Der Anaesthesist
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We observed 20 patients undergoing middle-ear surgery under NLA in combination with halothane for controlled hypotension in respect to haematocrit, plasma protein concentration, plasma volume (Evans Blue) and intravascular protein mass during and after anaesthesia and surgery. As surgical bleeding was almost nil and infusion therapy was not necessary, patients behaved as a "closed system". With the start of anaesthesia we found a significant decrease of haematocrit and plasma protein concentration, being complete after 45-60 min, and unchanged thereafter until the end of anaesthesia. ⋯ Just after termination of anaesthesia we observed a significant increase in haematocrit and plasma protein concentration compared to control values with a downward trend over the next hour. At that point we also measured a decrease in plasma volume by 10% and in plasma protein mass by 6% compared to controls. These findings are interpreted as part of an "arousal reaction" with a temporary disequilibrium between transcapillary filtration rate of water and proteins and back transport of these substances via lymph flow.
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1. Time of onset and duration of action of various doses of pancuronium, tubocurarine, alcuronium , metocurine or dimethyltubocurarine, gallamine and fazadinium were studied by means of mechanomyograms of the hand muscles (twitch) following supramaximal electrical stimulation of the ulnar nerve (100-120 V, 0.2 ms, 0.2 Hz) in 293 patients during neurolept anaesthesia. -2. With an intravenous injection rate of about 5s there was no difference in latency time, however, the time of onset was found to be dose dependent. ⋯ The relation between the duration of action and the dosage of a muscle relaxant could sufficiently be described by the equation Y = a x Yb and straightened applying a double-logarithmic plot. The values of a and b for various degrees of recovery were obtained by regression analysis. Thus, the duration of action can be predicted by substituting of dose values into the above equation.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
A comparison of alfentanil and fentanyl in short operations with special reference to their duration of action and postoperative respiratory depression.
Ninety women undergoing short gynaecological operations were included in a double-blind comparison of fentanyl and alfentanil, a structurally related and very short-acting narcotic analgesic. Anaesthesia was induced by methohexitone followed by a double-blind injection of either alfentanil (0.5 mg/ml) or fentanyl (0.05 mg/ml). ⋯ Cardiovascular parameters remained stable with both analgesics. There were no troublesome side-effects.
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The 3 in 1 block provides effective analgesia for the greater part of the lower limb. The technique is simple, it requires no special positioning and because of the favorable anatomical situation of the femoral nerve it has a particularly low complication rate. The prompt administration in the acute situation considerably reduces the symptoms and consequences of traumatic shock. ⋯ The 3 in 1 block enables almost painfree positioning of the side for the performance of spinal and epidural anaesthesia. Finally the 3 in 1 block can be a most potent method of analgesia in postoperative pain. With its minimal effects on vasomotor tone and bladder function the 3 in 1 block is in many cases preferable to continuous blockade via an epidural catheter.