Der Anaesthesist
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Case Reports
[Carotid aneurysm following apparent complications in catheterization of the internal jugular vein].
During resuscitation of a patient wih ruptured abdominal aortic aneurysm his right internal jugular vein was cannulated with a 12 gauge catheter-through-cannula assembly (Cavafix 458, Braun-Melsungen), using a high central approach, without any apparent complications. Five weeks later a dissecting aneurysm of the right common carotid artery developed. From clinical, angiographic and histological data it is very likely that the aneurysm resulted from the catheterization procedure.
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A method is described for reversible controlled ventilation of rats by transtracheal catheter (20 or 22 G). A small rodent ventilator is used, rather then a jet ventilator, because the former enables the mixing of inhalation anesthetics with the carrying gas mixture. The method proved to be the most successful one for weaning from controlled ventilation after cardiac arrest and resuscitation of rats. In general, the method can be considered as an alterative to oral intubation and tracheotomy for controlled ventilation in rats.
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The new relaxants vecuronium (Norcuron) and atracurium (Tracrium) have been compared with pancuronium (Pavulon) with respect to onset and duration of action and intubating conditions under clinical situations. A variant of the balanced anaesthesia technique with flunitrazepam, fentanyl and N2O/O2 was used. The following doses were considered equipotent (mg/kg body weight): vecuronium 0.07/0.10; atracurium 0.35/0.50; pancuronium 0.08/0.115. ⋯ The early recovery phase (from 5% to 25% recovery) was 6.1 +/- 2.4 after vecuronium, 8.3 +/- 1.7 after atracurium, 17.2 +/- 10.8 after pancuronium. There is a good correlation between our semiquantitative results, using the train of four, and quantitative recordings of muscle contractions reported in the literature. Both drugs show no cumulative effect after five repeated administrations.(ABSTRACT TRUNCATED AT 250 WORDS)
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In 93 patients (ASA I) undergoing orthopaedic operations respiratory and haemodynamic effects of alfentanil (steady state: spontaneous breathing halothane, N2O/O2) were measured. After injection of alfentanil apnoea was found be readily antagonized by Naloxone. ⋯ The decrease of arterial pressure could be prevented by pre-injection of atropine. Therefore an increased vagal tone must be responsible for depression of haemodynamic parameters.
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Myasthenia gravis is an autoimmune-disorder and clinically characterised by weakness of voluntary muscles including respiratory and pharyngeal muscles. As myasthenia gravis is a rare disease surgeons and anesthesiologists are only seldomly confronted with patients suffering from this disease. ⋯ On the other hand this paper gives information about the intensive care and management of patients suffering from myasthenic of cholinergic crisis, which is known to be a lifethreatening emergency. Finally, the paper describes shortly the long-term treatment with immunosuppressive or immunoregulatory measures.