Der Anaesthesist
-
Clinical Trial
[Quantification of variations in arm perfusion after plexus anesthesia with color doppler sonography].
The axillary brachial plexus block is a well-known technique for intra- and postoperative analgesia and sympathetic blockade in hand and microsurgery. The aim of this study was to show the influence of the axillary brachial plexus block on the blood flow as a side effect. METHODS. ⋯ CONCLUSIONS. The brachial plexus block combines two advantages: pain relief and pain management plus temporary sympathectomy. In conclusion, it prevents vasospasms and improves the circulation of the hand in patients undergoing reimplantation of limbs and those with nutritional disorders.
-
A separation of the individual latex layers is a known complication of endotracheal armoured tubes manufactured by immersion technique. This can result in herniation into the lumen with obstruction of the tube. Diffusion of nitrous oxide into the inner hernia considerably intensifies the obstruction. ⋯ A too-high drying temperature can cause premature layer separation. The tubes should never be processed more than 80 times. Routine examination of the tubes is imperative, especially at the predilection sites for layer separation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Total intravenous anesthesia (TIVA) in geriatric surgery. S-(+)-ketamine versus alfentanil].
In this prospective, randomized study, two regimens of total intravenous anaesthesia (TIVA), with propofol and S(+)-ketamine (S-ketamine) and with propofol and alfentanil, were compared with reference to endocrine stress response, circulatory effects and recovery. METHODS. The investigation was conducted in two groups of 20 ASA I-III patients over 60 years of age who were scheduled for endoprothetic orthopaedic surgery. ⋯ On the other hand, TIVA with propofol and alfentanil showed sympatholytic properties, with negative circulatory effects and a remarkable reduction of endocrine stress response. This might be beneficial in patients with hypertension and states of endocrine hyperfunction. Both regimens were accompanied by such typical side effects as dreams, delayed recovery, reduced ventilation, and emesis, which should also be considered.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Endotracheal intubation with propofol and fentanyl].
The routine use of succinylcholine for endotracheal intubation is being increasingly questioned. Initial studies have suggested that a combination of propofol and alfentanil without a muscle relaxant can provide good intubating conditions. However, most of these initial studies either did not have a double-blind design or did not include a control group with muscle relaxants. ⋯ CONCLUSION. The use of 0.1 mg fentanyl/sodium thiopental/succinylcholine results in no better intubating conditions than 0.1 mg fentanyl plus propofol. Under these conditions, without the use of a muscle relaxant, it is possible to carry out safe endotracheal intubation in cases where no complications are anticipated.