Der Anaesthesist
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The influence of pressure swings on the output of Dräger Vapor, Dräger Vapor 19, Cyprane Fluotec Mark 2, Cyprane Fluotec Mark 3 and Ohio halothane vaporizers was investigated. It is shown that significant deviations from the dial setting occur with all vaporizers if the swings are large enough. ⋯ The results indicate that swings, occurring during assisted or controlled intermittent positive pressure ventilation, can induce significant deviations at low carrier flow rates. The frequency and in-/expiration time ratio are relatively of minor importance.
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A 51 years old patient underwent 3 urological operations within a short space of time. The anaesthetic procedures (NLA and spinal anaesthesia) caused a rise of temperature, hyperventilation and tremor, suggesting a malignant hyperthermia. ⋯ In the daughter, some "whorled fibres" and single fibre necrosis, interpreted as signs of myopathy, were detected. The clinical syndrome of the father and the histological results of the daughter point out to the possibility that in this family a predisposition to malignant hyperthermia is present.
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A 13 year old girl who had suffered from an abortive form of malignant hyperthermia during tonsillectomy eight years before was scheduled for orthopaedic surgery. Dantrolene sodium, 3 mg/kg orally, was given prophylactically the day before surgery; preanaesthetic medication consisted of Thalamonal, a fixed combination of droperidol and fentanyl; anaesthesia was induced with methohexitone and maintained as neurolept anaesthesia with fentanyl and droperidol; tubocurarine was administered for tracheal intubation and intraoperative neuromuscular blockade. Using this anaesthetic regimen no adverse reaction was triggered.
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Randomized Controlled Trial Clinical Trial
[Influence of different preinjections on unfavourable side-effects of succinylcholine-induced block (author's transl)].
Pretreatment with a subparalytic dose of a nondepolarizing relaxant is used to prevent side-effects of the succinylcholine (Sch) dose needed for intubation. On the other hand small doses of Sch (self-taming) or lignocaine are recommended to avoid in part reversal of the Sch-induced block caused by nondepolarizing relaxant. 50 patients received different preinjections before Sch-induced relaxation: 2 mg alcuronium, n = 10; 1 mg pancuronium, n = 10; 0.1 mg/kg bw Sch, n = 10; 1 mg/kg bw lignocaine, n = 10; no pretreatment, n = 10. Injection of small doses of Sch or lignocaine prior to the Sch dose needed for intubation, offered no advantage in comparison to the conventional method of pretreatment with nondepolarizing relaxant, concerning intensity and duration of the relaxation, conditions for intubation and muscle fasciculations. After preinjection of Sch or lignocaine a similar rise of serum potassium was observed as without preinjection (0.4-0.5 mEq/l).