Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS最新文献_第4页

[Relationship between nutrition and ASA-classification in the elderly]. 【营养与老年人asa分级的关系】。

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-07-01 DOI: 10.1055/s-2004-814440

M Sakarya, F Karadağ, N Lüleci, G Tezcan Keleş, I Topçu, T Erinçler

{"title":"[Relationship between nutrition and ASA-classification in the elderly].","authors":"M Sakarya, F Karadağ, N Lüleci, G Tezcan Keleş, I Topçu, T Erinçler","doi":"10.1055/s-2004-814440","DOIUrl":"https://doi.org/10.1055/s-2004-814440","url":null,"abstract":"Objective: Old age and bad nourishment are risk factors for the postoperative period. In this study, the \"mini nutritional assessment\" (MNA) of elderly patients was evaluated before the operation and compared with their ASA-classification.Methods: 215 outpatients (age > 60 years) were included. MNA-score was fixed as follows: MNA 24 - 30 = normal (MNA I); MNA 17 - 23.5 = risk of malnutrition (MNA II; MNA < 17 = undernourished (MNA III). In addition, the ASA-score of all patients was registered. chi (2)-, Mann-Whitney-U- and correlation analysis were used for statistical analysis. A cut off-value of 24 was fixed for MNA and correlated with the ASA-score.Results: 34.9 % of all patients were allocated to MNA II or III, but only 19.9 % to ASA III or IV. The sensitivity of the ASA-classification for evaluation of the nutritional status was 0.33, selectivity was 0.87, positive predictive value was 0.58 and negative predictive value was 0.70.Conclusion: ASA evaluation is not suitable for assessment of the nutritional status. With regard to typical postoperative complications, the nutritional status of patients should be assessed separately.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":" ","pages":"400-5"},"PeriodicalIF":0.4,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2004-814440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40868238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

[ProSeal-laryngeal mask versus endotracheal intubation in patients undergoing gynaecologic laparoscopy]. [前喉罩与气管内插管在妇科腹腔镜患者中的应用]。

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-03-01 DOI: 10.1055/s-2004-814331

S N Piper, J G Triem, K D Röhm, W H Maleck, T A H Schöllhorn, J Boldt

{"title":"[ProSeal-laryngeal mask versus endotracheal intubation in patients undergoing gynaecologic laparoscopy].","authors":"S N Piper, J G Triem, K D Röhm, W H Maleck, T A H Schöllhorn, J Boldt","doi":"10.1055/s-2004-814331","DOIUrl":"https://doi.org/10.1055/s-2004-814331","url":null,"abstract":"Background: The aim of this study was to assess the practicality of the ProSeal laryngeal mask (PS-LMA) airway during laparoscopic surgery with capnoperitoneum compared to endotracheal intubation (ET).Methods: Prospective, randomized study. 104 patients undergoing gynaecologic, laparoscopic surgery were allocated randomly to two groups: 1. ET-group (n = 50). 2. PS-LMA-group (n = 54). Total intravenous anaesthesia was performed by the same anaesthesiologist.Measurements: Mean arterial pressure, heart rate, at 4 and circuit pressure at 2 measurement points, and the incidences of coughing and sore throat. Insertion of the ET and the PS-LMA was scored by using a four-point scale. Ease of placing the gastric tube was judged by measuring the number of attempts at insertion and the insertion times. A p-value of < 0.05 was considered as significant.Results: There were no differences between PS-LMA and ET concerning circuit pressure at any measurement point. At the end of anaesthesia, mean arterial pressure (92 +/- 13 vs. 100 +/- 14 mmHg; p < 0.01) and heart rate (66 +/- 13 vs. 76 +/- 14 beats/min; p < 0.01) were lower in the PS-LMA-group compared to the ET-group. At the end of anaesthesia 25 patients of the ET-group coughed but nobody in the PS-LMA-group (p < 0.00001). There was no difference with regard to postoperative sore throat. The insertion of the PS-LMA was easier compared to ET (p < 0.05), but we found no significant difference concerning insertion times. Fewer attempts at insertion of the gastric tube were necessary in the PS-LMA-group than in the ET-group (p < 0.01), whereas insertion times did not differ.Conclusion: The PS-LMA is a convenient and practicable approach for anaesthesia in patients undergoing laparoscopic surgery.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":" ","pages":"132-7"},"PeriodicalIF":0.4,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2004-814331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40861411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

[New insights in postoperative pain therapy]. [术后疼痛治疗的新见解]。

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-03-01 DOI: 10.1055/s-2004-814314

A Brack, B W Böttiger, M Schäfer

{"title":"[New insights in postoperative pain therapy].","authors":"A Brack, B W Böttiger, M Schäfer","doi":"10.1055/s-2004-814314","DOIUrl":"https://doi.org/10.1055/s-2004-814314","url":null,"abstract":"In this review, novel clinical studies on postoperative pain therapy are summarized. Based on these studies, several conclusions can be drawn: i) following tonsillectomy, postoperative therapy with NSAIDs leads to a significant increase in the number of reoperations; thus NSAIDs should be used with caution; ii) COX-2 inhibitors in combination with intravenous opioids improve recovery and functional outcome after knee replacement surgery; iii) the combination therapy of different non-opioid analgesics has no proven clinical efficacy and should not be used routinely; iv) patients' age is not a determinant in postoperative opioid titration after surgery; in contrast, it does predict opioid consumption during the first postoperative day; v) morphine and piritramide have identical analgesic efficacy and induce nausea and vomiting with the incidence; opioid selection can, thus, be based on economic considerations and vi) if tramadol is ineffective in postoperative pain therapy, this might be caused by an allelic variant of one of the cytochrome P450 enzymes (CYP2D6); these patients should be treated with a different opioid.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":" ","pages":"157-64"},"PeriodicalIF":0.4,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2004-814314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40861415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

[Legionella prevention in intensive care units]. [重症监护病房军团菌的预防]。

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-03-01 DOI: 10.1055/s-2004-814282

I F Chaberny, S Ziesing, P Gastmeier

引用次数: 2

[Theophylline induces contractures in porcine skeletal muscle preparations with the disposition to malignant hyperthermia]. [茶碱在猪骨骼肌制剂中引起挛缩，具有恶性高热倾向]。

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-03-01 DOI: 10.1055/s-2004-814328

M U Gerbershagen, M Fiege, R Weisshorn, K Kolodzie, F Wappler

{"title":"[Theophylline induces contractures in porcine skeletal muscle preparations with the disposition to malignant hyperthermia].","authors":"M U Gerbershagen, M Fiege, R Weisshorn, K Kolodzie, F Wappler","doi":"10.1055/s-2004-814328","DOIUrl":"https://doi.org/10.1055/s-2004-814328","url":null,"abstract":"Objective: Theophylline, a methylxanthine, leads to an increase of the cytoplasmic Ca(2+)-concentration in the muscle cell. Since the in-vitro contracture test (IVCT) with halothane and caffeine does not distinguish a 100% between malignant hyperthermia susceptible (MHS) and non-susceptible (MHN), we examined the in-vitro effects of theophylline in porcine skeletal muscle preparations.Methods: After approval by the local animal care committee ten MHS- and nine MHN-swine were anaesthetized and muscle biopsies taken. For IVCT, muscle specimens were exposed to bolus administrations of theophylline in concentrations of 3.0 respectively 5.0 mmol/l. Muscle contracture development and twitch amplitudes were recorded over a period of 30 minutes. Data are expressed as medians and ranges.Results: After both theophylline bolus administrations MHS-muscles developed significantly higher contractures compared to the MHN-specimens. The MHS-muscles reached a maximum contracture of 17.0 mN (7.2-59.6 mN) after administration of 3.0 mmol/l theophylline. In comparison, two MHN-specimens showed weak contractures with a maximum of 1.4 mN. The 5.0 mmol/l theophylline IVCT resulted in maximum contractures of 19.1 mN (2.1-39.2 mN) for the MHS-preparations. Just in three MHN-muscles weak contractures of 0.0 mN (0.0-0.8 mN) were recorded. Thus, a significant difference without overlap was revealed for the maximum contracture.Conclusion: Theophylline in concentrations of 3.0 and 5.0 mmol/l revealed a clear difference between MHS- and MHN-porcine muscle preparations. Further examinations on human skeletal muscles are needed to demonstrate the value of theophylline in the IVCT MH-diagnosis.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":" ","pages":"147-52"},"PeriodicalIF":0.4,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2004-814328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40861413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

[Delayed onset of malignant hyperthermia crisis during a living donor liver transplantation caused by sevoflurane]. 【七氟醚致活体供肝移植恶性高热危象延迟发作】。

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-03-01 DOI: 10.1055/s-2004-814333

I Gillmeister, C Schummer, M Hommann, W Schummer

{"title":"[Delayed onset of malignant hyperthermia crisis during a living donor liver transplantation caused by sevoflurane].","authors":"I Gillmeister, C Schummer, M Hommann, W Schummer","doi":"10.1055/s-2004-814333","DOIUrl":"https://doi.org/10.1055/s-2004-814333","url":null,"abstract":"We report on a 25-year old ASA physical status I patient, who developed within 20 minutes a full-blown malignant hyperthermia (MH) in the context of a living donor liver transplantation after 180 minutes of uneventful anaesthesia. The only trigger substance applied was Sevoflurane. The patient had already received a short, uneventful anaesthesia with Isoflurane a couple of years ago. In the context of the special constellation an initial dose of Dantrolene of 10 mg/kg body weight was administered. The patient was stabilised within 30 minutes, and the enzyme levels remained low compared with other case reports. The post-operative in vitro caffeine halothane contracture testing confirmed that son and mother were susceptible to MH, contracture testing in the father was negative. All known triggers may cause life-threatening MH crisis - even after hours and after inconspicuous multiple exposures to known trigger substances. Therefore all trigger substances must be avoided in all patients susceptible to MH.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":" ","pages":"153-6"},"PeriodicalIF":0.4,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2004-814333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40861414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

[Alternatives to endotracheal intubation: a matter of statistics?]. [替代气管插管:一个统计问题?]。

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-03-01 DOI: 10.1055/s-2004-814313

J Peters

引用次数: 1

[Warming efficacy and blood damaging of blood and infusion warmers]. 【补血温剂的温效与血损】。

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-03-01 DOI: 10.1055/s-2004-814326

O Moerer, A Bräuer, W Weyland, U Braun

{"title":"[Warming efficacy and blood damaging of blood and infusion warmers].","authors":"O Moerer, A Bräuer, W Weyland, U Braun","doi":"10.1055/s-2004-814326","DOIUrl":"https://doi.org/10.1055/s-2004-814326","url":null,"abstract":"Question: Inadequately warmed blood or infusions contribute to the development of perioperative hypothermia. Therefore we analysed the efficiency of several infusion warmers.Method: Tested infusion warmers: Model Autoline (Barkey) 500OR/241(Arizant), BW 385L(Biotest), H250/D50 und D60 (Level-1), H500/D300 (Level-1), Warmflo FW537-I/HEC40 (Tyco). Different solutions (saline, colloid solution and packed red blood cells PRBC) were tested varying the infusion flow, temperature of the solution and infusion pressure. Effective warming was defined as an infusion temperature > or = 33 degrees C. Haemolysis was measured by the increase of free plasma haemoglobin.Results: The infusion warmers were effective within the following flow ranges: Low flow rate (< 250 ml/h): Autoline, 500OR/241 and H250/D60. Medium flow rate (250-2500 ml/h): Autoline, 500OR/241, BW385L (> 480 ml/h), H250/D 60 und D50 (> or = 1300 ml/h), FW537-I/HEC40 (> 950 ml/h. High flow rate (2500-10,000 ml/h): BW385L (up to 5000 ml/h), H250/D50, H250/D60, H500/D300 and FW537-I/HEC 40(R). Highest flow rates (> 10,000 ml/h): H250/D60, H500/D300 and FW537-I HEC40. Colloidal solutions were warmed nearly as good as saline, cooled PRBC had a smaller range of effective warming. There was no relevant haemolysis in any of the tested systems (plasma free haemoglobin raise < 24 mg/dl in all systems).Conclusion: The warming capacity of the system and the length of the uninsulated infusion system determine the efficiency of an infusion warmer. The range of effective warming of an infusion warmer should be known for proper application.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":" ","pages":"138-46"},"PeriodicalIF":0.4,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2004-814326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40861412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

[Accidents with dangerous goods--how can the risks be recognized and assessed?]. 【危险品事故——如何识别和评估风险?】

IF 0.4

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2004-03-01 DOI: 10.1055/s-2004-814309

R Spörri, R Walther, A Reichert, R Braun

引用次数: 0