but require the overall revision of the anaesthesiological workplace and the reduction of occupational waste gas exposure to the lowest possible levels below all chronic exposure threshold values.