Der Anaesthesist
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The volume and pH of the gastric contents aspirated prior to anaesthesia were measured in 640 acute surgical patients. The material comprises 100 patients aged between 0 and 15 years, 415 between 16 and 60 years, and 125 between 61 and 93 years. The possible relation between the gastric contents and the patients' sex, age, weight, and surgical disease (abdominal or orthopaedic) was examined. ⋯ Analgesics do not increase the number of risk patients; however, the number was higher among patients having pains (p less than 0.05). The consumption of alcohol did increase the number of risk patients (p less than 0.001). The length of fasting time also considerable influenced the volume of gastric contents in the acute surgical patient.
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[The risk of anaesthesia. Investigations based on 153,660 anaesthetic procedures (author's transl)].
153,660 protocols of general and local anaesthesias were evaluated according to the complications observed during anaesthesia. The complications recorded were analysed with respect to the following criteria: type of anaesthetic procedure, experience of the anaesthesiologist, urgency of the operation and pre-operative condition (risk group) of the patient. ⋯ A further decrease of the anaesthetic risk is only possible if all measures for optimal preparation before an operation are fully met and compromises are avoided to the utmost. However, spectacular improvement must not be expected with these measures.
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In 12 normocapnic ventilated dogs the intracranial pressure (ICP) was increased 3-4 fold by distension of the balloon of a Foley catheter (imitating a space occupying lesion). Thereafter a shock state (aortic pressure PsA 80 mm Hg) over 20 min was induced by arterial bleeding. ICP and more pronounced cerebral perfusion pressure (CPP) decreased. ⋯ A further increase of PsA, ICP and especially CPP was seen after ketamine 1,0 mg/kg b.w. Based on this study it should be possible to use ketamine in small dose for induction of anaesthesia in the emergency of haemorrhagic shock even in head injury patients with increased ICP. There is no further serious increase in ICP.