0000000000088961
AUTHOR
Bernhard Kumle
The Effects of Sodium Nitroprusside-Induced Hypotension on Splanchnic Perfusion and Hepatocellular Integrity
UNLABELLED The purpose of our study was to investigate the effects of sodium nitroprusside-induced hypotension on splanchnic perfusion and hepatocellular integrity. Thirty patients undergoing radical prostatectomy were allocated randomly to a sodium nitroprusside (SNP) or control group (control). Regional pco2 was measured using gastric tonometry, and the regional to arterial difference in partial pressure of CO2 and intramucosal pH were calculated. The cytosolic liver enzyme alpha-glutathione S-transferase and standard liver enzyme markers (alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyltransferase) were also measured. Mean arterial pressure in the SNP group was 50…
Cost analysis of target-controlled infusion-based anesthesia compared with standard anesthesia regimens.
UNLABELLED With the development of new computer-assisted target-controlled infusion (TCI) systems and the availability of short-acting anesthetics, total IV anesthesia (TIVA) has become increasingly popular. The aim of this study was to compare costs of TCI-based anesthesia with two standard anesthesia regimens. Sixty patients undergoing elective laparoscopic cholecystectomy were randomly divided into three groups. Group 1 (TIVA/TCI) received TIVA using a propofol-based TCI system and continuous administration of remifentanil; Group 2 (isoflurane) underwent inhaled anesthesia with isoflurane, fentanyl, and N2O; Group 3 (standard propofol) received fentanyl and N2O and a continuous infusion …
RETRACTED ARTICLE: Volume replacement with HES 130/0.4 may reduce the inflammatory response in patients undergoing major abdominal surgery
Objectif : Verifier les effets du remplissage intravasculaire sur la reaction inflammatoire pendant une intervention chirurgicale majeure. Methode : Trente-six patients devant subir une intervention abdominale reglee ont ete repartis au hasard et ont recu soit de l'hydroxyethylamidon a 6 % (poids moleculaire moyen de 130 000 Dalton, degre de substitution de 0,4 ; n = 18, groupe HEA), soit une solution de Ringer-lactate (groupe RL ; n = 18) comme remplissage intravasculaire. Les liquides ont ete administres avant l'operation et, pendant 48 h a l'unite des soins intensifs. Le remplissage vasculaire dependait de parametres physiologiques. Les concentrations seriques d'interleukine (IL-6, IL-8 …
Low-Flow Desflurane and Sevoflurane Anesthesia Minimally Affect Hepatic Integrity and Function in Elderly Patients: Retracted
UNLABELLED Hepatic blood flow is reduced in a dose-related manner by all inhaled anesthetics now in use. We assessed hepatic function in elderly patients anesthetized with desflurane or sevoflurane. We measured the cytosolic liver enzyme alpha glutathione S-transferase (alpha GST), the formation of the lidocaine metabolite monoethylglycinexylidide (MEGX), and gastric mucosal tonometry-derived variables as sensitive markers of hepatic function and splanchnic perfusion. Thirty patients, 70 to 90 yr old, were allocated randomly to receive desflurane or sevoflurane anesthesia. Anesthetic exposure ranged from 2.1-4.5 minimum alveolar concentration hours. No significant changes in standard liver …
Economic aspects of different muscle relaxant regimens.
Objective At a time of cost reduction in medical care efforts to manage the ever-increasing costs of new pharmaceutical drugs become increasingly important. Costs of four different muscle relaxant regimens including the new intermediate-acting neuromuscular blocking drugs (NMBD) cisatracurium and rocuronium will be analyzed. Methods Eighty patients undergoing laparoscopic cholecystectomy were prospectively studied. All patients received standardized general anaesthesia with desflurane/fentanyl. Muscle relaxation was achieved with atracurium, cisatracurium, vecuronium, or rocuronium with 20 patients in each group. Intraoperatively muscle relaxants were added to maintain two twitches of the t…
Economic Considerations of the Use of New Anesthetics
UNLABELLED: Cost control in anesthesia is no longer an option; it is a necessity. New anesthetics have entered the market, but economic differences in comparison to standard anesthetic regimens are not exactly known. Eighty patients undergoing either subtotal thyroidectomy or laparoscopic cholecystectomy were randomly divided into four groups, with 20 patients in each group. Group 1 received propofol 1%/sufentanil, Group 2 received desflurane/sufentanil, Group 3 received sevoflurane/sufentanil, and Group 4 received isoflurane/sufentanil (standard anesthesia) for anesthesia. A fresh gas flow of 1.5-2 L/min and 60% N2O in oxygen was used for maintenance of anesthesia, and atracurium was given…
RETRACTED ARTICLE: Hemodynamics, intra-mucosal pH and regulators of circulation during perioperative epidural analgesia
Objectif: Etudier les effets de l'analgesie peridurale perioperatoire sur l'hemodynamie, la perfusion splanchnique et les regulateurs de la circulation. Methode : Vingt patients subissant un pontage aortique infrarenal ont ete repartis au hasard en deux groupes : un groupe GP recevant l'analgesie peridurale avec bupivacaine (15 ml a 0,125 %) avant l'operation, suivis de 10 ml de bupivacaine a 0,125 % et de 1 mg de morphine 8 h et 16 h apres l'operation; un groupe temoin GT sans catheter epidural. Le monitorage comprenait un catheter de l'artere pulmonaire et un tonometre gastrique. Les regulateurs de circulation etaient mesures sur des echantillons de sang : avant l'analgesie peridurale (T …
Retracted: Cerebral effects and blood sparing efficiency of sodium nitroprusside-induced hypotension alone and in combination with acute normovolaemic haemodilution
The combined reduction of oxygen-carrying capacity and perfusion pressure during the combination of acute normovolaemic haemodilution (ANH) and controlled hypotension (CH) raises concerns of hypoperfusion and ischaemic injury to the brain. Forty-two patients undergoing radical prostatectomy were prospectively allocated to receive CH induced by sodium nitroprusside (mean arterial pressure (MAP) 50 mm Hg), a combination of CH+ANH (post-ANH haematocrit 29%; intraoperative MAP 50 mm Hg), or standard anaesthesia (control). Serum levels of the brain-originated proteins neuron-specific enolase (NSE) and protein S-100, blood loss, transfusion requirements, adverse effects, and postoperative recover…