Der Anaesthesist
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The effects of spinal anaesthesia neuroleptanaesthesia and surgery on the metabolism of carbohydrates and fats were investigated in two groups of 11 young, metabolically healthy patients, undergoing trauma surgical procedures. For both groups the determined parameters glucose, lactate, glycerol, ketone-bodies, NEFA and insulin remained, during the operative and early postoperative phase, within the physiological range without any marked differences. Both anaesthetic procedures seemed to be equally suited for these operations; therefore other criteria should be used as a basis for the selection of the anaesthetic management.
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A scheme for evaluating brachial plexus block was developed, which is based on anatomical structures and which utilizes simple neurological examination techniques. It facilitates the localization of the tip of the cannula near the plexus, gives an idea of the spread of the local anesthetic in the region of the trunks and cords, gives well timed judgement on the success of the block and allows a comparison of the development of the block when using various techniques. ⋯ With the supraclavicular technique, motor as well as sensory blockade of all nerves of the brachial plexus occurred with about the same frequency; with the interscalene technique, the centre of the block affected the caudal nerves of the cervical plexus and the cranial nerves of the brachial plexus. Following both approaches, the blockade developed from proximal to distal areas, the motor blockade preceding the sensory blockade.