Der Anaesthesist
-
Since ketamine has been incriminated as triggering malignant hyperthermia (MH) [3, 9, 13, 14, 18], but has still been used uneventfully in MH susceptible patients, we performed an in vitro study to examine the safety of ketamine for use in human MH. METHODS. Muscle specimens of 20 patients who had muscle biopsies to diagnose MH were investigated. ⋯ Analogous findings in frog sartorius muscles can be found in the literature. Whereas the effect of ketamine on indirectly stimulated muscle has been investigated by several authors, the underlying mechanism of ketamine-induced twitch suppression in directly stimulated muscles is not known. Inhibition of calcium release from or accelerated uptake into the sarcoplasmatic reticulum have been reported.
-
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).
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Cannulation of the internal jugular vein using 2 ultrasonic technics. A comparative controlled study].
The internal jugular vein (IJV) is a common access route to the central venous system. Anatomical landmarks (group I) are normally used for localization of the IJV. We have compared this method with two other methods based on ultrasonic waves to identify the IJV and the carotid artery (CA) (even in atypical positions). ⋯ One patient (group I) displayed a hematoma following inadvertent puncture of the CA. In one patient in group II the IJV and CA could not be distinguished as one was overlying the other. The echocamera provided improved localization of the IJV and the CA in comparison with the Doppler ultrasound.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Anesthesia machines may not be contaminated with anesthetic vapors when a patient susceptible to malignant hyperthermia (MHS) is to be anesthetized. A clean machine may not always be available, and recommended protocols for preparing a contaminated machine are cumbersome and time-consuming. We suggest the use of an activated charcoal filter that is easily assembled from spare parts available in many anesthesiology departments (Fig. 2). ⋯ All parts are autoclavable. The filter adsorbs anesthetic vapors quantitatively (Fig. 3) without affecting humidity, nitrous oxide concentration, or circuit resistance. Storage of such a filter may obviate the need to keep a clean anesthesia machine available for MHS patients.