Der Anaesthesist
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In 93 patients (ASA I) undergoing orthopaedic operations respiratory and haemodynamic effects of alfentanil (steady state: spontaneous breathing halothane, N2O/O2) were measured. After injection of alfentanil apnoea was found be readily antagonized by Naloxone. ⋯ The decrease of arterial pressure could be prevented by pre-injection of atropine. Therefore an increased vagal tone must be responsible for depression of haemodynamic parameters.
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Myasthenia gravis is an autoimmune-disorder and clinically characterised by weakness of voluntary muscles including respiratory and pharyngeal muscles. As myasthenia gravis is a rare disease surgeons and anesthesiologists are only seldomly confronted with patients suffering from this disease. ⋯ On the other hand this paper gives information about the intensive care and management of patients suffering from myasthenic of cholinergic crisis, which is known to be a lifethreatening emergency. Finally, the paper describes shortly the long-term treatment with immunosuppressive or immunoregulatory measures.