Anaesthesiologie und Reanimation
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Anaesthesiol Reanim · Jan 1999
Randomized Controlled Trial Clinical Trial[Preoperative clonidine comedication within the scope of balanced inhalation anesthesia with sevoflurane in oral surgery procedures].
Both clonidine and sevoflurane are interesting drugs for anaesthesia in maxillo-facial surgery. The present study was performed to discover how far it is possible to combine the benefits of sevoflurane (fast modulation of depth of anaesthesia, rapid emergence and recovery) and clonidine (reduction of perioperative stress response, prophylaxis of postoperative shivering, analgetic, antiemetic and anaesthetic-saving effect) without compromising the pharmacokinetic of sevoflurane. Twenty-eight patients were included in the present double-blinded prospective study. ⋯ Preoperative clonidine comedication seems to complicate the management of anaesthesia. On the other hand, it is beneficial during the early postoperative period (e.g. stability in haemodynamics, prophylaxis of shivering) without compromising emergence and recovery. Our results show that therapy with clonidine should be better placed at the end of anaesthesia.
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Anaesthesiol Reanim · Jan 1999
Case Reports[High-frequency jet ventilation for placing tracheal stents--a case report].
Stenoses of the larynx and trachea may cause acute life-threatening situations. Surgical procedures in patients presenting this type of problem are a real challenge for the surgeon and the anaesthesiologist. Depending on the extent and the nature of the stenosis, the insertion of a stent may be the best therapeutic option. ⋯ In addition, at the end of the operation the newly implanted stent should not be altered by manipulations necessary for artificial respiration. We describe a new method which uses tracheal jet ventilation for implanting a stent with only short interruptions of artificial ventilation. During recovery from anaesthesia, there is no risk of dislocating the newly placed stent.
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The long predominance of the semi-open anaesthetic system in paediatric anaesthesia has been ended by the introduction of circle systems by Altemeyer. Narcoses in newborn infants, however, are usually performed with a circle system and a fresh gas flow (FGF) that greatly exceeds the ventilation volume per minute required. This prevents a desirable degree of gas climatisation. ⋯ When FGF was reduced there was a significant increase of temperature parameters after 25 min (gas) and 35 min (body). Body temperature came back to normal values or stayed normal. Artificial ventilation of neonates in anaesthesia lasting more than 50 minutes should routinely be performed with minimal FGF in order to ensure normothermia.
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Anaesthesiol Reanim · Jan 1999
[Value of the laryngeal mask in emergency care--a survey of North German emergency physicians].
In clinical routine, the laryngeal mask airway (LMA) has proved an alternative to both endotracheal intubation and mask ventilation. In a survey among North German emergency physicians, aspects such as doctors' acquaintance with the LMA, the degree of ist distribution, its use and its potential benefits under non-hospital emergency conditions were evaluated. ⋯ Sixty-three per cent considered the LMA the first-choice alternative in an unexpected "can't-ventilate-can't-intubate" situation. Use of the LMA should be extended in emergency medicine especially as its application is relatively easy to learn in clinical routine.
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Anaesthesiol Reanim · Jan 1999
Comparative Study[General anesthesia or spinal anesthesia for hip prosthesis replacement? Studies of acceptance of both procedures by patients].
Patients undergoing total hip replacement are given general anaesthesia or spinal anaesthesia. The aim of this study was to investigate the experiences of patients before, during and after general anaesthesia (68 patients) or spinal anaesthesia (77 patients). Our investigation revealed that with regard to complications (nausea and vomiting, headache and back pains), no differences between the two methods occurred. ⋯ We found that the time of postoperative analgesia after spinal anaesthesia (210 minutes) was significantly longer than after general anaesthesia (90 minutes). The majority of the patients in both groups (approximately 90%) were satisfied with the chosen method of anaesthesia and with the postoperative pain therapy. These findings make it possible to conclude that with the exception of differences in the postoperative analgesia time, there are no differences between general anaesthesia and spinal anaesthesia regarding complications and satisfaction of the patients with both methods of anaesthesia.