Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1993
Case Reports[Ambulatory epidural morphine analgesia via a transcutaneous implanted spinal catheter].
This report deals with a patient suffering from recurring rectum carcinoma infiltrating the lumbosacral plexus who received ambulant treatment with spinal opiate supply by a pump device, using a transcutaneous spinal catheter over a period of 12 weeks. The catheter turned out to be simple to implant. During the whole period no malfunctions occurred. This form of spinal analgesic treatment allowed the patient a relatively pain-free life outside the hospital.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1993
Randomized Controlled Trial Comparative Study Clinical Trial[The hemodynamic effects of atracurium in geriatric patients during intravenous anesthesia using propofol].
Neuromuscular blocking drugs may produce cardiovascular effects by virtue of drug-induced release of histamine or other vasoactive substances from circulating mast cells, effects at cardiac muscarinic receptors or effects at nicotinic receptors at autonomic ganglia. These haemodynamic reactions may be more pronounced in elderly patients, since cardiovascular compensating mechanisms are attenuated with advancing age. The present study was designed to investigate the cardiovascular effects of atracurium with special regard to the reactions in younger adults and in elderly patients. ⋯ Since the results of the present study suggest that haemodynamic reactions in younger adults and in the elderly are rare, atracurium can be recommended for neuromuscular blockade in elderly patients under propofol anaesthesia.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1993
Biography Historical Article[Arthur Läwen--a pioneer of modern anesthetic techniques].
The development of modern local anaesthetic techniques is connected with the name of Arthur Läwen. At the turn of this century, he started his surgical training with Heinrich Braun, who had performed a lot of research with various local anaesthetic methods and who was renowned world-wide as an authority for his contributions. It is not surprising that a main topic of Läwen's research was the development of new local anaesthetic regimes. ⋯ The further development of new techniques for the differential diagnosis of various illnesses must also be mentioned. A remarkable step towards a modern anaesthesia concept was the administration of curare for muscle relaxation in operative surgery. Another evidence of his foresight are his contributions in the development of an electrically driven apparatus to overcome respiratory failure "Läwen was in many ways a man before his time:" This appraisal by a surgeon colleague is true even today for several of his anaesthesia-related contributions, which are still part of the armamentarium of modern anaesthetic methods.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Single-shot spinal anesthesia versus continuous spinal anesthesia using the CoSPAN catheter].
We compared conventional single-shot spinal anaesthesia (SS) with continuous spinal anaesthesia (CS) in a randomised prospective study. ⋯ Fractionated injection of the local anesthetic via a spinal catheter was more precise in achieving the desired maximum cephalad spread than SS. The CS group revealed a significantly more stable blood pressure than the SS group. The use of a short-acting local anesthetic for CS provided an earlier postoperative return of motor function of the legs. Postspinal headache appears not to be a clinically relevant problem when 28-gauge spinal catheters are used.