Anästhesie, Intensivtherapie, Notfallmedizin
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Anasth Intensivther Notfallmed · Oct 1983
Case Reports[Malignant hyperthermia - therapy results with dantrolene. A case report].
A 5-year-old previously healthy girl, received general anaesthesia for performing an appendectomy. After administration of succinyl choline (20 mg, twice repeated) and halothane (increasing to 2 per cent by volume), the following symptoms of malignant hyperthermia became manifest during anaesthesia: rigor, tachycardia, cardiac dysrhythmia, temperature increase to 42.6 degrees C; anaesthesia was effected with 2 litres O2/min, 4 litres N2O/min, halothane 1.5-2 per cent by volume, using the Kuhn system. ⋯ The pattern of symptoms and therapy are critically reviewed. Basing on the cases described in literature, as known to the authors, the value of dantrolene in respect of treatment of malignant hypothermia in man is reviewed.
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Anasth Intensivther Notfallmed · Oct 1983
[Experiences with high-frequency jet ventilation in operations of the larynx and trachea].
60 ENT patients were ventilated with the high frequency jet ventilation method, using endotracheal catheters during 50 cases of laryngeal and 10 cases of tracheal surgery. Ventilation was carried out with equipment of type MK 800 (Acutronic Ltd.) using the following parameters; rate: 150/min, insufflation time: 30-40%, pressure: 0.7-2.1 bar, and flow minute volume (FMV) 7-23 1. Anaesthesia was carried out with flunitrazepam or diazepam, fentanyl and succinylcholine. ⋯ Hypoventilation occurred when the FMV was less than 250 ml/kg in patients with decreased lung function, when the tip of the catheter was inserted into a mainstem bronchus or near to the tracheostoma, or when gas escape was obstructed. Unhampered gas escape must be present at all times, because otherwise intratracheal pressure rises and ventilation becomes insufficient. If the pressure increase is marked under these circumstances it can even lead to a pneumothorax.