Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[Frequency and severity of throat complaints following general anesthesia with the insertion of various endotracheal tubes].
Laryngeal and pharyngeal complaints following general anaesthesia are well-known problems. The frequency, extent, and intensity reported in several studies are at variance. Such transient postoperative problems should not be considered equivalent to traumatic airway injuries caused by endotracheal intubation. ⋯ The patients of groups A-D underwent oral intubation using lidocaine gel 2%; adequate cuff inflation was determined just after intubation. The patients were questioned every 24 h for 2 days postoperatively using an analogue scale and "open" and "closed" questions. The single groups were comparable in age, sex, height, weight, number of smokers, duration of operation (only groups A-D), and preoperative diseases of the upper airways.(ABSTRACT TRUNCATED AT 250 WORDS)
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In addition to hemodilution, mechanical intraoperative autotransfusion (IAT) is the most important method of preventing or minimizing the transfusion of homologous blood in operations with major blood loss. Most of the problems associated with IAT could be solved by the use of cell separators, but the separated red blood cells still contain an average of 200 mg/dl free hemoglobin. By the determination of haptoglobin levels before and after IAT, we studied the effects of free hemoglobin on the patient. ⋯ In the control group only 26.5% of the haptoglobin levels were below normal and in no case was transport capacity exhausted (Table 3). The correlation between volume of retransfused autologous blood and decrease in haptoglobin level was small (r = 0.15). In a few cases with low volumes of retransfused blood the haptoglobin decrease may have been greater, so that free hemoglobin may have been present.
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Randomized Controlled Trial Clinical Trial
[Complaints in the postoperative phase related to anesthetics].
In two prospective, randomized studies the frequency of headache, nausea, vomiting, and analgesic requirement during the first postoperative 24 h was observed in order to study differences between the sexes and the inhalation anesthetics halothane, enflurane, isoflurane, or balanced anesthesia with enflurane/alfentanil. Nausea and vomiting were more frequent after enflurane than after halothane or isoflurane. There was no significant difference between anesthetics and frequency of headache, but there were significant differences in postoperative analgesic requirements which were highest after halothane and lowest after isoflurane. ⋯ The second study indicated that balanced anesthesia did not reduce the analgesic requirement compared to enflurane without alfentanil, but lead to a higher incidence of vomiting. After premedication with flunitrazepam and atropine and combined with 70% N2O/30% O2, isoflurane was the most favorable anesthetic agent with regard to the parameters studied. Balanced anesthesia with enflurane/alfentanil did not show any advantages for patients in the postoperative phase under the given conditions.