Der Anaesthesist
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In 1985 Brain et al. published their first experience with the laryngeal mask, developed by themselves. With this mask it is possible to seal the larynx and ventilate a patient during anesthesia without endotracheal intubation. Meanwhile, further reports of successful use have been published, especially in Great Britain. ⋯ Our investigation confirmed the previously described advantages of the laryngeal mask. We consider its use to be especially indicated in general anesthesia for short surgical or diagnostic procedures or if specific complications of endotracheal intubation should be avoided. A critical aspect in the use of the laryngeal mask is the fact that there is no complete isolation of the trachea and, therefore, an insufflation of the stomach or aspiration could occur, especially during critical situations (e.g. bronchospasms).(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
[Acoustic evoked potentials of medium latency and intraoperative wakefulness during anesthesia maintenance using propofol, isoflurane and flunitrazepam/fentanyl].
Auditory evoked potentials have been used as an indicator of awareness. During combined local and general anesthesia clinical signs of adequate anesthesia are difficult to evaluate. In the present study we combined peridural analgesia with three techniques of general anesthesia. ⋯ CONCLUSIONS. The maintenance of MLAEP and the primary cortical complex Na/Pa correlates with the incidence of motor signs of wakefulness. During the combination of regional and general anesthesia, isoflurane and propofol seem to provide better suppression of intraoperative wakefulness than bolus injections of flunitrazepam/fentanyl.
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Randomized Controlled Trial Clinical Trial
[Optimal dosage strategies in total intravenous anesthesia using propofol and ketamine].
The combination of propofol and ketamine for total intravenous anesthesia was investigated; the intention was to minimize the side effects of each drug by the concomitant application of the other drug. METHODS. Twenty patients scheduled for lower abdominal interventions were divided into two groups. ⋯ The major known side effects of propofol (reduced hemodynamics during induction) and ketamine (psychic disturbances and cardiovascular stimulation) were absent and respiratory function was adequate after the end of surgery. This technique, therefore, can be used in risk patients and under disaster conditions when i.v. access is the only possible route of drug administration. The use of computer-assisted infusion pumps markedly enhances handling and controllability of total i.v. anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
[A comparison of autologous transfusion procedures in hip surgery].
The risks associated with transfusion can be minimized with autologous blood. The efficiency of preoperative deposit, preoperative hemodilution and intra- and postoperative autotransfusion in reducing homologous transfusions has been demonstrated. There seem to be few studies, however, that compared the different methods of autologous transfusion. ⋯ CONCLUSION. Under the conditions studied, preoperative autologous deposit was the most efficient method of autologous transfusion for hip arthroplasty. It should be employed primarily.