Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1995
Review[Cardiovascular morbidity and anesthesia].
One of every four persons in the Western industrialised nations has cardiovascular disease. The perioperative setting in those patients is associated with the risk of myocardial ischaemia (PMI) and myocardial infarction, and also with the risk of perioperative stroke and dysfunction of the central nervous system (CNS). Perioperative cardiovascular morbidity represents a major healthcare challenge. ⋯ In fact, only one recent study has established that perioperative stroke is preventable with the use of an adenosine-regulating agent. Thus, it appears that it may be possible to prevent stroke, even though these results require confirmation. Because of the aging of our population, and the medical, financial and social impact of cardiovascular disease, the development of anti-ischaemic therapy, particularly in the surgical patient, will be a critical area of medical research for the next several decades.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1995
The influence of the double burst stimulation (DBS) pattern on the DBS-train-of-four ratio relationship.
The double-burst-stimulation (DBS) is a new stimulation pattern developed to facilitate tactile evaluation of residual neuromuscular blockade. DBS consists of two bursts of high frequency stimulations separated by a short time interval. ⋯ At any chosen level of reversal defined by a TOF ratio, it should therefore be possible to construct a DBS ratio, where fade just can be detected by tactile evaluation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1995
Case Reports[Unexpectedly difficult intubation: fiberoptic endotracheal intubation with the laryngeal mask].
A 67-year old patient, scheduled for elective transvesical resection of the prostate gland, presented intubation problems. Fibreoptic assessment of the larynx revealed secretions as well as a swollen laryngeal mucosa; endotracheal intubation guided by the fibreoptic bronchoscope was not possible. After multiple attempts to intubate the trachea a laryngeal mask airway was inserted. ⋯ The laryngeal mask airway, a relatively new device for airway protection, has proved to be beneficial in planned as well as in unexpectedly difficult endotracheal intubation. However, although the laryngeal mask airway may solve ventilation problems initially, prelaryngeal alterations present a contraindication for perioperative ventilation via the laryngeal mask airway. The fibreoptic intubation through the laryngeal mask airway is an important technique to consider in the "cannot intubate" situation.