Anästhesie, Intensivtherapie, Notfallmedizin
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Anasth Intensivther Notfallmed · Apr 1985
Randomized Controlled Trial Comparative Study Clinical Trial[Circulatory effects of vecuronium as well as pancuronium under different conditions of anesthesia].
The cardiovascular effects of equipotent doses (1,25 X ED95) of vecuronium (70 micrograms/kg iv) and pancuronium (80 micrograms/kg iv) were studied in 16 patients scheduled for elective coronary artery bypass surgery during steady-state conditions of isoflurane (0,4-0,5 vol% end-tidal)-nitrous oxide anaesthesia. All patients were chronically treated with oral beta receptor-blocking agents. Vecuronium did not cause any significant cardiovascular changes whereas pancuronium produced increases in heart rate (13%), cardiac index (15%) and mean arterial pressure (4%) while systemic vascular resistance decreased (8%). ⋯ The administration of pancuronium (80 micrograms/kg) caused the greatest percentage increases in HR (20%), CI (22%), MAP (8%) and RPP (31%) in this group of patients. In contrast, patients (n = 8) anaesthetized with isoflurane-nitrous oxide who were not on preoperative beta-receptor blocker medication, demonstrated higher haemodynamic control values and less increases in HR (10%), CI (10%) and RPP (15%), MAP did not change. The clinical significance of these findings is discussed.
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Up to now there are almost no investigations on the situation of relatives of ICU patients. Therefore a study was designed into the impressions left on relatives by intensive care treatment in their next of kin. A questionnaire including 46 items was developed which mainly refers to the following topics: first contact with the ICU, experience with the situation in the ICU, information given on the patient's state, psychosocial assistance, evaluation of experiences made in the ICU. ⋯ The relation to the medical and nursing staff is described as positive, especially by relatives of surviving patients. In retrospect the relatives--like the former ICU patients--hold a positive view of the intensive care unit. The reasons are discussed.