Der Anaesthesist
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Comparative Study
[Continuous measurement of cardiac output based on the Fick principle in cardiac anesthesia].
With the development of fiberoptic and pulse oximetry, as well as the development of the more modern methods of oxygen consumption measurements, the online monitoring of Fick cardiac (FCO) output has become possible in the clinical treatment routine. The aim of this study was to compare fiberoptically measured mixed venous oxygen saturation with values from blood samples and continuously determined Fick cardiac output with intermittent thermodilution cardiac output (TCO). Ten patients undergoing coronary artery bypass grafting were measured during the perioperative period. ⋯ The limits of confidence (95%) were 0.18 to 0.66 l/min. There was no systematic difference between mixed venous saturation measurements with the fiberoptic system and from blood samples. The cardiac output values derived from fiberoptic and pulse oximetry can be considered sufficiently reliable for clinical purposes.(ABSTRACT TRUNCATED AT 250 WORDS)
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The problems associated with "difficult airways" have almost subsided since the introduction of flexible fiberoptic bronchoscopes for tracheal intubation. Limitations of this technique persist with uncooperative patients, children and infants. ⋯ The device makes intubation possible with all sizes of fiberoptic bronchoscopes. The prerequisites for application of this technique include an airway that will be maintained by mask ventilation.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Sufentanil: the effect on cardiocirculatory parameters and intubation conditions on administration of pancuronium or vecuronium].
A lack of uniform methodology used in the assessment of moderate doses of sufentanil in combination with non-depolarizing neuromuscular blocking drugs formed the basis of the current study which compared under randomized conditions the effects of sufentanil-pancuronium versus sufentanil-vecuronium on hemodynamics, intubating conditions and chest wall rigidity during induction of anesthesia. MATERIAL and METHODS. One hundred and twenty ASA physical status I and II patients aged between 20 and 40 years of age who were undergoing elective urological surgery were included in the study. ⋯ Neuromuscular transmission was monitored with the Datex Relaxograph, a neuromuscular transmission analyzer, that utilizes the integration of the EMG response. Producing train-of-four (TOF) stimuli, with a pulse width of 100 microseconds and a frequency of 2 Hz every 20 s the following parameters were recorded by the Datex Relaxograph: The percentage of first twitch amplitude compared with the reference (T1), and the train-of-four (TOF) ratio, i.e., the ratio of last twitch height to first height. Measurements were taken after premedication in the operating room, the value which served as a baseline (t0), 1 min after sufentanil or placebo (t1), 1 min after priming or placebo (t2), 1 min after thiopentone (t3), and 1 min after intubation (t4).(ABSTRACT TRUNCATED AT 400 WORDS)
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Review Historical Article
[Spongia somnifera. Medieval milestones on the way to general and local anesthesia].
Medieval medicine was highly innovative compared to ancient and early modern medicine. The achievements then did not merely comprise new models from the viewpoint of the history of science: development of the university, a well-defined curricula and official degrees, obligatory fees and cost reducing measures. They also included therapeutic procedures like nerve suture, antisepsis, chemotherapy (colchicine), cardiac glycosides (scillaren, convallerin), the development of visual aids (binoculars, magnifying glass, microscope, presbyopic glasses) and further improvement of plastic surgery by the application of delayed grafts (lips/nose plastic). ⋯ This holds true for the extirpation of abdominal tumors as well as for the concept of therapeutic fever. It also pertains to anesthesia, which in the Middle Ages was developed from ancient methods of sedation. Medieval scholars perfected the method into achieving the first total anesthesia (resorption/inhalation anesthesia) and then local anesthesia (application of morphine at the cornea).