Anaesthesiologie und Reanimation
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Anaesthesiol Reanim · Jan 2000
Randomized Controlled Trial Comparative Study Clinical Trial[Is the combination of nitrous oxide and hyperventilation in elective neurosurgical operations useful?].
The use of nitrous oxide (N2O) and hyperventilation (HV) in elective neurosurgery is controversially discussed. The emphasis of the study was to show the effects of N2O and/or moderate hyperventilation (paCO2 31.0 +/- 1.2 mmHg) on parameters of cerebral metabolism: jugularvenous oxygen saturation (SjVO2), cerebral extraction of oxygen (CEO2), arterial jugularvenous difference of oxygen contents (AJDO2), arterial jugularvenous difference of lactate (AJDL) and glucose (AJDGL) and lactate-oxygen index (LOI). The study was approved by the Ethics Committee of the University of Leipzig. ⋯ The parameters AJDL, AJDGL and LOI did not show any significant changes in any of the four groups. The described data represent a reduction of cerebral oxygenation, but deleterious effects caused by cerebral ischaemia could not be observed. Based on our data, hyperventilation and its combination with N2O should not be used routinely in neuroanaesthesia.
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Anaesthesiol Reanim · Jan 2000
Randomized Controlled Trial Comparative Study Clinical Trial[Anesthesia with remifentanil combined with desflurane or sevoflurane in lumbar intervertebral disk operations].
Recovery characteristics, haemodynamic profile, analgesic requirement and costs were evaluated and compared in patients undergoing elective lumbar discectomy with remifentanil-based anaesthesia using either desflurane or sevoflurane as the volatile anaesthetic agent. Sixty-two patients (ASA I/II status) were randomly assigned to receive either desflurane and remifentanil or sevoflurane and remifentanil (in oxygen/air) for anaesthesia. After induction with 0.5 microgram/kg/min remifentanil, 4 to 5 mg/kg thiopentone and 0.5 mg/kg atracurium, the patients received 0.25 microgram/kg/min remifentanil and 0.5 +/- 0.05 MAC of one of the volatile anaesthetic agents for further maintenance of anaesthesia. ⋯ Incidence and severity of side-effects such as nausea, vomiting or shivering did not differ between the groups and were acceptable under clinical conditions. Costs for desflurane were significantly higher than those for sevoflurane, but total costs were not different between the groups. Concerning recovery profile, desflurane/remifentanil seems to have small advantages over sevoflurane/remifentanil in patients undergoing lumbar vertebral disc resection.
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Anaesthesiol Reanim · Jan 2000
Historical Article[Historical vignettes in intensive care medicine].
Intensive care medicine is the youngest anaesthesiological field. Its roots only go back to the 19th century. ⋯ In Germany, the first intensive care units were set up at the end of the fifties. Soon after, in the sixties, publications on intensive care already made up a large part of anaesthesiological literature.
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Anaesthesiol Reanim · Jan 2000
Biography Historical Article[Otto J"ungling--the first "specialist in anesthesiology" in Berlin].
Compared to English-speaking countries, anaesthesiology in Germany developed into an independent field relatively late. German doctors were sent abroad to other European countries to learn modern anaesthetic techniques. At the beginning of the fifties, colleagues from East Germany had increasing problems to travel abroad. ⋯ A transportable suction unit was one of his excellent ideas. Furthermore, he rendered outstanding services to the training of anaesthesists in Berlin. Otto Jüngling resigned in February 1959 due to unsatisfactory cooperation with public authorities and went back to Austria were he lives today as a pensioner.