Anästhesie, Intensivtherapie, Notfallmedizin
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Anasth Intensivther Notfallmed · Apr 1989
Case Reports[Heart arrest in implantation of a cemented total hip joint endoprosthesis under spinal anesthesia--a case report].
A case of intraoperative death because of right heart failure due to extensive pulmonary fat and bone marrow embolism in an 85 year old woman during cemented total hip replacement under spinal analgesia is reported.
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Anasth Intensivther Notfallmed · Apr 1989
[Percutaneous transtracheal ventilation using Nu-Trake cricothyreotomy instruments and tracheoscopic follow-up examination].
Practicability and efficiency of the cricothyreotomy set Nu-Trake was investigated in corpses (n = 10) in the institute of Pathology and clinically in laryngectomy patients (n = 5) including endoscopical controls. The practicability proved to be good, the time needed to perform the coniotomy did not last longer than 2 minutes. But complications in the investigation on the corpses could not be avoided. ⋯ This can be explained by the diameter of 7.2 mm of the used tube. Endoscopic controls showed a sufficient distance of the tip of the tubes from the pars membranacea tracheae and almost no bleeding within the trachea. Similar as with other coniotomy-technics the cricothyreotomy with the Nu-Trake set bears the risk of typical complications which have to be overcome by training of this important measure of emergency.
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The pathological course of the most common diseases of the shoulder includes pain as a main symptom. Besides other methods of treatment the infiltration of the suprascapular nerve can improve the therapeutic methods in many cases. ⋯ In 6 more patients it led to an significant reduction of pain. In conclusion this method of local anaesthesia can be recommended as an additional treatment of patients with pain of the shoulder because the rate of complications is low and the technique can easily be done.
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Anasth Intensivther Notfallmed · Apr 1989
Clinical Trial Controlled Clinical Trial[The effect of pancuronium and norcuron on hemodynamics, coronary circulation and myocardial oxygen consumption in coronary surgery patients].
The effects of the non-depolarizing muscle relaxants pancuronium (Pancuronium) and vecuronium (Norcuron) (0.1 mg/kg) on myocardial blood flow, myocardial oxygen consumption, myocardial lactate balance, cardiovascular dynamics and electrocardiogram were studied in two groups of eight patients undergoing coronary artery bypass surgery. After an introduction of anaesthesia with 0.015-0.02 mg/kg rohypnol, isoflurane (0.5 Vol%) and N2O/O2 neuromuscular blockade was induced with pancuronium or vecuronium combined with a single dose of 0.005 mg/kg fentanyl. Measurements and electrocardiogram were performed before anaesthesia, in steady state of anaesthesia and after relaxation with pancuronium or vecuronium, combined with fentanyl. ⋯ The higher metabolic demand in the pancuronium group induced a significantly lower coronary vascular resistance (CVR). All the other hemodynamic parameters did not differ significantly in both patients groups. In all the patients we could not observe ST-segment depressions or elevations in the ECG, increases of PCWP or myocardial lactate productions.(ABSTRACT TRUNCATED AT 250 WORDS)