Anästhesie, Intensivtherapie, Notfallmedizin
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Anasth Intensivther Notfallmed · Aug 1988
Randomized Controlled Trial Comparative Study Clinical Trial[Methohexital/alfentanil-thiopental/alfentanil for total intravenous anesthesia for direct laryngoscopy with 100% O2 jet ventilation].
For the direct laryngoscopy and microscopic examination of the larynx with exploratory excision and pulpectomy using low frequency jet-ventilation with 100% oxygen we used total intravenous anaesthesia with a strong acting opioid and a barbiturate. Because the achievement of sufficient reflexes and a high degree of vigilance postoperatively are to be aimed, Methohexitone (M) and Thiopentone (T) were investigated in the regard of the suppression of vigilance in the postoperative period. 40 patients were randomly assigned to the group M (n = 20) or T (n = 20). The evening before operation, an intelligence test and a syndrome-short-test (SST) were performed for the measurement of attention and memory (functional psychosis). ⋯ The following parameters were measured: Blood pressure, heart rate, duration of operation and anaesthesia, parameters of vigilance 30, 60 and 120 minutes after operation (SST) and the ability of performance. The groups were comparable with respect to all data except the parameters of vigilance. The patients receiving M were significantly more vigilant 30 min., 60 min. (SST) and 120 min (SST) after the end of anaesthesia than patients receiving T (p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anasth Intensivther Notfallmed · Aug 1988
[The reliability of pulse oximetry monitoring of arterial oxygen saturation in centrally intubated and hypothermic patients].
The present study tests the effectiveness of pulse oximetric measurement in attaining reliable saturation values even in patients with hypothermia and centralization. 20 patients who had all required endoprosthetic surgery of the lower extremities were included in the study. During the process of removing 98 samples for arterial blood-gas analysis, pulse oximetric saturation, heart rate (pulse oximeter and ECG), rectal temperature, peripheral temperature at the back of the fingers, arterial pressure (catheter) and central venous pressure were registered. The results can be summarized as follows: 1. ⋯ In the area examined, the reliability of pulse oximetric measurement is influenced neither by blood pressure fluctuations nor by intravascular hypo- or hypervolemia. 4. There is merely a sharp increase in the Pulsoximeter when the temperature decreases. The Pulsoximeter still indicates the correct saturation as long as the peripheral pulse rate corresponds to the heart rate on the ECG Monitor.