Search results for "Anesthesia"

Oral Dabigatran Etexilate Versus Enoxaparin for Prevention of Venous Thromboembolism After Total Hip or Knee Arthroplasty: A Pooled Analysis of Four …

2011

Abstract Abstract 2312 Introduction: Thromboprophylaxis after major orthopaedic surgery reduces the risk of venous thromboembolism (VTE). Four randomized, double-blind, non-inferiority trials compared oral dabigatran etexilate doses of 220 mg or 150 mg once daily (qd) with subcutaneous enoxaparin for the primary prevention of VTE in patients undergoing elective total hip or knee arthroplasty. In the hip arthroplasty trials (RE-NOVATE® and RE-NOVATE® II) the treatment duration was 28–35 days; in the knee arthroplasty trials it was 6–10 days (RE-MODEL™) and 12–15 days (RE-MOBILIZE®). Three of the trials used a comparator enoxaparin regimen of 40 mg qd started the evening before surgery, while…

Perioperative diaphragm point-of-care ultrasound as a prediction tool of postoperative respiratory failure in high-risk patients: A feasibility study…

2021

Abstract Introduction Respiratory muscle function in the postoperative period is a key to whether a patient develops Postoperative Respiratory Failure (PRF) or not. PRF occurs when the gas exchange does not meet metabolic needs. Ipsilateral paralysis of the hemidiaphragm after interscalenic brachial plexus block (ISB) causes an acute reduction of respiratory muscle function. This reduction does not cause PRF when the contralateral hemidiaphragm generates enough gas exchange to meet metabolic demands. Objectives To study the evolution of hemidiaphragmatic muscle function during the perioperative period with diaphragmatic ultrasound (D-POCUS), and use it as an innovative tool to predict PRF, …

The use of rapid onset opioids for breakthrough cancer pain: the challenge of its dosing.

2011

Breakthrough cancer pain (BTcP) has been defined as a transitory increase in pain intensity on a baseline pain of moderate intensity in patients on analgesic treatment regularly administered. This review provides updated information about the use of opioids for the treatment of BTcP, with special emphasis on the use of new rapid onset opioids (ROOs). Due to its slow onset to effect oral opioids cannot be considered an efficacious treatment for BTcP. Parenteral opioids may provide rapid onset of analgesia, but not always available particularly at home. Different technologies have been developed to provide fast pain relief with potent opioid drugs such fentanyl, delivered by non-invasive rout…

Case Report: Insulinoma Presenting as Excessive Daytime Somnolence

2021

Currently, undiagnosed insulinomas remain a difficult clinical dilemma because its symptoms in most cases can easily be misdiagnosed as other diseases. In this article, we present the case of a 14-year-old girl who presented to our hospital with recurrent episodes of excessive daytime sleepiness and abnormal behavior during sleep that had been going on for 3 months. Insulinoma is a rare neuroendocrine tumor that causes excessive release of insulin, resulting in episodes of hypoglycemia. It usually manifests as autonomic sympathetic symptoms. These symptoms resolved rapidly with the administration of glucose. After successful removal of the tumor, daytime sleepiness and abnormal nighttime be…

Blood CO2 and pH Transients During Apnoea after O2 Breathing in Patients

1990

Endotracheal intubation always is combined with an apnoea the duration of which is dependent on the technique used, the skills of the intubator, and the anatomical situation. The resulting typical potential risks may be (among others) both hypoxaemia and hypercapnia. Therefore the tolerable apnoea time for an intubation procedure is limited in clinical practice to 1 – 2 minutes. It must be noted that the developing hypercapnia is inevitable, whereas hypoxaemia may be avoided even in prolonged apnoea (e.g. >2 min) with “adaequate” preoxygenation [Duda et al., 1988]. Using de-nitrogenation techniques (breathing pure oxygen for 30 to 60 min) “anaesthetized and curarized normal subjects tolerat…

Hirnprotektion unter Notfallbedingungen: Sind Anästhetika neuroprotektiv?

1997

Intubationsbedingungen nach Rocuronium und Succinylcholin

1996

OBJECTIVE Rocuronium is a new non-depolarising steroidal muscle relaxant with a short onset time. The present study was undertaken to compare intubating conditions as well as onset and clinical duration of a single dose of 0.6 mg/kg (2 x ED95) with a single dose of 1 mg/kg suxamethonium (3 x ED95). METHODS After obtaining informed consent and approval of the Ethics Committee, 40 adult patients (ASA I-III) participated in this study. After premedication with oxazepam, anaesthesia was induced with fentanyl and propofol and maintained with propofol, N2O and supplements of fentanyl as needed. Muscular relaxation was assessed by EMG recording of adductor pollicis muscle after supramaximal single…

Verschiedene Opioide beim kardiovaskul�ren Risikopatienten

1994

Efficient analgesia may be the major objective in the cardiovascular risk patient following myocardial infarction, acute occlusion of peripheral vessels, or dissection/perforation of major abdominal vessels. It was the purpose of the study to investigate the haemodynamic and respiratory side effects of eight different opioids in 57 circulatory risk patients prior to major vascular surgery. Methods. Patients were randomly allocated to eight groups, each receiving a different opioid within a clinical, equipotent dose range (buprenorphine, fentanyl, morphine, nalbuphine, pentazocine, pethidine, tramadol, alfentanil). A complete haemodynamic and blood gas status was obtained prior to as well as…

No evidence for efficacy of intrathecal verapamil in the treatment of tonic-clonic status epilepticus

1992

In two patients with refractory generalized tonic-clonic status epilepticus, 15 mg of the calcium antagonist verapamil was given by suboccipital intrathecal administration. During a 2–6-h observation period, seizure frequency did not decrease. However, in one patient, verapamil induced severe hypotension. Subsequent thiopental anesthesia suppressed convulsions immediately. Our results indicate that, in contradistinction to animal studies with different administration techniques, intrathecal administration of verapamil does not produce any anticonvulsant effect in humans.

The influence of nimodipine on chromatolysis of motoneurons following axotomy with and without reinnervation: A quantitative image analysis

1996

Using a recently developed image analysis method to quantify the time course of chromatolysis in injured motorneurons we tested the effect of the calcium entry blocker nimodipine (1000 ppm in food pellets) on regenerating and degenerating motoneurons. Following facial-facial, hypoglossal-hypoglossal anastomosis with complete regeneration and following facial and hypoglossal nerve resection which causes a partial neuronal degeneration and postoperative survival times of 4 to 112 days, the texture of the Nissl substance of facial and hypoglossal motoneurons was analyzed on both sides of the brainstem in paraffin serial sections with a VIDASplus image analyzer. Monitoring alterations of the Ni…