Der Anaesthesist
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Comparative Study
[Comparative clinical studies on vecuronium, atracurium and pancuronium in older patients].
The relaxants vecuronium (Norcuron), atracurium (Tracrium), and pancuronium (Pavulon) have been investigated with respect to onset and duration of action in old patients compared with young patients. A variant of a balanced anaesthesia technique with flunitrazepam, fentanyl and N2O/O2 was used. The following equipotent doses were investigated (mg/kg body weight): vecuronium 0.07/0.10; atracurium 0.35/0.50; pancuronium 0.08/0.115. ⋯ The duration of action to a 25% recovery and the early recovery phase from the appearance of the first to the fourth twitch in the TOF showed no difference between young and old patients. It is concluded that there are no considerable differences with respect to the duration of action between young and old patients. However, to obtain a similar degree of relaxation, it is recommended to use a somewhat higher dose level with atracurium.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Analgesia and adverse effects of nalbuphine (Nubain) in comparison with morphine following hysterectomy].
In a randomized double-blind-study nalbuphine 20 mg i.m. was compared with morphine 10 mg i.m. in 49 patients over the first 48 postoperative hours after hysterectomy. Nalbuphine proved to be a good analgetic, not statistically different from morphine but having statistically significantly fewer side effects.
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The passage of a tube through the nose to the epipharynx is potentially dangerous during the nasotracheal intubation because of the possibility of cuff damage, obstruction of the tube, the impossibility of advancing the tube and contamination. It seems therefore useful to protect the cuff e.g. by a finger stall, but using this procedure complications can occur which are reported. A better solution to protect the cuff will be shown.
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Two patients were rewarmed from hypothermia (esophageal temperature 27.2 degrees C, 27.5 degrees C respectively). The first case suffered from head-injury after alcohol ingestion and was deeply comatose. A metabolic or cardiovascular regulatory response to cold was not observed in this patient. ⋯ In contrast to the first case his norepinephrine levels were elevated to 1,500 pg/ml and his epinephrine levels only to 450 pg/ml. After onset of surface rewarming an additional increase in norepinephrine levels was observed and an increasing rate of PVC's (15/min) recorded, which ceased when temperature returned to normal. Our observations indicate that part of the cardiac complications during rewarming from deep hypothermia may result from thermoregulation and additional catecholamine liberation.