Anästhesie, Intensivtherapie, Notfallmedizin
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Anasth Intensivther Notfallmed · Jun 1982
[Tube change in nasotracheally intubated intensive care patients using injector ventilation: a method for the prevention of hypoxic complications].
Conventional methods for the replacement of nasotracheal tubes are often dangerous. The interruption of respiration while replacing the nasotracheal airway may cause severe hypoxia. We developed a technique which shortens the time of apnoe to a few seconds. ⋯ Now the new endotracheal tube is guided into the trachea by the nasogastic tube while jet ventilation is continued. We used this technique 19 times without any complications. We found the method safe and simple, giving sufficient ventilation in all patients, provided that contraindications and precautions are observed.
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Anasth Intensivther Notfallmed · Jun 1982
Clinical Trial Controlled Clinical Trial[Pain treatment by sub or epidural opiate administration].
Morphine and opiate analogues for pain relief were applied epidurally or intrathecally. Synthetic opioids, eg. pethidine, pentazocine or piritramide proved unsuitable with both modes of administration. Only morphine in doses as low as 2 mg reliably produced analgesia lasting from 16-24 hours. ⋯ Conversely this very side effect may advantageously be employed in patients on ventilator treatment as a method for analgesia and sedation. Lumbar epidural administration of single doses of morphine 2 mg at present is the most effective treatment both for pain following thoracotomy, laparotomy, surgery on the vertebral column, gynecological and urological procedures and pain due to trauma to the chest wall or pelvis, provided supervision in an intensive care ward guards against possible side effects. Epidural or intrathecal opiate is not suitable for the treatment of chronic or functional pain.
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Anasth Intensivther Notfallmed · Jun 1982
Case Reports[Malignant hyperthermia. Current aspects of dantrolene treatment of 2 cases of hyperthermia maligna incipiens].
During induction with volatile anaesthetic agents and succinylcholine (suxamethonium) both children showed a singular clinical symptom: trismus. In the first case(1) narcosis had been interrupted followed by clinically controlled recovery. One week later, after treatment with oral dantrolen (Dantamacrin), anaesthesia with triggerfree agents was performed without complications. ⋯ Both children showed significant increases of Creatin-Kinase-activities over 5000 U/l after the interrupted narcosis (1) and postoperatively as being typical biochemical parameters for incipient hyperthermia maligna. All other parameters were normal. A review is given on the use of dantrolene-sodium, its development and its use in our department as lifesaving agent in malignant hyperthermia.
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Anasth Intensivther Notfallmed · Jun 1982
[Possible patient overheating by OP-table heating equipment].
The technical equipment used in the operation theatre must be safe and foolproof. We observed a complication of near overheating a patient using the thermomaquet heating pads. The conclusion of our observation is that such heating pads must have a high-temperature cut-off device.