Anaesthesiologie und Reanimation
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Anaesthesiol Reanim · Jan 1991
[An attempt at a mathematical prediction of the depth of insertion of the needle in peridural anesthesia].
The purpose of the investigation was to correlate the distance from the skin to the flaval ligament with the individual data of patients such as bodyweight, height, sex and age with the aim of predicting the depth of insertion of the needle. In a retrospective study we examined 448 patients (217 men and 231 women). In the anaesthetic records the depth of insertion of the needle was noted together with the patients' personal data. ⋯ With these formulae a rough prediction for the depth of insertion can be made, with x representing the bodyweight and y the expected depth in cm. The measured values fluctuated between 3.5 and 7.4 cm in the 217 men, with the medium value at 4.08 cm. In the 231 women the measured values fluctuated between 3.3 and 6.9 cm with the medium value at 4.67 cm.
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Anaesthesiol Reanim · Jan 1991
Review Comparative Study Clinical Trial Controlled Clinical TrialCardiac dysrhythmias during dental surgery. Comparison of hyoscine, glycopyrrolate and placebo premedication.
The incidence of cardiac dysrhythmias was investigated in 60 patients undergoing dental operations under halothane anaesthesia following either hyoscine, glycopyrrolate or placebo as a supplement to nalbuphine for premedication. Forty-five percent of the patients given 6 micrograms/kg hyoscine exhibited cardiac dysrhythmias compared to 25 percent of the group given 4 micrograms/kg glycopyrrolate and to 5 percent in the placebo group. ⋯ There was neither a connection between the frequency of cardiac dysrhythmias and the demographic characteristics of the patients nor with their PaCO2. The author recommends to avoid premedication with anticholinergic combined with halothane anaesthesia with spontaneous respiration during dental operations.
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With the combination of a noninvasive saturation measurement and plethysmography, pulse oximetry has become an important monitoring method for peripheral perfusion and oxygen supply. Indications for pulse oximetry is practically every anaesthesia especially in geriatric patients and patients with one-lung-anaesthesia, obesity, asthma and emphysema. Pulse oximetry has proved its worth in the transport of emergency patients. ⋯ Accuracy of response of most currently available pulse oximeters lies between 2-3% (SD) with oxygen saturations between 80-100%. Deviations increase at lower oxygen saturations. Pulse oximetry will soon be regarded as minimal monitoring standard worldwide together with the ECG, blood pressure, pulse and respiratory monitoring.
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Anaesthesiol Reanim · Jan 1991
[A computer-controlled closed circle system for ventilation during anesthesia and intensive care and its possibilities for patient monitoring].
A computer feed back controlled anaesthesia- and intensive care ventilator has been developed with on-line and separate lung function measurement. The system design is built on the principle of a totally closed circuit (closed rebreathing respirometer) and an inspiratory "high flow", the gas being rotated through the closed circuit unidirectionally by a blower with 70 l/min. Ventilation is performed by metal membranes freely movable in membrane chambers with an internal part included into the closed circuit and an external part connected to pressurized air controlling inspiratory valves expiratory valves. ⋯ Ergonometric aspects led to the triangular from of the new anaesthesia and intensive care ventilator with the controlling service screen turnable to all three sides of the ventilator (high flexibility of the user) and all necessary equipment and material included into the "Anaesthesia workstation". All measured and present parameters are continuously displayed on the service (computer) screen and entered into the computer-memory in minute cycles with a memory capacity of 75 h anaesthesia. At any desired moment the memorized values can be transferred to IBM-compatible disc systems for storage or into the respective data management systems, thus at the end of anaesthesia, at the end of the working day or at the end of the week.
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EEG and multimodal evoked potentials are currently the most frequently used methods of brain functioning monitoring in severely acute primary or secondary brain damage. Development or regression of brain function disturbances can be reliably assessed in this way. The methods are suitable for early diagnosis of intracranial complications and contribute to diagnosis of irreversible loss of cerebral function. ⋯ EEG and evoked potentials can be monitored at the bed-site. If there are no technical facilities for long-term EEG monitoring, repeated conventional single tracings are of value in these cases. When both the acoustic evoked brain stem potentials and the early somatosensory potentials are to be examined, the possibility exists to differentiate between hemispheric and brain stem damage and to use these results for prognosis assessment.