Anaesthesiologie und Reanimation
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For an exact evaluation of the risks of operations it is necessary to assess both co-existing and concomitant diseases before the performance of anaesthesia. The relatively low incidence of neurological and muscular diseases (0.02 to 0.7/1,000) and the low probability of an operation of a patient suffering from these diseases lead to higher anaesthesiological risks during the operation and the perioperative period. The anaesthetist is usually not always aware of all the special pathophysiological problems which have to be taken into consideration when these patients have to be anaesthetized. In order to reduce the risk of anaesthesia of these patients, we discuss the most important of these uncommon neurological diseases regarding their special anaesthesiological management.
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Anaesthesiol Reanim · Jan 1994
Comparative StudyA comparison of the accuracy of the Siemens injection vaporizer and the Enfluratec 3 vaporizer.
The accuracy of two Siemens injection vaporizers was examined under operating theatre conditions. For comparison, two Enfluratec 3 vaporizers were tested. The concentrations of enflurane produced by the vaporizers were measured both by an anaesthetic agent monitor and by chromatography. ⋯ The former vaporizers seem to be less robust than the Enfluratecs and should be used according to the manufacturer's recommendations. The pressures in the central system were higher than those called for. In addition, improper coupling of the Siemens apparatus to the ventilator may well have influenced the results.
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Anaesthesiol Reanim · Jan 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Mechanomyographic and electromyographic studies of endotracheal intubation with 2 different rocuronium dosages].
Rocuronium is a new, intermediate-acting, nondepolarizing relaxant with rapid onset of action leading to both good and very good intubation conditions. It was the aim of our study to investigate the onset of action, the intubation conditions and the course of relaxation using two different dosage regimes. Thirty consenting ASA 1 and 2 patients received either 0.6 mg/kg (2 x ED 95; group 1) or 0.06 mg/kg as priming dose followed by an intubating dose of 0.24 mg/kg rocuronium (group 2) four min later. ⋯ The clinical duration of action was significantly longer in group 1 (28.4 +/- 8.0 min) than in group 2 (14.8 +/- 2.5 min). It can be concluded that rocuronium which has shorter intubation times than atracurium and vecuronium is very useful for endotracheal intubation in both dosage regimes in long and very long lasting operations. Using the "priming principle" the patient has to be carefully controlled during priming time.
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Anaesthesiol Reanim · Jan 1994
Comparative Study[Anesthesia with the closed PhysioFlex system in comparison with conventional anesthesia procedures].
So far the anaesthetic technique of the closed circuit system in clinical routine could not be used adequately, because suitable mixtures of respiration gas components were not available and the maintenance of a sufficient gas volume in the anaesthetic circle system was not possible with the standard anaesthesia machines. The anaesthesia machine PhysioFlex was especially constructed to deliver anaesthetics in a closed circuit system. In this anaesthesia machine the concentrations of the respiratory gases and the gas volume in the circle system are automatically controlled by a feedback mechanism. ⋯ After the induction the desired inspiratory oxygen-concentration was reached within 5 minutes, the expiratory isoflurane-concentration within 10 minutes in the CC group and was maintained reliable. The consumption of liquid isoflurane was 12.9 ml/h in the HF group, 7.5 ml/h in the LF group and 5.3 ml/h in the CC group. The anaesthetic management was possible without any problems in all three groups.
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Anaesthesiol Reanim · Jan 1994
Review[The present possibilities for routine use of blood-saving measures from the anesthesiologic point of view--theoretical basis and clinical practice. I. Potential risks of homologous transfusion; normovolemic hemodilution].
This paper, which is the first part of four, deals with the potential risks of homologous blood transfusion as well as with normovolemic hemodilution, an autologous transfusion method, which is easily to be applied and not expensive. Although the various methods of autologous transfusion are well known for many years the public discussion on the "AIDS-topic" has led to a growing interest in blood-saving measures. However, in contrast to the so-called "AIDS-topic" the potential risks of a transfusion-transmitted hepatitis as well as the immunologic effects of homologous blood are of much greater importance. ⋯ Moreover, drug-induced stimulation of the erythropoiesis by means of erythropoietin and the additional (intravenous) administration of iron may become a further component among autologous transfusion methods. Normovolemic hemodilution means exchange of autologous blood versus an artificial colloid. To make sure for normovolemia is to be considered a "conditio sine qua non" for "functioning" of normovolemic hemodilution.(ABSTRACT TRUNCATED AT 250 WORDS)