Der Anaesthesist
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Biography Historical Article
[Eduard C. H. von Siebold: "The use of sulfur ether vapor in obstetrics" (1847). A contribution to the beginning of modern obstetric analgesia and anesthesia in Germany].
In 1847 J. Y. Simpson in Scotland was the first to describe the administration of ether for analgesia in painful deliveries. ⋯ While he was satisfied with the good analgesia without sequelae of the new-born, he was discouraged by the termination of uterine contractions observed in all his patients. He concluded that ether was not a useful substance for analgesia during vaginal delivery, since it disturbed the natural course of labour. On the other hand, von Siebold was very pleased with the administration of ether for operative obstetric procedures such as forceps deliveries or placental retention.
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Randomized Controlled Trial Clinical Trial
[Are tramadol enantiomers for postoperative pain therapy better suited than the racemate? A randomized, placebo- and morphine-controlled double blind study].
The goal of this prospective, randomised and double-blind pilot-study was to investigate the analgesic potency and the side-effects of tramadol enantiomers in clinical practice. One hundred patients recovering from orthopaedic surgery with a postoperative pain intensity of more than 50 on a visual analogue scale 0-100 mm (Table 1) were recruited for the study. They were treated in a randomised, double-blind way with a maximal dose of 150 mg i.v.(+)-,(-)-tramadol, racemate, or 15 mg i.v. morphine or saline in the placebo group (5 groups, 20 patients each). ⋯ There were no side-effect in the tramadol racemate group. The enantiomers were equal to the racemate in analgesic potency, but inferior by far to morphine. They showed more adverse events and, hence, can not be preferred to the racemate in postoperative pain therapy.
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The aim of this study is to examine whether a routine preoperative ECG is necessary in children to assess the risks in anaesthesia and surgery. ⋯ Routine preoperative ECGs are unnecessary in children unless there are clinical symptoms of heart diseases or heart disease is suspected.
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Clinical Trial
[Cytokine release and changes in mononuclear cells in peripheral blood under the influence of general anesthesia].
Anaesthetic agents are believed to have an adverse effect on human immune defense mechanisms. We investigated changes in peripheral immune cell numbers such as natural killer (NK) cells, B cells and T lymphocyte subpopulations (CD4+ and CD8+ cells) and differences in cytokine production after stimulation with different mitogens before and during narcosis. ⋯ These findings suggest that general anaesthesia interferes with immune cell number and immune cell response. This may explain the clinically well-recognized disturbance of human immunity after surgery and general anaesthesia.