Der Anaesthesist
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Clinical Trial
[Safe handling of the laryngeal mask airway in eye surgery].
We prospectively used the laryngeal mask airway (LM) in eye surgery to evaluate: 1) the limits of safe handling; 2) the feasibility of its use in long operative procedures, and 3) whether patients with higher anaesthetic risk (hypertension, asthma, children) may profit from the LM. ⋯ Limits for the use of the LM in eye surgery are delineated. Within these limits, the LM offers control over the airway comparable to that of an endotracheal tube with less stimulation. The LM has to be applied by an experienced user, and has advantages in eye surgery.
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Clinical Trial
[The Mallampati Score. Prediction of difficult intubation in otolaryngologic laser surgery by Mallampati Score].
The Mallampati score (MS), later modified by Samsoon and Young, is a common method used to predict difficult intubation. We tested its predictive value in otolaryngologic (ENT) laser surgery. ⋯ Difficult intubation was significantly more common in patients with MS > or = 3. Low sensitivity (60%) and specificity (72%) limit the clinical value of this test, however.
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We performed a prospective multi-center study in order to determine the causes of 30-day perioperative mortality. ⋯ In order to further reduce perioperative mortality in critically ill patients, every hospital should aim to optimize the structure of the surgical and anaesthesiological departments. A delay due to logistical or personnel problems may be a co-factor in perioperative mortality. Recovery rooms with experienced personnel should be the standard in postoperative anaesthesiological care. (ABSTRACT TRUNCATED)
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The mucociliary escalator of the lung is an important protective transport system by means of which inhaled particles and microorganisms are removed from the tracheobronchial system. In general, it is assumed that anaesthetics inhibit mucociliary clearance [3,5,6,19,27]. In the present prospective study the effect of combination anaesthesia with isoflurane, fentanyl, vecuronium, and nitrous oxide-oxygen mixture on bronchial mucus transport velocity (BTV) was investigated. ⋯ Combination anaesthesia with isoflurane, fentanyl, vecuronium, and O2:N2O does not influence BTV in patients with healthy lungs.
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A 22-year-old male suffering from neuropathic pain in his right leg had sufficient analgesia with oral tilidin 300 mg per day. Nevertheless, the general practitioner decided to change the therapy to transdermal fentanyl. ⋯ After the patch was removed another 60 min later, the patient made a complete recovery. The risks following inappropriate application of transdermal fentanyl are discussed.