Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1992
[Therapy of hemorrhagic shock using small volumes of hypertonic-hyperoncotic NaCl-dextran solution--effects on the brain].
Infusion of small volumes of hypertonic/hyperoncotic solution (HHL: 7.2% NaCl/10% dextran 60) is highly effective in haemorrhagic shock. Cardiovascular function is restored in a matter of minutes by rapid mobilisation of extravasal fluid. However, little experience has been collected to date on the side effects on the brain by this new form of shock therapy. ⋯ The regional cerebral blood flow (H2-clearance) and the cerebral O2 supply were studied by determining the pO2 of the cerebral cortex in experimental animals without haemorrhagic shock but with infusion of HHL. Finally, separate single tests were conducted to analyse the effect of the infusion of HHL on the intracranial pressure after induction of a focal cold lesion of the brain in combination with the implantation of a rubber balloon in the epidural space as an intracranial space-occupying growth. Infusion of HHL during shock produced rapid normalisation of cardiac output, whereas in normovolaemic animals without shock it produced a temporary increase of this parameter.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1992
[Are humidity filters necessary in the inspired air in the breathing circuit? A new in vivo method of measuring humidity in the air breathed].
Humidification of inspiratory gases under anaesthetic conditions still is a matter of controversial discussion. Physiological humidification and heating of breathing air are preconditions for mucociliary clearance, pulmonary cleaning and defence mechanisms. These functions of the upper respiratory tract are eliminated by application of artificial airways. ⋯ After one hour's respiration with this system without HME a relative humidity of 87% at 30 degrees C (26 mg/l) is reached after replaced HME. Initial relative humidity in a semiopen CPAP-system is about 12% at 28 degrees C (3 mg/l). This is increased to 85% at 29.5 degrees C (25 mg/l) after 15 minutes respiration with HME.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1992
[The spontaneous and evoked EEG in anesthesia].
Clear differentiation between nociception and pain, or, better, between anti-nociception and pain relief, is essential for understanding the analgesic mechanisms in anaesthesia. Nociception is a neuronal activity in the pain-mediating and pain-processing nervous system, i.e. in the peripheral axons, in the spinal short cord and in certain brain structures. The nociceptive system has been well documented by experiments, especially in animals. ⋯ Since pain is the conscious processing of nociceptive information, attenuating the vigilance also alleviates pain; there is no pain without consciousness. Most of the centrally acting analgesics will also reduce vigilance; e.g. driving is not permitted under analgesia with opiates. Alcohol is another example, although it minimally affects the nociceptive system, it substantially lowers the vigilance, thereby alleviating pain.(ABSTRACT TRUNCATED AT 250 WORDS)