Der Anaesthesist
-
Randomized Controlled Trial Clinical Trial
[Short donation intervals in preoperative autologous blood donation in the concept of autologous transfusion].
Homologous transfusion is associated with infectious and immunological risks. Preoperative autologous deposit reduces homologous transfusion requirements considerably. Usually donations are carried out at weekly intervals. ⋯ Homologous transfusion requirements were similar in the two groups (1 unit in group I, vs 3 units in one patient and 1 unit in two patients in group II). CONCLUSIONS. Short donation intervals resulted in a higher preoperative erythrocyte mass after similar preoperative deposit, and significantly higher blood loss was tolerated with similar homologous transfusion volume.
-
The duration of spinal anaesthesia in infants is short compared to adult patients. When tetracaine is used, the addition of epinephrine significantly prolongs the duration. For bupivacaine, however, the influence of epinephrine on the duration is not clear. ⋯ CONCLUSIONS. Epinephrine 1:200,000 significantly prolongs the duration of spinal anaesthesia in former preterm infants. Haemodynamic parameters in this age group remain unchanged during spinal anaesthesia and are not influenced by the addition of epinephrine.
-
The rapid sequence induction of anaesthesia in patients with an increased risk of pulmonary aspiration is a quite involved procedure associated with many potential dangers. A new nasogastric balloon tube has been developed, which will prevent the reflux of gastric contents by blocking the cardia with a balloon. It was the aim of this initial study to assess the efficiency of the tube in animals, healthy volunteers and patients. ⋯ The average time from loss of consciousness to tracheal intubation was 164 +/- 8 s. CONCLUSIONS. It is concluded from the present results, with further clinical studies pending, that the gastric balloon probe permits low-risk conventional induction sequence of anaesthesia in patients with an increased risk for pulmonary aspiration and that the device may also be safely used during the extubation phase.
-
The decrease of functional residual capacity during anaesthesia makes mechanical ventilation mandatory. Volume- and pressure-controlled modes should both be possible. Ventilator-assisted spontaneous respiration is rarely indicated during general anaesthesia, and this mode is therefore unnecessary for anaesthesia machines. ⋯ For easier management, fresh-gas-flow-compensated circle systems facilitating adjustment of tidal volume after changes of fresh gas flow are desirable. Precautions aimed at the prevention of ventilation with hypoxic gas mixtures are still insufficient: the oxygen failure devices (nitrous oxide flow shutoff valve) are only effective if oxygen pressure from the gas supply is low. Distinct improvements have been achieved with oxygen ratio systems, preventing the administration of hypoxic gas mixtures at fresh gas flows higher than 1 l/min.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Postoperative pain therapy. The efficacy of a serotonin antagonist (GR 38032F;ondansetron) and the prostaglandin synthesis inhibitor lysin acetylsalicylate (Aspisol)].
Serotonin is one of the many neurotransmitters involved in nociception. Serotonin antagonists may therefore reduce postoperative pain. In the present study we examined whether the new 5-HT3 receptor antagonist GR 38032F (ondansetron) reduced postoperative pain after minor surgery and compared its effectiveness with that of lysin acetyl salicylate (Aspisol). ⋯ For 42 out of 100 patients no analgesics were needed within the first 3 h after end of surgery. Ondansetron was no more effective than placebo in reducing postoperative pain. Lysin acetylsalicylate, however, may be an effective alternative to opioids for the treatment of postoperative pain.