Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1996
Case Reports[Perioperative management of the patient with atypical Parkinson disease].
Recent neuropathological findings define that 10-20% of the Parkinson patients belong to the atypical Parkinson's syndrome due to multi-system disease marked by typical Parkinsonian symptoms such as rigor, tremor and akinesia and early onset of severe autonomic, cerebellar or pyramidal disorders. Symptoms like postural hypotension, dysphagia, hypersalivation, urinary bladder dysfunction, thermodysregulation, abnormalities in eye movement, early falls or dementia etc. are frequently seen in these patients. In these patients dopamin depletion in the nigrostriatal pathway is combined with degeneration of other cerebral structures like olivopontocerebellar and intermediolateral columns. ⋯ Both responded to antiparkinsonian drugs, the first to orally applied L-dopa, the second to intravenous amantadine. Most probably the interruption of the treatment with high dosages of L-dopa (in these patients given in 2-4 hours intervals) had caused these complications. The special nature of the anaesthesiological management of atypical Parkinson patients is reviewed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1996
[Continuous fiberoptic monitoring of oxygen saturation in cerebral veins in severe craniocerebral trauma--experiences and results].
Monitoring of jugular-venous O2-saturation (SjO2) enables the assessment of cerebral oxygen supply and the rapid detection of cerebral desaturation in patients with severe head injury. Furthermore, it may help to optimize circulation, ventilation, and intracranial hypertension therapy in these patients. This study was performed to evaluate the reliability of SjO2-monitoring as well as to measure cerebral O2-extraction and the frequency of episodes of cerebral desaturation after traumatic brain injury. ⋯ Monitoring of SjO2 in severe head injury provides an estimate of cerebral oxygen supply and may improve the assessment of therapeutic measures in these patients. The high incidence of erroneous readings of the SjO2 is a major drawback of this method. Initially after trauma, a high extraction of oxygen was found, followed by a marked decrease in the subsequent days, presumably reflecting an early, decreased cerebral blood flow and a hyperaemic flow pattern thereafter. Continuous measurements of SjO2 may contribute to advanced, organ-specific cerebral monitoring in severe craniocerebral trauma. The reliability of data, however, should be considerably improved for common clinical use.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1996
Biography Historical Article[Jonnesco total spinal anesthesia].
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 1995
[Exposure of intensive care personnel to isoflurane in long-term sedation].
Isoflurane is a suitable agent to produce sedation in the intensive care unit (ICU). However, data concerning occupational exposure to isoflurane during long-term sedation are not yet available. The purpose of this study was to evaluate occupational exposure to isoflurane in the ICU. ⋯ We conclude that an effective high flow scavenging system, a low-leakage anaesthesia machine and an airconditioning equipment without recirculation could keep occupational exposure low. The majority of the measured values was below the NIOSH recommendation (2 ppm). All values was lower than a national state recommendation (10 ppm). Under other circumstances (e.g. without scavenging system) air pollution will be higher and therefore measurements at the working place are needed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 1995
Review[Intravenous anesthesia--current aspects].
Intravenous anaesthesia as a defined technique has become popular in recent years, since new developed drugs and more sophisticated application systems were introduced into clinical practice. However, only a minority of anaesthesiologists really practise this new technique. The scientific basis of continuous intravenous anaesthesia has not been spread widely in the anaesthetic community yet. ⋯ The newly found properties of propofol, such as antiemetic, anticonvulsive and antioxidant, and its present clinical use are described. Finally, modern continuous intravenous anaesthetica techniques have been feasible only by the development of efficient application systems. The text gives an overview of the properties of modern syringe pumps and future developments of "smart" pumps.