Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jan 1978
Case Reports[Brachial plexus paralysis after stellate blockade and plexus anaesthesia (author's transl)].
Brachial plexus paralysis is a serious complication of stellate blockade (n = 2) and plexus anaesthesia (n = 6) as was observed in 8 patients. It is frequently characterised by localised motor and sensory defects in the affected arm and sometimes accompanied by a causalgia-like pain. ⋯ Prophylactically intraneural injections must be avoided. The electrifying pain during insertion of the needle and (or) immediate anaesthetic effect require correction of needle position.
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A new technique for the functional treatment of chronic intractable pain with a cerebral stimulation system under the patient's control is described. A four-pole electrode, diameter 0.65 mm (made by Medtronic), was implanted under stereotaxic control into nine patients. Stimulation was via a substernally implanted receiver connected to the intracerebral electrode. ⋯ The pain-suppressing effect lasted for up to seven hours, so that three stimulations for 30-40 minutes daily were sufficient, as demonstrated by an observation period of up to 21 months. The only complication was transitory oculomotor paresis. The described reversible non-destructive stereotaxic and functional technique of stimulation is preferable to the coagulation method in the treatment of chronic intractable pain.
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Dtsch. Med. Wochenschr. · Sep 1977
[Percutaneous puncture of the femoral vein for haemodialysis: report of 5000 punctures (author's transl)].
Using the Seldinger technique, a total of 5306 percutaneous femoral vein catheterisations were performed in the course of ten years. Two-catheter venovenous dialysis was performed 2357 times and single-needle technique 592 times. ⋯ The results indicate that for every 1000 percutaneous femoral-vein catheterisations one must expect one severe complication. However, by using the correct catheter technique, especially careful manipulation of the wire, complications can be largely avoided.
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Dtsch. Med. Wochenschr. · Jun 1977
[Short- and long-term prognosis of cardiac arrest in acute myocardial infarction (author's transl)].
Of 80 patients with acute myocardial infarction who had a cardiac arrest without shock 42 (52.5%) were resuscitated in a cardiological intensive care unit. Twenty-six were finally discharged from hospital. After an average of four years, 21 patients were still alive. ⋯ Ventricular extrasystoles were demonstrated by ECG in 11. Eight had depressive episodes. It is likely that a further decrease in death-rate can be achieved only if the interval between onset of infarction and admission to an intensive care unit can be shortened.