Anaesthesiologie und Reanimation
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Anaesthesiol Reanim · Jan 1996
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial[Comparison of the effect of desflurane and isoflurane on neuromuscular blockage with vecuronium on geriatric patients].
Volatile anaesthetics have long been known to intensify the effect of muscle relaxants. In this study we investigated the effects of desflurane and isoflurane on the neuromuscular blockade of vecuronium in geriatric patients. Fifty-two patients requiring elective surgery, aged > or = 65 years, with ASA status II - III were randomly assigned to receive general anaesthesia using desflurane (Des, n = 26) or isoflurane (Iso, n = 26). ⋯ There were no differences between the two groups (p > 0.05). These results suggest that augmentation of neuromuscular blockade by older fluorinated anesthetics is also exhibited by desflurane. The magnitude of this effect in geriatric patients is similar to that of isoflurane.
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Anaesthesiol Reanim · Jan 1996
Review Randomized Controlled Trial Comparative Study Clinical Trial[Prevention of postoperative nausea and vomiting with single and repeat administration of ondansetron--review of the literature on different administration forms].
Postoperative nausea and vomiting (PONV) is still a common perioperative complication and ondansetron has proved to be an effective antiemetic substance in its prevention. The antiemetic effect of single and repetitive application was evaluated in this study. Fifty-one female patients who underwent gynaecological surgical procedures took part in a random double-blind study. ⋯ Ondansetron was shown to be a well-tolerated antiemetic and seems to have a higher reductive effect on PONV when given in a single dose and not repetitively. The prophylaxis of vomiting seems to be more effective than the reduction of nausea. Follow-up studies will have to clarify our findings.
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Mivacurium is a potent, short-acting, nondepolarizing relaxant of the benzylisoquinoline series. In adults endotracheal intubation can be performed after a 2 x ED95 dose of 0.15-0.2 mg/kg within 2-2.5 minutes. In infants onset time and clinical duration of mivacurium are significantly shorter than in adults. ⋯ The properties of mivacurium described above are related to patients with normal pseudocholinesterase activity. Particularly patients with atypical pseudocholinesterase show a marked increase in clinical duration. Side-effects due to significant histamine release with flush, tachycardia and hypotension are seldom observed if mivacurium is injected slowly over a period of more than 30 seconds and bolus injections of more than 2 x ED95 or 3 x ED95 are avoided.
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Anaesthesiol Reanim · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Combination of intravenous patient-controlled analgesia with epidural anesthesia for postoperative pain therapy].
The aim of this study was to prove the hypothesis that a combination of epidural anaesthesia with intravenous patient-controlled analgesia (PCA) could improve perioperative pain management. Patients of the urological department undergoing lower abdominal surgery were randomized for two different pain managements. Patients of group 1 (n = 37) were narcotized, intubated and ventilated for the operation; arriving at the recovery room, they were given a PCA-pump, the drug used was piritramide and the parameters were bolus 2.5 mg, blocking time 20 minutes and no basal infusion rate. ⋯ The benefits of better pain management contrast with the risks resulting from combining the two techniques. In our patients we found an improvement of pain management in the early postoperative period. The combination of epidural anaesthesia with intravenous patient-controlled analgesia can be regarded as a further possibility for treating postoperative pain in the sense of "balanced pain management".
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Anaesthesiol Reanim · Jan 1996
Comparative Study[Clinical experiences with fiber optic intubation with the Bonfils intubation fiberscope].
In a prospective study 107 patients were analyzed regarding difficulty of intubation. One hundred and three were intubated with the retromolar fibrescope named after Bonfils. The report gives an account of the intubation technique and experiences with this device. ⋯ For this technique, a sufficient opening of the mouth for the introduction of the apparatus is necessary. The rigid fibrescope cannot compete with the flexible optic, but supplements the repertoire of aids for difficult intubations. It could open up new areas of indication for safe and gentle intubation.