Der Anaesthesist
-
Case Reports
[Successful thrombolysis of a fulminant lung embolism during cardiopulmonary resuscitation].
A healthy 38-year-old woman suffered a sudden cardiac arrest 2 days after a vaginal hysterectomy. Although standard cardiac life support (CPR) was instituted immediately after the event, it was not possible to re-establish a spontaneous circulation for about 40 min. Systemic intravenous thrombolytic therapy with slow injection of 1.5 million IU urokinase was performed as a final life-maintaining measure because of the high probability that the underlying cause was a pulmonary embolus; 10 min later (after 60 min of ongoing CPR) the patient regained a stable circulation. She survived without neurological deficit in spite of the long duration of CPR.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Intravenous versus thoracic-epidural patient-controlled analgesia following extended abdominal or thoracic surgery].
Intravenous patient-controlled analgesia (PCA-i.v.) has has markedly improved postoperative pain-relief. Alternatively, peridural anesthesia has been used successfully in high risk patients with the disadvantage of a more intense postoperative care. In this study we compared the applicability of intravenous vs. peridural patient-controlled analgesia on a general ward. ⋯ This study demonstrates that epidural PCA can be used on a general surgical ward as an alternative method compared to intravenous PCA. PCA-PDK may be advantageous over intravenous PCA since both techniques require similar intense monitoring and side effects in the PCA-PDK group appear to be less.
-
Randomized Controlled Trial Clinical Trial
[The effects of dopexamine. Transpulmonary shunt volume in thoracic surgical procedures with one-lung respiration].
To study the influence of dopexamine on pulmonary shunt and hypoxic pulmonary vasoconstriction during major thoracic surgery with one-lung ventilation (OLV). ⋯ It is concluded that dopexamine can be used to improve haemodynamics and oxygen delivery during thoracic surgery without increasing venous admixture during one-lung ventilation.