Der Anaesthesist
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A new fiberoptic endoscope is presented for the special situation of endotracheal intubation only in anesthesiological and intensive care. There is quite an improved cost efficiency due to decreased price, considering its variety of uses.
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Comparative Study
[Pulse oximetry as a continuous, noninvasive monitoring procedure. Comparison of 2 instruments].
Pulse oximetry allows continuous registration of the arterial oxygen saturation by using the light absorption in a wave range between 600 and 1,000 nm. In addition the peripheral pulse is determined by a plethysmographic method. Two new devices, the Biox III pulse oximeter and the Nellcor pulse oximeter were compared for the following three items: 1. ⋯ The onset time for registering a suddenly appearing hypoxia: For the Biox III oximeter we found a time lag between 6 and 42 s (median 21 s), for the Nellcor Oximeter between 12-39 s (median 21 s). 3. The pulse frequency corresponded very well with the simultaneously registered heart rate of the ECG. Our results indicate that pulse oximetry--a continuous and noninvasive method--is a reliable monitor for oxygen saturation, and provides trend informations about circulation, both of which are particularly appropriate for patients breathing spontaneously.
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Comparative Study
[Atracurium: neuromuscular blockade in repeated administration].
The neuromuscular blocking action of repeated injections of atracurium and vecuronium was studied in 74 surgical patients during balanced anaesthesia (methohexitone or etomidate, intubation after suxamethonium, fentanyl, droperidol, N2O). The initial bolus dose (ID) of atracurium was 0.25 mg/kg and of vecuronium 0.05 mg/kg followed by repeated increments (RD) of atracurium 0.1 mg/kg and vecuronium 0.0125 mg/kg when neuromuscular function (EMG) had recovered to about 30% of pre-relaxant control. Dose-response relationships revealed atracurium to be about 1/5 as potent as vecuronium; the ED50 of atracurium was 0.13 +/- 0.03 mg/kg and of vecuronium 0.023 +/- 0.007 mg/kg. ⋯ Neither cardiovascular side-effects nor signs of histamine release were observed after both relaxants in our particular dose range. It is concluded, that atracurium is a favourable blocker for anaesthetic practice: The time of onset is approximately the same compared with vecuronium. The duration of action, however, is slightly longer but still truly intermediate long.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
[Vecuronium: onset of effect and intubation conditions in comparison to pancuronium and suxamethonium].
The onset of neuromuscular blockade following the i.v. injection of vecuronium and pancuronium 0.05, 0.08 or 0.1 mg/kg and suxamethonium 0.5 or 1.0 mg/kg was studied in 304 patients during induction of anaesthesia by means of the compound action potential derived from the adductor pollicis muscle, which was indirectly stimulated via the ulnar nerve. The intubation conditions 1-5 min after injection were assessed using a scoring system related to ease of laryngoscopy, movement of vocal cords and coughing, and reflex movements of extremities. Development of motor blockade was time- and dose-dependent. ⋯ Although suxamethonium acts the fastest and tracheal intubation can be achieved within 0.5-1.0 min, its use involves certain side effects and disadvantages. Vecuronium acts considerably faster than pancuronium and good or excellent intubation conditions are present within 2 min. Suxamethonium is no longer the muscle relaxant of choice for intubation except for crash intubation, e.g., in patients with a full stomach.
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Clinical Trial Controlled Clinical Trial
[Transdermal scopolamine (TTS-scopolamine) for the prevention of postoperative nausea and vomiting].
Parenteral scopolamine lost its significance for premedication because of severe side effects, at least in German speaking countries. The drug is now available as a transdermal therapeutic system (TTS-Scopolamine) which provides constant low plasma concentrations for three days, high enough to act as an antiemetic but low enough to be free from severe side effects. In a double blind study against TTS-Placebo TTS-Scopolamine was investigated in 40 patients, undergoing minor gynecological surgery. ⋯ There were no severe side effects. TTS-scopolamine can be recommended as an antiemetic for premedication, especially when benzodiazepines are used for the relief of anxiety. It should be administered on the evening before and can be removed one or two days after surgery.