Anaesthesiologie und Reanimation
-
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.
-
Anaesthesiol Reanim · Jan 1996
Biography Historical Article[The 16th October 1846 and its outcome].
Morton's first successful public demonstration of ether anaesthesia for a surgical operation, performed on October 16, 1846 in Boston/Massachusetts, had far-reaching consequences. The first effect was the surprisingly fast propagation of the new way of preventing pain to nearly all parts of the globe. Anaesthesia made it possible to perform operations previously considered impossible under conditions now acceptable for the patient. ⋯ Much later, the special field of anaesthesiology emerged. Today, 150 years after Morton's pioneer work, anaesthesiology comprises not only pain relief for operative procedures but also responsibilities in Emergency and Critical Care Medicine and in the treatment of patients with chronic pain. Accordingly, without the least disparagement of daily interdisciplinary cooperation, one can wholeheartedly support Mayrhofer's view that the "Century of Surgeons" has given way to the "Century of Anaesthesiologists".
-
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.
-
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.
-
Anaesthesiol Reanim · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Effect of rocuronium in sufentanil/isoflurane and sufentanil/propofol anesthesia].
It is a well-known fact that the duration of the effect of non-depolarizing neuromuscular blocking agents is influenced by other anaesthetics. Etomidate, propofol and nitrous oxide have no influence on the duration of effect of rocuronium, but a prolongation of the rocuronium effect under the influence of isoflurane has been described. In this study, we investigated the onset time, duration of effect and recovery index of rocuronium in isoflurane/N2O/sufentanil anaesthesia compared with these parameters in propofol/N2O/sufentanil anaesthesia. ⋯ Significant changes in arterial blood pressure or heart rate were not observed. The intubation conditions after 60 seconds were excellent in 34 patients (85%) and good in 6 patients (15%). It can be concluded that in comparison with anesthesia maintained by propofol/sufentanil and nitrous oxide/oxygen, the relatively low but necessary supplementation with isoflurane instead of propofol does not lead to a clinically relevant amplification of the relaxing effect of rocuronium.