Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1996
[Peridural catheter for postoperative long-term analgesia in children].
Continuous epidural anaesthesia is a well established procedure for postoperative analgesia as well as sympathicolysis in adult patients. It is, however, much less frequently reported in infants and children. ⋯ The results of continuous epidural anaesthesia and sympathicolysis in infants and children are encouraging. This technique is readily employable and complications seem to be rare. Satisfactory analgesia and sympathicolysis were achieved. Based on the results of our bacteriological studies we recommend that caudal catheters are tunnelled subcutaneously in cranio-lateral direction.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1996
[Acute effects of complete blood exchange with ultra-purified hemoglobin solution or hydroxyethyl starch on liver and kidney in the animal model].
The present animal study investigates the influence of an acute and almost complete isovolaemic haemodilution with a new ultrapurified polymerized bovine haemoglobin (UPBH) on hepatic and renal function and histology in comparison to hydroxyethylstarch (HES). ⋯ The high degree of purification and polymerization of bovine haemoglobin associated with adequate tissue oxygenation by increased oxygen extraction resulted in normal histological and functional findings after acute and almost complete blood exchange with UPBH. In contrast, HES-treated animals showed severe histological changes of renal tubuli caused by isovolaemic anaemia.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1996
[Postoperative mediastinal and subcutaneous emphysema after intubation narcosis].
The case of a 16-year old female is presented who underwent laparoscopy under general anaesthesia and uncomplicated endotracheal intubation. Four hours after uneventful anaesthesia and extubation the patient started vomiting and coughing. Subcutaneous tissue emphysema developed and pneumomediastinum was diagnosed on a chest roentgenogram. ⋯ A tracheal lesion during intubation is the most frequent and thus the most probable cause of air accumulation presenting as pneumomediastinum, pneumothorax or subcutaneous emphysema. As in the present case, increased airway pressure from vomiting or coughing even after a latent period may induce the phenomenon. Very occasional reports on spontaneous pneumomediastinum in young individuals must not detract the circumstances of endotracheal intubation from suspecting an iatrogenic lesion, confirming it by immediate endoscopy and thereupon deciding on conservative or surgical treatment.