Der Anaesthesist
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Difficult intubations can occur in cases of anatomical or physiological abnormalities of the face and neck. They are frequently predictable when specific signs are evident preoperatively. There are still occasional unexpected difficulties during conventional laryngoscopy when common blades like the Macintosh and Foregger types are used. ⋯ Because of its dual availability, it offers both direct and non-direct visualisation of the larynx. Handling of this mirror-blade can be practised extensively, which allows integration of this equipment in the "failed intubation drill". This should be an integral part of the teaching and training of anaesthesia personnel.
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Comparative Study
[Does the photoplethysmographic technique show an improvement in the measurement of the indirect blood pressure in intensive care patients?].
In the present report we investigated whether oscillometric and plethysmographic arterial blood pressure measurement techniques yielded different results compared to invasive blood pressure measurements in 18 mechanically ventilated and 14 spontaneously breathing patients. METHODS. Blood pressure was recorded simultaneously with plethysmographic, oscillometric, and invasive systems (FINAPRES 2300, HP 78352A, and 78534A, respectively). ⋯ Both methods have to be optimised in hardware and software. However, the photoplethysmographic results showed an improvement in blood pressure measurement in ventilated patients. Due to the remaining deviations between the non-invasive and invasive measurements, especially in critically ill patients in the intensive care unit, direct measurement cannot be replaced by either of the non-invasive methods.
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Case Reports
[Anesthetic-induced heart arrest. A case report of 2 infants with previously unrecognized muscular dystrophy].
We report two boys aged 4 and 10 months who suffered cardiac arrests after induction of anaesthesia. Both infants had no personal or family history of myopathy. In both cases anaesthesia was induced by inhalation with halothane and N2O/O2 (70/30). ⋯ Two months later a muscle biopsy taken from the quadriceps showed marked muscular dystrophy. Duchenne's muscular dystrophy could be excluded. The most likely underlying reasons for these complications are discussed: anaesthesia-induced acute rhabdomyolysis or malignant hyperthermia.
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Letter Historical Article
[The first treatise on ether anesthesia in Germany dated 1847].