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DerAnaesthesist.40430431.eng.abstr
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DerAnaesthesist.40430431.eng.abstr
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"Introduction . For many years , the main goal of premedication was prevention of the dangerous side effects sometimes encountered in anesthetics with anticholinergics , antiemetic antihistaminics , and opioids . Because the rules were always preoperative fasting , premedication was administered i.m. Thus , the onset of action was within 15 - 30 min from administration . In recent years , with the introduction of newer anesthetics with fewer side effects , anxiolysis became the main aim in premedication . Moreover , the oral route became popular since it obviously did not increase the acidity or volume of the gastric content . However , the uptake and thus onset of action of orally administered drugs may take longer and can differ considerably between individual patients . Therefore , the optimum interval between administration and induction of anesthesia remains controversial . The present study was carried out to examine the time course of drug action and the effects of different premedication regimens on the electroencephalogram ( EEG ) . Patients and methods . After obtaining informed consent , in 38 unselected adult patients ( ASA I and II , 65 years ) scheduled for elective surgery , the EEG was recorded continuously before and after premedication . The patients were randomly assigned to four groups : M : midazolam , 0.2 mg/kg BW orally ; N : nordazepam , 0.2 mg/kg BW orally ; AP : atropine , 0.5 mg , plus promethazine , 50 mg i.m. ; APP : atropine , 0.5 mg , plus promethazine , 50 mg , plus pethidine , 0.7 mg/kg BW i.m. The EEG was recorded for a reference period of 10 min before and a study period of 30 min after premedication . Automated EEG processing was performed with CATEEM ( computer-aided topographical electroencephalometry ) . Surface electrodes were placed according to the 10 - 20 system . Date were collected via an amplifier ( resistance 10 M ) and a digitalization unit ( filter 0.2 - 35 Hz , sampling rate 512 Hz , 12 bit A/D convertor ) . The original EEG signals were used in an interpolation algorythm to produce an additional 82 virtual recording points , allowing for high topographical resolution . After spectral analysis ( fast Fourier transformation ) , the different frequency ranges of the EEG power spectrum are displayed in different colors . The screen displays the on-line map with color-based topographical power distribution . In order to achieve a pharmacodynamic time profile , the study period was subdivided into three periods of 10 min each . For clinical evaluation of vigilance , a 6-grade scoring system was used ( 1=awake, 6=not arousable ) . Results . All data are presented with respect to reference period . The power density of each frequency range for each electrode is integrated over the selected period and mean values are shown . Changes in power density with time are expressed as percentage change from reference period . Biometrical data showed no significant differences between groups . The median vigilance score 30 min after premedication ( end of study period ) was 4 in groups M , AP , and APP , and 3 in group N. In both benzodiazepine groups , a distinct increase in power density was found in the -bands , while in groups AP and APP the increase was most pronounced in the and bands . In group M , there was a linear increase in 1 power up to 310% , while in the 2 range there was a 170% maximum within the second period of 10 min . In group N , there was a similar course with a lower increase in 1 ( 220% ) and 2 ( 130% ) . Increases in both -bands were most pronounced with frontal electrodes . While group M showed an increase in power ( 150% ) , together with moderate suppression in ( 1 50% , 2 40% ) , nordazepam caused only a slight increase ."
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DerAnaesthesist.40430441.eng.abstr
|
DerAnaesthesist.40430441.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430441.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Non-invasive blood pressure measurements by the auscultatory method do not provide reliable , reproducible blood pressure values in many neonates because the Korottkoff sounds are often very difficult to detect . This resulted in the development of many alternative indirect methods . Devices utilizing the Doppler ultrasound technique have not found wide acceptance . Since the introduction of automated oscillometric blood pressure monitors , arterial blood pressure has been increasingly brought into discussion as an indicator of the circulatory state . This is the first study to investigate the similarity and reproducibility of the data obtained with five oscillometric devices for measurement of blood pressure in neonates . Materials and methods . Since investigations on the technical performance are not practical in the clinical setting of a neonatal or pediatric ward , we used two simulators , the CuffLink ( Dynatech , Nevada , USA ) and a device developed by the PTB ( Physikalisch-Technische Bundesanstalt ) . While the latter uses oscillations originally obtained from neonates , the CuffLink uses artificial and therefore ideal signals for the blood pressure monitors . The signals used for the PTB simulator were obtained from three neonates with an average age of 2 months and a weight of 3.5 kg , 4.4 kg , and 7.8 kg . The following blood pressure monitors were studied : Hoyer/Colin , BP-1001; Datex , Cardiocap II ; SpaceLabs , model no . 90426 ; Hewlett-Packard , NBP M1008A ; Critikon , Dinamap 1846. Before the measurements were started , the cuff pressure display of each monitor was checked according to a verification procedure . Although the 4 mm Hg margin of error was not exceeded , the results were corrected . Results . The results of the measurements show significant differences between the blood pressure monitors from the various manufacturers , with the differences for the ideal signals of the CuffLink-Simulator being less pronounced than those for the PTB simulator . Direct comparison of results is therefore often impossible . The standard deviation , taken from 20 measurements per monitor and simulation , is below 4 mm Hg for both simulators . We can therefore conclude that the reproducibility of data is satisfactory and the emerging trend is reliable . Discussion . The difference between the results of the PTB simulator and the CuffLink are probably due to the method of evaluation and the identification of artifacts of each blood pressure monitor . This is also confirmed by the studies of Mieke et al. The manufacturers should provide devices that display comparative results and improve the algorithms for detection of artefacts , increasing the accuracy of their blood pressure monitors . This could be done with the help of simulators . Considering the pathophysiological characteristics of neonates and infants , the systematic differences between the five monitors have to be regarded as serious ."
],
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DerAnaesthesist.40430454.eng.abstr
|
DerAnaesthesist.40430454.eng.abstr
|
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"As early as 1974 , Brian advocated the prone position for ventilated patients [ 5 ] . He suggested that this position might enhance ventilation of the dorsal parts of the lungs , thereby improving oxygenation . These considerations have been confirmed by several experimental and clinical studies [ 1 , 6 , 13 , 17 ] . Better secretion removal , decreased intrapulmonary shunting , and an increased FRC are thought to be responsible for the observed improvement of oxygenation . However , the prone position never became very popular in the clinical treatment of the adult respiratory distress syndrome ( ARDS ) . Routine performance of thoracic CT scans in ARDS patients demonstrated preferential distribution of pathological densities in the dependent lung areas . The prone position therefore could possibly benefit these patients , as shown by two recent studies [ 8 , 11 ] . The aim of our study was to evaluate the influence of repeatedly turning the patient to the prone position on gas exchange and thoracic CT findings in multiple-trauma patients . Methods . Seven ventilated intensive care patients with severe ARDS ( Murray Score > 2.5 [ 9 ] , Quotient > 0.7 [ 4 ] , mean airway pressure > 18 cm H2O, thoracic CT scan showing dorsal atelectases ) were included in the study . Patients were turned from the supine to the prone position at 12-h intervals using an air-cushion bed ( Mediscus , Austria ) . Redistribution of dystelectatic or atelectatic dependent lung areas was verified by means of repeated thoracic CT scans ( Figs . 1 , 8 ) . Results . The patients were intermittently turned for 6.5 +/- 1.1 days . The course of gas exchange is shown in Figs . 2 and 3. Initially , improvement of the respiratory quotient could only be achieved during prone positioning , from the 2nd day in the supine position as well . Intrapulmonary shunting showed a similar trend ( Figs . 4 and 5 ) . No significant changes in cardiovascular parameters could be observed . Control thoracic CT scans showed uniform reduction of atelectases in dependent lung areas ( Figs . 1 and 8 ) . The inspiratory fraction of oxygen could be reduced significantly as of the 2nd day ( Fig . 7 ) . Constant levels of positive end-expiratory pressure and tidal volume were associated with decreasing mean and plateau airway pressures ( Fig . 6 ) . Discussion . Repeatedly turning the patient to the prone position produced long-lasting improvement of arterial oxygenation , which persists up to the end of the weaning process . This is in good accordance with other studies [ 1 , 2 , 6 , 8 , 11 , 13 , 17 ] , however , this is the first study to report an observation period of more than 6 days of repeatedly turning the patient . These positive effects on gas exchange can be attributed to sudden improvement of the ventilation-perfusion ratio within the lung areas that become dependent after turning to the prone position . Due to reduced hydrostatic pressure [ 11 ] and relative hyperventilation [ 7 , 16 ] , previously collapsed alveoli are recruited in the lung areas that become non-dependent after turning to the prone position ."
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DerAnaesthesist.40430463.eng.abstr
|
DerAnaesthesist.40430463.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430463.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 25-year-old woman with Kartagener's syndrome was admitted to hospital for laparoscopy because of sterility . Kartagener's syndrome is a rare disorder involving the combination of situs inversus , bronchiectasis and sinusitis . A dynein deficiency leads to ciliary dyskinesia . When general anaesthesia is to be induced in a patient with Kartagener's syndrome the following points must be borne in mind : ascertainment of the preoperative pulmonary status , antibiotic coverage , recognition of dextrocardia , necessity for aseptic techniques because of the possibility of abnormal neutrophil chemotaxis . Anticholinergic and antitussive medications are relatively contraindicated , as are nasal tubes . In the present case an intubation anaesthesia with thiopental , nitrous oxide , enflurane and succinylcholine was carried out ; cefoxitin was administered for antibiotic treatment , and the patient made an uneventful recovery ."
],
"offsets": [
[
0,
932
]
]
}
] |
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],
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] |
DerAnaesthesist.40430466.eng.abstr
|
DerAnaesthesist.40430466.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430466.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report on two patients with subcutaneous carbon dioxide ( CO2) emphysema that developed during laparoscopic surgery with CO2 pneumoperitoneum ( PP ) , in whom pulmonary elimination of CO2 ( ECO2, Servo ventilator with integrated CO2 analyzer 930 , Siemens ) was continuously monitored . Patient 1 was a 61-year-old man with laparoscopic herniotomy . ECO2 immediately before PP was 120 ml/minxm2 and increased rapidly after 45 min PP to a maximum value of 340 ml/minxm2. At that time , minute ventilation had been increased from 7 to 11 l/min and PaCO2 had risen from 35 to 57 mm Hg. At the end of the procedure the patient showed excessive subcutaneous emphysema . Patient 2 was a 71-year-old woman in whom diagnostic laparoscopy was performed for staging of a pancreatic tumor . ECO2 immediately before PP was 140 ml/minxm2, increasing dramatically after 45 min PP to a maximum value of 529 ml/minxm2 ( Fig . 1 ) . At that time minute ventilation had been increased from 6.2 to 12.5 l/min and PaCO2 had risen from 40 to 77 mm Hg. PP was terminated and the patient was found to have extreme subcutaneous emphysema . She was mechanically ventilated for a further 40 min to normalize PaCO2 and ECO2. It seems reasonable to suppose that an increase in ECO2 by more than 100% of control during CO2-PP is an early sign of CO2 emphysema . In this situation hypercapnia is potentially life-threatening . Evidently , reabsorption of CO2 from loose connective tissue is far more rapid and effective than CO2 resorption from the peritoneal cavity . The incidence of CO2 emphysema during laparoscopic surgery is said to be in the range of 0.3 - 3% , but even higher incidences may be found when it is carefully looked for . Continuous observation of ECO2 is non-invasive and relatively inexpensive and may give new insights into pathophysiological changes during CO2-PP in the future ."
],
"offsets": [
[
0,
1877
]
]
}
] |
[
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],
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{
"id": "DerAnaesthesist.40430466.eng.abstr-s1-t2",
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"id": "DerAnaesthesist.40430466.eng.abstr-s1-t5",
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{
"id": "DerAnaesthesist.40430466.eng.abstr-s1-t7",
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DerAnaesthesist.40430494.eng.abstr
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DerAnaesthesist.40430494.eng.abstr
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"id": "DerAnaesthesist.40430494.eng.abstr-passage-0",
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"text": [
"Modern medicine has succeeded in achieving enormous technical developments . One recent highlight has been the introduction of postmortem organ transplantation . At the same time , serious objections have been raised concerning the radical changes in the cultural conception of the inviolable body . One major objection arises from the conflict of considering a brain-dead person as dead . The presence of brain death is a prerequisite for post-mortem organ donation , because only during this phase of dying does the individual quality as dead while the organs , other than the brain , remain viable . The objection implies scepticism as to the physician's ability to distinguish a dead from a living person . On the other hand , even the critics must rely on the physician's ability to discriminate , e.g. , when to discontinue resuscitation . The medical community has not found reasons to restrict the definition of irreversible coma 25 years after its first formulation . It must be clearly recognised that reasons other than medical ones can be decisive for refusing organ donation . One ethical problem is the therapeutic benefit of organ transplantation . The beneficiary of the treatment is not the donor , but another person , the recipient . The concept of human dignity does not allow the use of a person fur purposes other than the ones he/she consents to , as Immanuel Kant stated . Although the human corpse is not a person in the full sense , even if it is protected by the thought of respect for the former person , the life-interest of the organ recipient had to be considered legitimate . The resulting conflict between the respect for the donor and the life-interest of the recipient should be balanced by seeking the donor's consent as far as possible . The proposed information model seems adequate at the moment . A common report of both churches in Germany in 1990 supported postmortem organ transplantation . The report dealt with the medical problems and harmonized them with the Christian value of solidarity . The ethical alternatives to organ transplantation , however , are not mentioned . Within this limitation , the report seems to adequately express the aim to strengthen individual competence and plead for fair perception of the neighbour's life-interest ."
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DerAnaesthesist.40430500.eng.abstr
|
DerAnaesthesist.40430500.eng.abstr
|
[
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"Ondansetron , a selective 5-HT3 receptor antagonist , has recently been shown , in a dose of 8 mg , to be superior to 1.25 mg droperidol in preventing postoperative vomiting . There are indications that a dose of 4 mg of ondansetron may be just as effective in reducing postoperative nausea and vomiting as a dose of 8 mg [ 16 ] . The aim of this study was to evaluate the efficacy and the adverse effects of 4 mg ondansetron in the prevention of postoperative nausea and vomiting compared to droperidol in patients undergoing surgery with inhalation anaesthesia supplemented with alfentanil . Methods . Following institutional approval , 40 ASA physical status I and II women scheduled for minor gynaecological surgery gave informed consent to participate in this randomized , double-blind comparative study . Five minutes before induction of general anaesthesia , 20 patients received a single intravenous ( IV ) dose of 4 mg of ondansetron and the remaining 20 received 1.25 mg droperidol IV . Anaesthesia was induced with 2.1 - 4 mg/kg of thiopental and 0.1 mg of alfentanil IV and maintained with 65% nitrous oxide and 1.5% - 3% enflurane in oxygen . On pain stimuli another 0.2 - 0.4 mg of alfentanil was given . Total effective antiemetic response was defined as the absence of nausea and vomiting for 24 h postoperatively . The incidence of nausea , vomiting and the number of patients showing total antiemetic response as well as the incidence of adverse effects were compared with the chi2 test and P 0.05 was considered significant . Results . Patients were similar with respect to age , height , body weight and total anaesthetic agents received . Duration of anaesthesia and the time until awakening was not significantly different among groups . Postoperatively 7 out of 20 patients given 4 mg of ondansetron and 3 out of 20 patients with droperidol vomited ( n.s. ) . The incidence of nausea was 11 out of 20 in the ondansetron group , and 4 out of 20 in the droperidol group ( P 0.05 ) . Sixteen patients in the droperidol group and 8 patients in the ondansetron group showed a total effective antiemetic response ( P 0.05 ) . Postoperative sedation and well-being scores did not differ significantly among groups . Conclusion . Our results show that for the prevention of postoperative nausea and vomiting 4 mg of ondansetron was inferior to 1.25 mg of droperidol . The drugs were given intravenously prior to general anaesthesia for minor gynaecological surgery with nitrous oxide and enflurane in oxygen supplemented with small boluses of alfentanil ."
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DerAnaesthesist.40430504.eng.abstr
|
DerAnaesthesist.40430504.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430504.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction . Ondansetron is more effective than a placebo in treating postoperative nausea and vomiting ( PONV ) , but it has not been proved to be superior to established antiemetics for prophylaxis or therapy . We compared ondansetron vs droperidol for the treatment of PONV . Methods . Our prospective , randomized double-blind study was performed between 15 October 1992 and July 1993 ; it included 271 gynaecological ASA I - III inpatients who had been operated on under general anaesthesia with intubation . Patients were excluded if : there was no informed consent ; it was an ambulatory or emergency operation ; the patient was pregnant or breast feeding ; allergies were being treated with antihistamines ; drug addiction was present or convulsions or Parkinson's disease ; any pre- or intraoperative antiemetic medication had been administered . All patients wishing an antiemetic and/or suffering from at least one emetic episode during the first 24 h postoperatively received either 8 mg ondansetron or 1.25 mg droperidol from identical 4 ml ampoules intravenously . The verbal nausea score ( 1=none, 2=mild, 3=moderate, 4=severe) was recorded every 30 min for 4 h , then before and 2 h after each antiemetic dose . All emetic episodes and the interval between administration and effect were also noted . Patients were interviewed 36 - 48 h postoperatively on subjective effects , side-effects and individual acceptance . After oral premedication with diazepam , anaesthesia was induced with thiopental , in a few cases with etomidate or propofol . Relaxation was achieved with pancuronium or atracurium and , when indicated , with succinylcholine . Muscular relaxation was antagonized with neostigmin and glycopyrrolate . Gastric content was aspirated once after intubation . Anaesthesia was maintained with nitrous oxide/oxygen , enflurane , halothane or isoflurane and fentanyl up to 0.3 mg . Statistical evaluation was performed by the unpaired Student's t-test and the Mann-Whitney U test . Categoric variables were examined by the 2 test . Significance was defined as P 0.05. Results . Of 271 patients , 100 ( 37% ) experienced PONV . The groups were statistically comparable with respect to demographic data , type and duration of operation , emesis record , perioperative uterotonic medication . Twenty patients in the ondansetron group and 27 in the droperidol group received the first antiemetic within 2 h , the other patients up to 17 h after extubation . Nausea scores and emetic episodes were identical before antiemetic medication . The reduction of these parameters after medication was similar . Complete response over 6 h was 60% in the ondansetron and 68% in the droperidol group . In both groups the first medication failed in 4 cases during the initial 2 h . Twenty of the ondansetron and 16 of the droperidol patients needed a second dose ; among these 2 and 4 , respectively , a third ampoule . No rescue medication was necessary over 24 h and a mean of 1.4 ampoules was administered in both groups . Onset and quality of emetic action were identical in both groups . It was not possible to evaluate 25 interviews due to linguistic or amnestic problems . Multiple side-effects were noted frequently . Injection pain was reported significantly more often in the droperidol , pruritus in the ondansetron group . Ninety-three percent of the ondansetron and 85% of the droperidol patients opted for the same drug for future PONV treatment . Conclusions . Ondansetron ( 8 mg ) and droperidol ( 1.25 mg ) proved to be equally effective when used as a postoperative antiemetic . Both drugs showed similar side-effects . Due to differences in methods it was difficult to compare our results to those obtained in other studies ."
],
"offsets": [
[
0,
3756
]
]
}
] |
[
{
"id": "DerAnaesthesist.40430504.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"Ondansetron"
],
"offsets": [
[
15,
26
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0061851"
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},
{
"id": "DerAnaesthesist.40430504.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"placebo"
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52,
59
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],
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"db_id": "C0032042"
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},
{
"id": "DerAnaesthesist.40430504.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"postoperative"
],
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[
72,
85
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032790"
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},
{
"id": "DerAnaesthesist.40430504.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"nausea"
],
"offsets": [
[
86,
92
]
],
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DerAnaesthesist.40430521.eng.abstr
|
DerAnaesthesist.40430521.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430521.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In most ventilators used in anaesthesia tidal volume delivered during mechanical ventilation is different from the tidal volume preset at the respirator on the basis of respirator and circuit compliance and gas compression during inspiration . The error in ventilation due to the compressed volume is especially significant clinically when the tidal volume is very small or when the airway pressure is very high . In newborns and neonates in particular , decreasing lung compliance during a surgical procedure may contribute to marked hypoventilation . We therefore investigated ventilation in newborn piglets during decreasing lung compliance induced by tension pneumothorax . We used the anaesthesia ventilator CICERO ( Draeger , Luebeck , Germany ) and the SERVO 900 C ventilator ( Siemens-Elema , Sweden ) . Materials and methods . Two anaesthesia ventilators , the CICERO ( group I , n=8) and the SERVO ventilators ( group II , n=8) were investigated following randomized selection in a group of 16 newborn piglets ( Table 1 ) . After normoventilation for 60 min a tension pneumothorax at +10 mbar was induced . After 15 min the pneumothorax was increased to +20 mbar and maintained at this level for the rest of the study . When hypercapnia ( PaCO2>45 mm Hg ) resulted , the respiratory rate was increased by +10/min after 15 min with pneumothorax at +20 mbar . When hypercapnia continued , the respiratory rate was increased again 25 min and if necessary also 35 min after the induction of pneumothorax at 20 mbar . After normoventilation for 60 min ( T1) ( Table 2 ) , after 15 min with pneumothorax at +10 mbar ( T2) and after 15 min ( T3), 25 min ( T4), 35 min ( T5) and 45 min ( T6) with pneumothorax at +20 mbar the following parameters were obtained : central venous ( CVP ) and mean arterial pressure ( MAP ) , heart rate ( HR ) , arterial ( PaCO2 and end-tidal CO2 tension ( PetCO2 ) , peak inspiratory pressure ( PIP ) , respiratory frequency ( RF ) and expiratory tidal ( Vtex ) and minute volume ( VE ) . Results . In group I the pneumothorax resulted in a significantly smaller increase in PaCO2 ( 43.3 +/- 6.2 mm Hg ) than in group II ( Fig . 1 ) , and hypercapnia was present in only 3 piglets . Vtex ( Fig . 2 ) , VE ( Fig . 3 ) and PIP ( Fig . 5 ) increased significantly , with significantly higher values than in group II , while PetCO2 ( Fig . 6 ) decreased significantly . In group II the pneumothorax was attributed to a significant increase in PaCO2 and a marked hypercapnia in all piglets ( PaCO2 61.2 +/- 5.9 mm Hg ) ( Fig . 1 ) . Vtex ( Fig . 2 ) and VE ( Fig . 3 ) remained unchanged , while PIP ( Fig . 5 ) and PetCO2 ( Fig . 6 ) increased . Following the increase in RF ( Fig . 4 ) in all piglets , Vtex and VE increased and PaCO2 and PetCO2 decreased . Conclusions . During ventilation of neonates with the SERVO ventilator a decrease in lung compliance will cause hypoventilation and hypercapnia . This is reflected by an increase in peak inspiratory pressure and can be corrected by increasing the respiratory rate . In contrast , the CICERO is able to preserve ventilation by an internal correction for gas compression , but it does not guarantee normoventilation in all cases . In neither group does the end-tidal PCO2 reflect the true ventilation during decreasing lung compliance , so that arterial blood gas analysis seems to be mandatory for the diagnosis of hypercapnia in such situations ."
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[] |
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DerAnaesthesist.40430528.eng.abstr
|
DerAnaesthesist.40430528.eng.abstr
|
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"The aims of the study were : ( 1 ) to predict reversal time from intensive atracurium blockade ; and ( 2 ) to determine the optimal time of neostigmine administration during recovery from atracurium blockade , i.e. , the time at which the administration of neostigmine results in the shortest total recovery time ( time from administration of last supplemental dose of atracurium to train-of-four [ TOF ] ratio 0.70 ) , and at the same time results in the shortest time from administration of neostigmine to TOF ratio 0.70. Method . The spontaneous and neostigmine-facilitated recovery in 52 healthy women anaesthetised with thiopentone , fentanyl , droperidol , and nitrous oxide was followed . Post-tetanic count ( PTC ) of TOF stimulation of the ulnar nerve and mechanomyography were used for monitoring neuromuscular transmission . The neuromuscular blockade was induced with atracurium 0.6 mg/kg and supplemental doses of 0.15 mg/kg were given when the first twitch response in the TOF ( TH1) had recovered to 20% . Neostigmine 0.036 mg/kg body weight was given at different levels of neuromuscular blockade to 37 of the patients . Results . Multiple regression analyses including pre-reversal time ( time from administration of the last atracurium dose to neostigmine administration ) , PTC , weight , and age of the patients suggest that pre-reversal time is the best predictor of reversal time : reversal time=27.3 min- ( 0.89xpre-reversal time [ min ] ; ( SEE=6.0 min ) . If pre-reversal time is unknown , PTC can be used : reversal time=24 min- ( 4.5xln PTC ) at time of reversal ) ; ( SEE=6.8 min ) . Total recovery time was 47 min ( SEM=2.0 min , n=15) in the patients allowed to recover spontaneously , and 29 min ( SEM=1.2 min , n=29) in the patients reversed by neostigmine ; the difference of 18 min ( SE diff 2.0 min ) was significant ( P 0.0005 ) . The level of blockade indicated by PTC ( 1 - 24 ) at the time of reversal had no influence on the total recovery time . The spontaneous recovery times from reappearance of TH1 and TH1=10% to TOF ratio 0.70 were 29.2 min ( SEM=1.7 min ) and 24.4 min ( SEM=2.6 min ) , respectively . Discussion . The results suggest that pre-reversal time is the strongest predictor of reversal time when neostigmine is administered during intense atracurium blockade . To achieve the optimal time-saving effect , neostigmine must be given 18 min ( the time saved by giving neostigmine ) plus 7 to 11 min ( needed for neostigmine to reach its peak effect ) , giving a total of 25 to 29 min before TOF ratio 0.70. As TH1 is between 1% and 10% 25 to 29 min before TOF ratio 0.70 is reached during spontaneous recovery , the optimal level of neuromuscular blockade for neostigmine administration in atracurium blockade is when TH1 is between 1% and 10% . Conclusion . Reversal time can be predicted as 27.3 min- ( 0.89xpre-reversal time ( min ) , and the optimal time of neostigmine administration in atracurium blockade appears to be when TH1 is 1% - 10% ."
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DerAnaesthesist.40430534.eng.abstr
|
DerAnaesthesist.40430534.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430534.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Because the brain is highly vulnerable to damage from even a brief imbalance of oxygen delivery and demand , intraoperative disturbances of local oxygen supply must be avoided . Until now , there has been no method allowing fast and reliable intraoperative measurement of the local oxygen supply in the human brain . Intraoperative investigations were therefore performed using the Erlangen micro-lightguide spectrophotometer . Methods . Intraoperative investigations of local intracapillary haemoglobin saturation ( SO2) were performed during neurosurgical interventions using the Erlangen micro-lightguide spectrophotometer ( EMPHO ) . Measurements were performed in eight patients ( age 31 - 67 years ) during neurosurgical interventions . Three received thiopentone anaesthesia , and three received propofol . In two patients thiopentone anaesthesia was later changed to propofol . The EMPHO enables rapid , non-invasive measurement of local intracapillary SO2. White light from a Xenon-arc lamp is transmitted by a 250-µm micro-lightguide to the tissue . The remitted ( reflected ) light is led by 6 micro-lightguides surrounding the illuminating one to a rotating band-pass interference filter disk . Light in the range of 502 to 630 nm is detected with a photomultiplier . In this range haemoglobin shows an SO2-dependent spectrum , which is then analysed . Because the measurements are performed with micro-lightguides , high spatial resolution is attained . Representative measurements can be performed in a very short period of time ( approx . 60 s ) ; thus , the EMPHO enables rapid monitoring of local SO2 in the brain . Results . The effect of propofol and thiopentone anaesthesia on the distribution of local intracapillary haemoglobin saturation was investigated during neurosurgical interventions . The arterial PCO2 was similar in both groups ( 31 +/- 0.7 and 31 +/- 0.5 mm Hg , respectively ) . There were also no differences in arterial blood pressure . The FiO2 was 0.28 +/- 0.04 in the thiopentone group and 0.30 +/- 0.1 in the propofol group . In all patients receiving propofol anaesthesia higher local SO2 values were found , even if the patients first received thiopentone ( values in parenthesis ) . The mean local SO2 amounted to 65.4% ( 57.3% ) in the propofol group and 38.8% ( 45.2% ) in the thiopentone group . The number of values below 25% SO2 was 5.6% ( 5.8% ) in the propofol group and 18.7% ( 19.1% ) in the thiopentone group ."
],
"offsets": [
[
0,
2463
]
]
}
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DerAnaesthesist.40430547.eng.abstr
|
DerAnaesthesist.40430547.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430547.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The analgetic efficacy of intraoperative infiltration with bupivacaine 0.5% or saline of the skin incisions for the endoscopic trocars was examined in 30 female patients following operative endoscopic pelviscopy in a double-blind study . Infiltration of the peritoneum , abdominal wall , and subcutaneously was performed by endoscopic view before skin suture . There were no significant differences between the two groups in age , duration of surgery , operative technique , intensity of preoperative acute and chronic pain , or state of anxiety . Postoperative pain assessment was performed using a numeric rating scale ( NRS ) hourly within the first 8 h and after 24 h postoperatively . After 8 h patients were asked for the localisation and description of the worst pain . Cumulative tramadol doses were calculated for 3 , 8 and 24 h using patient-controlled analgesia ( PCA ) . Pain intensity within the first 8 h postoperatively did not differ between the bupivacaine and placebo groups ( Fig . 1 ) . The mean NRS after bupivacaine infiltration was 4.6 ( +/- 2.4 ) in the 1st - 3rd h and 3.4 ( +/- 1.8 ) after 6 - 8 h ( placebo : 4.8 ( +/- 2 ) and 2.4 ( +/- 1.7 ) ) . In both groups most patients reported lower ( 40% ) or upper ( 12% ) abdominal visceral pain as their worst pain . Pain due to skin incision was noted less , but in equal numbers in both groups . Of the patients in the bupivacaine group 77% and in the control group 80% started with PCA due to increasing pain scores within 60 to 120 min . The numbers of tramadol demands and given doses did not differ ( Fig . 2 ) . Therefore , intraoperative infiltration of the abdominal wall and skin with bupivacaine cannot be recommended for postoperative pain therapy after pelviscopy . Pain involving visceral afferents seems to play the major role following abdominal endoscopic surgery . In addition , the study supports recent reports showing that even after minimal invasive surgery most patients need opioids in the early postoperative period ."
],
"offsets": [
[
0,
2014
]
]
}
] |
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DerAnaesthesist.40430553.eng.abstr
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DerAnaesthesist.40430553.eng.abstr
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"Case report . A 34-year-old male ( 190 cm/100 kg ) was scheduled for surgery of the nasal septum . He had had uneventful anaesthesia for appendicectomy 14 years earlier : following 600 mg thiopentone , 180 mg suxamethonium and up to 2 vol . % halothane for 20 min had been used and no symptoms of malignant hyperthermia ( MH ) were recorded . Following oral premedication with 2 mg flunitrazepam at 7.00 a.m. anaesthesia was induced with a priming dose of atracurium at 8.45 a.m. followed by 0.2 mg fentanyl , 500 mg thiopentone , and 100 mg suxamethonium . Endotracheal intubation was accomplished easily [ 9 ] , and the patient was ventilated manually in a semi-closed circle system until spontaneous ventilation resumed . Enflurane ( 1.5% for 5 min , 1.0% for 10 min , and 0.8% until the diagnosis of MH was suspected ) was given in 33% O2/66% N2O. Seventy minutes after induction it was noted that the spontaneous respiratory rate and minute volume had risen continuously from 10/min and 6 l/min , respectively , to 20/min and 12 l/min . Attempts at deepening anaesthesia with repeated doses of fentanyl up to a total dose of 0.95 mg failed to reduce the hyperventilation . In spite of a high fresh gas flow of 6 l/min and assisted manual ventilation , the FIO2 started to fall from 0.34 to 0.28 at 10:20 a.m. The O2/N2O ratio was changed to 1 : 1 , but the FIO2 remained at 0.3. MH was suspected , enflurane was discontinued , and an arterial blood gas analysis was done ( Table 2 ) . When marked acidosis and hypercarbia were found , dantrolene 2.5 mg/kg was given , the operation was terminated , and the patient's trachea was extubated and he was monitored closely in the intensive care unit for 24 h . Vital signs were stable ( Table 3 ) and no further complications were observed . The patient did not mention pain or uneasiness postoperatively . About 6 months later , a muscle biopsy was done according to the European MH Protocol [ 5 ] and the patient was found to be MHEh . Discussion . In this case five main reasons for the hypercarbia and mixed acidosis must be considered ( Table 1 ) . Firstly , hypoventilation does not seem to be reasonable as the patient was ventilated with 8 to 12 l/min , which is within the range of 80 - 120 mg/kg - min . Secondly , we can exclude shock and hypoperfusion because the patient had a normal blood pressure and heart rate ( within 65 - 90 beats/min ) , his fingertips and skin were well perfused , his body temperature was 37 °C, and there was no sign of muscle rigidity . Thirdly , a defect of the CO2 adsorber as well as CO2 admixture to the N2O and O2 ventilation gases can cause hypercarbia . We use two absorbers in sequence of which one is changed every day , and found neither a change in colour of the indicator nor an abnormally raised temperature of the absorbers [ 11 ] . A postoperative check of the ventilator showed no defect in the O2/N2O supply and a correctly functioning anaesthesia apparatus . A malfunction of both CO2 absorbers resulting in intraoperative hypercarbia could not explain a postoperative mixed acidosis lasting for more than 6 h . Anaesthesias performed at the same time using soda lime from the same canisters were totally uneventful . Conclusion . It is concluded that the hypercarbia and mixed acidosis were caused by hypermetabolism . A thorough postoperative examination by an internist did not reveal any thyroid , pulmonary , endocrine , or circulatory reason for our intra- and postoperative findings . Iatrogenic factors like superficial anaesthesia or systemic side effects of adrenaline admixture to local anaesthetics can cause hypermetabolism without striking clinical signs , but they do not cause mixed acidosis lasting longer than 6 h ( Table 2 ) . The most suitable explanation in this case is an abortive form of MH ."
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"id": "DerAnaesthesist.40430553.eng.abstr-s26-r31-t2.1-t3.1",
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] |
DerAnaesthesist.40430557.eng.abstr
|
DerAnaesthesist.40430557.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430557.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Malignant hyperthermia ( MH ) is a rare , life-threatening pharmacogenetic disease . The genetic incidence is estimated to be 1 : 10 000. In predisposed individuals , MH is triggered by volatile anaesthetics and/or depolarizing muscle relaxants by an abnormal increase of intracellular calcium concentration in skeletal muscle cells . The clinical presentation may vary from abortive MH to the fulminant MH crisis . Early diagnosis , the use of electrocardiography and capnography for anaesthetic monitoring , immediate cessation of trigger agents and dantrolene treatment are essential components of an effective MH therapy . In some MH families , a genetic alteration of the ryanodine receptor gene ( a calcium channel of the sarcoplasmic reticulum ) on chromosome 19 has been identified as the potential cause of MH susceptibility . Recent molecular biological findings support the view of MH being a heterogenetic disease . At present , the diagnosis in potentially MH-susceptible individuals is still made using the in vitro halothane and caffeine muscle contracture test ."
],
"offsets": [
[
0,
1078
]
]
}
] |
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"id": "DerAnaesthesist.40430557.eng.abstr-s1-t2",
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"id": "DerAnaesthesist.40430557.eng.abstr-s1-t3",
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"id": "DerAnaesthesist.40430557.eng.abstr-s1-t5",
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"concentration"
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"id": "DerAnaesthesist.40430557.eng.abstr-s2-t7",
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"cells"
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"id": "DerAnaesthesist.40430557.eng.abstr-s2-t9",
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"id": "DerAnaesthesist.40430557.eng.abstr-s2-t10",
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] |
[] |
[] |
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] |
DerAnaesthesist.40430573.eng.abstr
|
DerAnaesthesist.40430573.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430573.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Total intravenous anaesthesia ( TIVA ) is increasingly used in short-stay surgery such as laparoscopic cholecystectomy . TIVA may provide fast recovery of psychomotor function , thus being of benefit to both the patient's behaviour and postoperative management . The purpose of this prospective study was to compare postoperative recovery from TIVA using propofol or methohexitone as the hypnotic component and balanced anaesthesia with isoflurane . Patients and methods . After giving informed consent and approval by the ethical committee of our hospital , 51 patients ( ASA I , II ) were investigated in a prospective study . Patients were randomised to receive either isoflurane , methohexitone , or propofol . Perioperative management with regard to premedication , intraoperative analgesia , relaxation , ventilation , and postoperative analgesia was carried out identically for all groups . Postoperative vigilance , pain , and nausea scores were assessed 15 , 30 , 60 , 120 , and 360 min after extubation with a visual analogue scale ( VAS ) . At the same points , psychomotor recovery was investigated with the following assays : sedation as shown in Table 1 ; orientation with ten questions as to person , time , and location ; memory as expressed by the patient's ability to repeat five words ; a calculation test with five subtractions of the number 7 beginning from 100 ; and word generation by the number of words with an initial \" m \" given within 1 min and with animal names . Data were analysed with Kruskal Wallis ' test for multiple comparisons between the groups and with Friedman's test for repeated measurements . All values are given as medians ( interquartile range ) or ranges . Results . There was no difference between the groups ' physical condition ( Table 2 ) . All intraoperative parameters compared well between groups ; the management of anaesthesia was smoother with isoflurane than with the other anaesthetics . Psychomotor recovery was somewhat faster in the propofol group than the methohexitone group , as indicated by sedation score , orientation , memory and calculation tests ( Table 4 ) , word generation tests ( Fig . 4 ) , and subjective vigilance score ( Fig . 3 ) . The difference in recovery time between the propofol and isoflurane groups was minimal and without any significance or relevance . The incidence of postoperative nausea was significantly lower after balanced anaesthesia with isoflurane ( 24% , P 0.05 ) as compared to TIVA with either propofol ( 53% ) or methohexitone ( 41% ) . However , there were only minor differences between the groups ; the ability to cooperate and be mobilised was not limited . Discussion . Each of the three techniques used in this study is suitable for anaesthesia in patients undergoing laparoscopic cholecystectomy . Since fast recovery of vigilance and psychomotor function is very important in outpatient surgery , opioid-supplemented propofol anaesthesia is well established . Inhalation anaesthesia with isoflurane in air/oxygen without adding nitrous oxide compares well to propofol TIVA for laparoscopic surgery ."
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DerAnaesthesist.40430582.eng.abstr
|
DerAnaesthesist.40430582.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430582.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Preoperative detection of a patent foramen ovale ( PFO ) may be achieved employing either transthoracic echocardiography ( TTE ) with the Valsalva manoeuvre in the awake patient or trans-oesophageal echocardiography ( TEE ) in the anaesthesised patient . Our study was undertaken to validate these methods with regard to their efficacy in identifying patients at risk for paradoxical air embolism ( PAE ) . Methods . In 67 patients ranging from 28 to 70 years of age , TEE was performed utilising the Valsalva manoeuvre prior to surgery . The patients were informed about all procedures and agreed to take part in the study . After induction of anaesthesia the patients were evaluated with TEE in the supine and sitting positions . At end-inspiration 10 ml agitated gelatine solution ( Gelafundin ) was injected through a central venous catheter into the right atrium after airway pressure of 20 cm H2O had been maintained for 5 s. The injected bolus was observed throughout the ventilatory cycle , with special attention being given to early expiration and systole . A right-to-left shunt was assumed if five echo targets were observed in the left atrium . Results . The prevalence of PFO detected by TTE/Valsalva was 9% . The diagnosis was confirmed by TEE in 2 patients in the supine and 1 in the sitting position . An echocardiogram in these patients showed bulging of the septum to the left , which was not seen in those patients in whom PFO was detected only by TTE . Discussion . The reason for the lower incidence of PFO detected by TEE during airway pressure 20 cm H2O may have been an insufficient increase of pressure in the right atrium with a negative right-to-left atrial pressure gradient . A standardised ventilation manoeuvre with supra-atmospheric airway pressure of 20 cm H2O is not sufficient . Bulging of the intra-atrial septum from right to left during airway pressure is a possible indication of the efficacy of the manoeuvre , regardless of the influence of the breathing pattern ."
],
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0,
2006
]
]
}
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] |
DerAnaesthesist.40430594.eng.abstr
|
DerAnaesthesist.40430594.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430594.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Total intravenous anaesthesia ( TIVA ) using a combination of a hypnotic and an analgesic agent is gaining increasing popularity as an alternative to balanced anaesthesia with volatile anaesthetics for abdominal surgery . Among the required characteristics of the drugs used in this technique are a good correlation between dose , plasma concentrations , and effect as well as rapid elimination from the circulation , allowing close control of anaesthetic depth . Two hypnotic drugs with similar pharmacokinetic and pharmacodynamic profiles are propofol and methohexitone , both of which can be employed as a component of a TIVA technique . Two TIVA combinations utilising either of these drugs with alfentanil were tested against isoflurane-nitrous oxide in a balanced regimen . Methods . Twenty-seven healthy women undergoing hysterectomy for non-malignant diseases participated in the study after having given written consent . They were randomly allocated to receive either isoflurane ( Iso ) , methohexital-alfentanil ( M-A ) , or propofol-alfentanil ( P-A ) . Blood samples for determination of cortisol , prolactin , catecholamines , glucose , lactate , non-esterified fatty acids , and pharmacon concentrations were drawn repeatedly from before induction until 360 min after surgery . Anaesthesia was induced in group Iso with fentanyl 0.1 mg and M 1.5 mg - kg-1 and maintained with Iso-N2O. In the TIVA groups M or P was given in a two-step infusion to load peripheral compartments and then maintain plasma concentrations within the hypnotic range . A was given as a continuous infusion in an identical dose ( 0.1 mg - kg-1 initial , 0.125 mg - kg-1 - h-1 maintenance ) in both groups . If signs of insufficient depth of anaesthesia occurred ( heart rate or systolic blood pressure > 25% above baseline ) , then first A ( 0.5 - 1 mg ) , and if that was ineffective , then 50 mg hypnotic was administered . The A infusion was stopped 30 min before the end of surgery , and Iso or the hypnotic was stopped at skin closure . Recovery time was the time until the patients were able to give their birth date after stopping the Iso or hypnotic . Results . The three groups were comparable with regard to age , weight , and duration of surgery . The total doses of M and P were 1,357 +/- 125 mg ( mean +/- SEM ) and 1,315 +/- 121 mg , respectively , and the total A doses were 20.7 +/- 2.5 mg ( M-A ) and 23.4 +/- 3.5 ( P-A ) . The peak plasma concentrations were P 10.6 +/- 1.5 µg - ml-1 and M 12.4 +/- 2.6 µg - ml-1. At the end of surgery the P concentrations were in the projected range while those of M were somewhat lower than expected ( P3.7 +/- 0.4 µg - ml-1; M 3.5 +/- 0.6 µg - ml-1). Three patients each in the P-A and M-A groups required supplementary A injections . Five patients in the P-A group required additional bolus injections of the hypnotic as compared to 2 in the M-A group . The median recovery times were Iso 15 min , M-A 50 min , and P-A 25 min ( P 0.05 ) . The incidence of shivering was Iso 3/9 , M-A 5/9 , and P-A 0/9 ( P 0.05 ) ; vomiting occurred with equal frequency in all groups ( Iso 33% , M-A 33% , P-A 22% ) . The patients were somewhat more restless in group M-A . Systolic blood pressure dropped in a similar manner in all groups after induction of anaesthesia ( Iso -31% , M-A -37% , P-A -36% ) but recovered during surgery . The intraoperative response of cortisol ( Iso +216% , M-A +92% , P-A +43% ) and catecholamines ( noradrenaline Iso +56% , M-A +30% , P-A -21% ) was lower in the TIVA groups , whereas prolactin increased after induction in all groups . Plasma concentrations of glucose , lactate , and fatty acids were lower in the TIVA groups than in the Iso group intraoperatively , but increased to comparable postoperative levels ."
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DerAnaesthesist.40430605.eng.abstr
|
DerAnaesthesist.40430605.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430605.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Etomidate is a hypnotic with only minor effects on haemodynamics . Although its rapid elimination kinetics would suggest its use in total intravenous anaesthesia ( TIVA ) and sedation , its administration in higher doses or for a prolonged period has been discouraged due to its inhibitory effects on corticosteroid synthesis . Newer evidence that the suppression of cortisol synthesis might not be total requires a re-evaluation of this drug as a component of a TIVA technique . The effects of high-dose etomidate with fentanyl on spontaneous and stimulated corticosteroid levels as a measure of the magnitude and duration of adrenocortical suppression , as well as on plasma concentrations of adrenocorticotropic hormone ( ACTH ) -endorphin , and catecholamines during cardiac surgery were investigated in a prospective , randomised study and compared to those following the administration of midazolam-fentanyl . Patients and methods . Nineteen patients undergoing myocardial revascularisation were assigned to two groups : group 1 : etomidate-fentanyl ( n=9) and group 2 : midazolam-fentanyl ( n=10). Anaesthesia was induced with fentanyl 0.5 mg and either etomidate 0.3 mg/kg or midazolam 0.2 mg/kg . Relaxation was achieved with pancuronium 0.1 mg/kg . Anaesthesia was maintained during extracorporeal circulation ( ECC ) with an infusion of etomidate ( 0.36 mg - kg-1 - h-1) or midazolam ( 0.16 mg - kg-1 - h-1) and fentanyl ( 10 µg - kg-1 - h-1. Blood samples were drawn before induction , before ECC , and 1 , 6 , and 20 h after surgery . Cortisol secretion was stimulated with 0.25 mg ACTH1 - 24 IV at 6 and 20 h postoperatively . Results . The total drug doses were etomidate 87 +/- 3 mg and midazolam 46 +/- 2 mg . Plasma cortisol concentrations decreased in the etomidate group from 20 ( 10 - 31 ) to 10 ( 6 - 31 ) µg - dl-1 ( median and range ) before ECC , but had returned to baseline at 1 h and were significantly increased at 6 h [ 29 ( 15 - 47 ) µg - dl-1] and 20 h [ 46 ( 29 - 62 ) µg - dl-1]. There was no difference between the groups except at 20 h , when cortisol levels were higher in the etomidate group . The stimulated cortisol increase was markedly impaired in this group at both measuring points . ACTH and -endorphin were markedly increased in the etomidate group and ACTH concentrations were eight times greater than the corresponding values in the midazolam group after surgery ( ACTH 141 vs. 18 pmol - l-1). Plasma catecholamine concentrations increased significantly in both groups . Noradrenaline concentrations were greater in the etomidate group at 6 h after surgery . Two patients in the midazolam group and none in the etomidate group required circulatory support with exogenous catecholamines . Discussion . It is concluded that the stress of cardiac surgery can overcome the block in cortisol synthesis caused by the administration of high-dose etomidate by substantially increasing ACTH secretion . The administration of high-dose etomidate was not associated with cardiovascular instability . The use of etomidate as a component of TIVA can therefore not be ruled out on the grounds of insufficient cortisol secretion ."
],
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3163
]
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"re-evaluation"
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] |
DerAnaesthesist.40430614.eng.abstr
|
DerAnaesthesist.40430614.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430614.eng.abstr-passage-0",
"type": "abstract",
"text": [
"More than 50% of all congential haemangiomas are located on the head and neck . Because most orofacial haemangiomas exhibit the tendency to grow rapidly , they are often treated by embolisation and excision . Case report . The case of a 5-year-old patient is presented , who was admitted to the hospital for embolisation and immediate surgery of a haemangioma of the right side of the face and upper lip . After the injection of 2 ml fibrin glue she suddenly developed hypotension , tachycardia , a low oxygen saturation , and a low end-tidal carbon dioxide partial pressure . There was no failure of the breathing circuit and no airway obstruction could be found . Most likely these symptoms were due to transport of the fibrin glue from the haemangioma into pulmonary vessels . The therapy included the administration of heparin and antihypotensive drugs . After stabilisation , the patient was transferred to the intensive care unit for 1 day without further complications . Conclusion . Pulmonary embolism after injection of fibrin glue into an orofacial haemangioma has not previously been reported , but it should be considered that systemic complications can occur after injecting substances for embolisation into vessel-rich tissues ."
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[] |
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},
{
"id": "DerAnaesthesist.40430614.eng.abstr-s11-r75-t4.1-t6.1",
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},
{
"id": "DerAnaesthesist.40430614.eng.abstr-s11-r76-t3.1-t6.1",
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},
{
"id": "DerAnaesthesist.40430614.eng.abstr-s11-r77-t1.1-t3.2",
"type": "produces",
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},
{
"id": "DerAnaesthesist.40430614.eng.abstr-s11-r78-t3.2-t9.1",
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},
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},
{
"id": "DerAnaesthesist.40430614.eng.abstr-s11-r80-t6.1-t3.2",
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},
{
"id": "DerAnaesthesist.40430614.eng.abstr-s11-r81-t3.2-t8.1",
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},
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},
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{
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"id": "DerAnaesthesist.40430614.eng.abstr-s11-r87-t8.1-t10.1",
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}
] |
DerAnaesthesist.40430618.eng.abstr
|
DerAnaesthesist.40430618.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430618.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Securing the airway following surgery can be a problem in certain patients . Preparation , therefore , should include a plan for safe reintubation , if necessary . We report two patients with a difficult airway ( recurrent thyroid carcinoma , inoperable carcinoma of the hypopharynx ) who were at a high risk for intubation under general anaesthesia . In addition , one of the patients suffered from an acute abdomen and ileus . We used a guidewire placed into the trachea via a fiberscope to facilitate fiberoptic reintubation ."
],
"offsets": [
[
0,
529
]
]
}
] |
[
{
"id": "DerAnaesthesist.40430618.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"surgery"
],
"offsets": [
[
30,
37
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038894"
},
{
"db_name": "UMLS",
"db_id": "C0038895"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"patients"
],
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[
66,
74
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"plan"
],
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[
120,
124
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032074"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"reintubation"
],
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[
134,
146
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021925"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"patients"
],
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[
178,
186
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"thyroid"
],
"offsets": [
[
223,
230
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040132"
},
{
"db_name": "UMLS",
"db_id": "C0040134"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"carcinoma"
],
"offsets": [
[
231,
240
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007097"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"carcinoma"
],
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[
254,
263
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007097"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"hypopharynx"
],
"offsets": [
[
271,
282
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0153398"
},
{
"db_name": "UMLS",
"db_id": "C0020629"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"risk"
],
"offsets": [
[
304,
308
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0035647"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"intubation"
],
"offsets": [
[
313,
323
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021925"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-t8",
"type": "umlsterm",
"text": [
"general anaesthesia"
],
"offsets": [
[
330,
349
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002915"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
377,
385
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"abdomen"
],
"offsets": [
[
409,
416
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0000726"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"ileus"
],
"offsets": [
[
421,
426
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021843"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"acute abdomen"
],
"offsets": [
[
403,
416
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0000727"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"trachea"
],
"offsets": [
[
465,
472
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040578"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"fiberoptic"
],
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[
504,
514
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0029144"
}
]
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"reintubation"
],
"offsets": [
[
515,
527
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021925"
}
]
}
] |
[] |
[] |
[
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},
{
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"arg2_id": "DerAnaesthesist.40430618.eng.abstr-s3-t7",
"normalized": []
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r3-t8.1-t5.1",
"type": "associated_with",
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{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r4-t1.1-t7.1",
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{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r5-t8.1-t4.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r6-t2.2-t4.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r7-t2.2-t2.1",
"type": "disrupts",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r8-t5.1-t2.2",
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"arg2_id": "DerAnaesthesist.40430618.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r9-t8.1-t3.1",
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{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r10-t2.1-t5.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r11-t6.1-t7.1",
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"normalized": []
},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r12-t6.1-t7.1",
"type": "evaluation_of",
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{
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r14-t2.1-t4.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r15-t2.2-t5.1",
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{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r16-t5.1-t7.1",
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{
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r18-t2.1-t2.2",
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{
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r20-t2.2-t5.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r21-t2.2-t4.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r22-t5.1-t4.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r23-t2.2-t3.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r24-t6.1-t8.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r25-t7.1-t1.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r26-t2.2-t5.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r27-t5.1-t3.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r28-t8.1-t1.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r29-t6.1-t8.1",
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},
{
"id": "DerAnaesthesist.40430618.eng.abstr-s3-r30-t2.2-t3.1",
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DerAnaesthesist.40430642.eng.abstr
|
DerAnaesthesist.40430642.eng.abstr
|
[
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"id": "DerAnaesthesist.40430642.eng.abstr-passage-0",
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"Continuous monitoring of blood gases and pH could add substantially to patient safety . During the last decade , efforts have been made to develop continuous optochemical blood gas sensors . The initial evaluation of such fibreoptic-based systems showed major patient-interface problems [ 11 ] . We evaluated a new intra-arterial blood gas monitoring system ( PB3300 , Puritan-Bennett , Carlsbad CA ) under routine clinical conditions . Methods . After institutional review board approval and with written informed consent , 38 sensors were tested in 25 patients with acute respiratory failure ( e.g. , the acute respiratory distress syndrome , complications after lung transplantation ) . Two conventional bench-top blood gas analysers ( ABL 520 and ABL 300 , Radiometer , Copenhagen ) served as criterion standards . The mean differences ( bias ) and standard deviations ( SD ) of the differences ( precision ) were calculated according to the method of Bland and Altman [ 2 ] . In addition , linear regression analysis and correlation coefficients were calculated . The quality of blood pressure tracings was assessed using a grading system . Results . The median sensor lifetime was 81.3 h ; 869 blood samples ( median 14 per sensor ) were analysed for the comparison of continuous and conventional blood gas analysis . The ranges for measured parameters were : pH : 6.92 to 7.55 ; PCO2: 20 to 83 torr ; PO2: 31 to 518 torr . The mean differences ( SD ) were : pH : -0 . 03 ( 0.03 ) or -0 . 4 ( 0.4 ) % ; PCO2: -2 . 6 ( 4.1 ) torr or -6 . 9 ( 10.9 ) % ; PO2: -3 . 4 ( 10.5 ) torr or -2 . 9 ( 7.0 ) % . The results of linear regression analysis and the correlation coefficients are depicted in Table 2. The mean grade of blood pressure tracings was satisfactory for the clinical setting . Conclusions . The continuous blood gas monitor is sufficiently accurate and precise for clinical use . Bias and precision are better than those known from former studies evaluating fibreoptic blood gas monitors under experimental conditions [ 7 ] . Cost-effectiveness was not an issue of this study ."
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[] |
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DerAnaesthesist.40430648.eng.abstr
|
DerAnaesthesist.40430648.eng.abstr
|
[
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"id": "DerAnaesthesist.40430648.eng.abstr-passage-0",
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"Hypothermia ( Tcore 36 °C) can be observed in 60% - 80% of all admissions to the post-anaesthetic recovery unit . Effective warming devices may accelerate rewarming , improve patient comfort , and suppress shivering thermogenesis . This study was designed to compare the efficiency of warming devices in extubated postoperative patients and their effect on postoperative oxygen uptake ( V. O2). Methods . Thirty-five ASA I and II patients after laparoscopic hernioplastic repair with core temperatures 36 °C were randomly assigned to either postoperative nursing under a radiant heater ( group R , n=11, Aragona Thermal Ceilings CTC X , Aragona Medical AB , Taeby , Sweden ) , a forced air system ( group L , n=12, Bair Hugger , Augustine Medical Inc. , Eden Prairie , Minnesota , USA ) , or a normal cotton hospital blanket ( group K , n=12). Anaesthesia was conducted totally intravenously with propofol , alfentanil , and vecuronium . Mean body temperature and total body heat were calculated from urinary bladder temperature and four subcutaneous temperature measurements . The rate of thermogenesis was calculated from continuous measurement of V. O2 ( Datex Deltatrac Metabolic Monitor , Datex Instrumentarium Corp. , Helsinki , Finland ) . Heat balance was derived from the increase in total body heat minus body heat production . Heart rate and noninvasive blood pressure were measured by the Cardiocap ( Datex Instrumentarium Corp. , Helsinki , Finland ) . All data were transferred to an IBM-compatible computer at 60-s intervals . Measurements were stopped when core temperature reached 37 °C. The rate of change was calculated for each variable for the period 15 min after the beginning of rewarming to attainment of 37 °C. Data are presented as median , minima , and maxima ( min - > max ) ; the Mann-Whitney U test was used to test for significance of group differences . Results . All groups were comparable for body weight , height , age , and amount of postoperative infusions . Temperatures at admission were 35.2 ( 33.4 - > 35.9 ) , 34.7 ( 34.3 - > 35.8 ) , and 35.4 ( 34.3 - > 35.9 ) °C for groups R , B , and K , respectively . No significant differences in the rate of central rewarming could be found for these groups with 0.81 ( 0.41 - > 1.32 ) , 0.76 ( 0.40 - > 1.07 ) , and 0.70 ( 0.37 - > 1.13 ) °C/h ( Fig . 1 ) . The mean V. O2 of 3.41 ( 3.07 - > 3.73 ) , 3.55 ( 2.78 - > 4.06 ) , and 3.79 ( 2.51 - > 7.00 ) ml/kg/min also did not differ significantly ( Fig . 3 ) . Significant differences between groups R and B [ 4.39 ( 3.74 - > 6.19 ) and 4.30 ( 3.46 - > 6.67 ) ml/kg/min ] and K [ 5.92 ( 3.79 - > 10.64 ) ml/kg/min ] were found for V. O2 maxima during the course of investigation ( Fig . 4 ) . The heat balance revealed significant differences among treatment and control groups with -88 ( -266 - > +30 ) , -41 ( -212 - > +12 ) , and -191 ( -265 - > -86 ) kJ/h for groups R , B , and K. We additionally calculated the heat balance as a quotient , which showed 0.70 ( 0.22 - > 1.07 ) , 0.86 ( 0.44 - > 1.04 ) , and 0.49 ( 0.31 - > 0.79 ) for groups R , B , and K ( Fig . 4 ) . The mean rate-pressure product of all groups did not differ significantly during the period of investigation . Conclusions . Neither external heat supply by radiant heat nor by a forced warm air system significantly reduced rewarming time in extubated , awake patients . As measured by heat balance , both active treatments saved about 20% more body heat production than in the control group . Continuing peripheral vasoconstriction may be the reason for the low efficiency of heat transfer . Thermal treatment did reduce the peak load ( max . V. O2) on the oxygen transport systems , though shivering was treated by pethidine if it occurred . External rewarming did not reduce the average load ( mean V. O2)."
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DerAnaesthesist.40430658.eng.abstr
|
DerAnaesthesist.40430658.eng.abstr
|
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"id": "DerAnaesthesist.40430658.eng.abstr-passage-0",
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"Automated measurements of respiratory gas exchange recently became available for the determination of oxygen uptake ( V. O2) in critically ill patients . Whereas these metabolic gas monitoring systems ( MBM ) are assumed to measure total body V. O2, the reversed Fick method in principle excludes intrapulmonary V. O2. Previous clinical reports comparing V. O2 measured by the reversed Fick principle ( V. O2 Fick ) with V. O2 measured by MBM ( V. O2 MBM ) found that V. O2 MBM was significantly greater than V. O2 Fick . It was suggested that these differences between methods represent V. O2 of pulmonary and bronchial tissue , as intrapulmonary V. O2 had been estimated to account for 15% of total body V. O2 in dogs with experimental pneumonia . The objective of this study was to compare V. O2 Fick with V. O2 MBM in patients with and without pneumonia and to assess the reproducibility of both methods in critically ill patients . Method . With institutional approval nine critically ill patients with acute pneumonia were studied under controlled mechanical ventilation . The diagnosis of pneumonia was based on respective changes of chest X-rays , body temperature > 38 °C, and WBC counts > 12,000/mm3. Inspiratory oxygen fractions ( FIO2) ranged from 0.3 to 0.6 ; all patients routinely received opioids and hypnotics . Complete muscle relaxation was achieved during the periods of measurement to avoid sudden changes in V. O2 due to shivering or involuntary movements . Arterial and pulmonary-arterial blood samples were drawn simultaneously after aspiration of the sevenfold catheter dead space . Measurements of haemoglobin concentration ( Hb ) , fractional oxygen saturation ( SO2), and O2 partial pressure ( PO2) were performed by use of a calibrated haemoximeter and blood gas analyser , respectively ; 2x5 thermodilution measurements of cardiac output ( CO ) were spread randomly over the respiratory cycle for each determination of V. O2 Fick . To minimise systematic errors of CO measurements , the CO computer was calibrated in an extracorporeal model using an electromagnetic flowmeter . Calculations of V. O2 Fick were based on an oxygen binding capacity of 1.39 ml/g Hb . Simultaneous measurements of V. O2 MBM were obtained by use of a Datex Deltatrac MBM that had been validated in vitro with a gas dilution model of respiratory gas exchange . Calibration of the MBM was performed prior to each measurement . Gas supply of the respirator was provided by an external high-precision mixing device to reduce errors in V. O2 measurements that may arise from short-term oscillations in FIO2. All patients with pneumonia were studied on three consecutive days ; thus , measurements from 27 days could be analysed . On each day two sets of measurements were performed at an interval of 60 min to assess the reproducibility of differences between methods . During each set of measurements duplicate blood samples were drawn twice , before and after thermodilution measurements of CO , to evaluate the short-term repeatability of V. O2 Fick . The beginning and the end of each set of measurements were marked in the computer record of the MBM to assess the respective repeatability of V. O2 MBM . Fifty control measurements were performed in ten patients undergoing major neurosurgical procedures . None of these patients exhibited signs of pulmonary infection . Except for the number of repeated measures , all V. O2 measurements were obtained in the same way as in the study group ."
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DerAnaesthesist.40430667.eng.abstr
|
DerAnaesthesist.40430667.eng.abstr
|
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{
"id": "DerAnaesthesist.40430667.eng.abstr-passage-0",
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"The advantages of the addition of low-dose sufentanil to local anaesthetics in epidural analgesia during labour ( improvement of analgesia , reduction of total dose of local anaesthetic , reduction of rate of instrumental delivery outweigh ) far the disadvantages ( pruritus , sedation , potential maternal and neonatal respiratory depression ) . In over 8000 cases , the addition of incremental sufentanil ( 7.5 µg) up to 30 µg has not caused any negative effects on newborns , and hence , the addition of sufentanil is justified ; it may even be indicated . Sufentanil has not yet been registered for epidural analgesia in Germany , in contrast to other countries . In considering whether this fact may prohibit its use , two aspects should be discussed : therapy and clinical experiments . The difference lies in the purpose rather than in the method of administration . Ethical and legal requirements for clinical tests are anchored in the declaration of Helsinki and the code of the medical profession . The legal background for therapy is represented in the proviso of the German Civil and Criminal Codes as well as the code of conduct on professional liability of the physician . Pain during labour is no absolute indication for the addition of sufentanil , but there are considerable arguments for its superiority in comparison to other standard procedures : the side effects and complications are very limited . Justification of this method is relatively easy in view of the fact that sufentanil has already been registered for peridural analgesia in obstetrics in many other countries . Last but not least , the patient must give informed consent before any procedure can be performed ."
],
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] |
DerAnaesthesist.40430674.eng.abstr
|
DerAnaesthesist.40430674.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430674.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Cannulation of the axillary vein is claimed to be an effective and relatively safe access to the central venous ( CV ) system [ 2 , 4 , 5 , 8 ] . However , anatomical landmarks recommended for venous location ( Muskulus pectoralis minor , processus coracoideus ) are probably hard to identify in the majority of intensive care ( ICU ) patients . This investigation evaluated unidirectional 8 MHz Doppler ultrasound ( US ) in locating the axillary vein . Success rates and complications of this CV access in ICU patients is analysed . Methods . The experimental design was approved by the local ethical committee ( RUB ) . In 50 patients from our ICU cannulation of the axillary vein was attempted ; all were in need of a CV line . Other CV puncture sites ( except for the subclavian vein ) were associated with contraindications . Patients were placed in a 15 ° Trendelenburg position ( 15 exceptions ) ; the arm was abducted to 45 ° [ 5 , 8 ] . The course of the axillary vein was located by Doppler US and marked on the skin with a felt pen . Prior to puncture , US intensity was judged by a score ranging from 0 to 4. After skin desinfection , sterile draping , and local anaesthesia , puncture of the axillary vein was attempted . The puncture kit Leader-Cath 11515 ( Vygon , Aachen , FRG ) was used . When venous blood could be aspirated , the Seldinger guide-wire was inserted and the definite catheter placed . The experimental design allowed up to ten punctures , slightly modified in angle and direction of the needle , if puncture of the axillary vein or guide-wire placement failed . The cannulation attempt was classified as unsuccessful in the following cases : malposition , axillary vein not encountered by the puncture needle , guide-wire placement unsuccessful , or if identification and cannulation of the vein lasted more than 20 min . The puncture attempts were evaluated in respect to success rate , time , relation of US intensity to puncture attempts and CV pressure , complications , and malposition . Results . Of the 50 attempted CV catheters , 43 were placed successfully . In 2 cases the axillary vein could not be encountered by the puncture needle . Guide-wire placement did not succeed in 4 patients . One catheter was malpositioned in the ipsilateral internal jugular vein . Four inadvertent punctures of the axillary artery remained without sequelae after compression . No further puncture-related complications were observed . With high US intensity score the number of puncture attempts necessary for successful vein cannulation was lower . On the other hand , complications and puncture failure seemed to be more frequent in patients with lower US intensity scores . Discussion . CV access via the axillary vein had a satisfying success rate ( 43/50 ) and proved to be a safe procedure in our ICU patients despite higher risk factors compared to a healthy population . Although ethical reasons did not allow a randomised comparison with the standard technique , location of the axillary vein by Doppler US is likely to improve cannulation results and reduce complications induced by \" blind \" needle probing . With a low US intensity score , the rate of successful punctures is lower and complication rates increase . In some patients , e.g. , those with extended tumour operations involving the head and neck , CV access via the axillary vein may be of high clinical value ."
],
"offsets": [
[
0,
3411
]
]
}
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"Cannulation"
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0,
11
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},
{
"id": "DerAnaesthesist.40430674.eng.abstr-s1-t2",
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"vein"
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28,
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}
]
},
{
"id": "DerAnaesthesist.40430674.eng.abstr-s1-t3",
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"axillary vein"
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19,
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"id": "DerAnaesthesist.40430674.eng.abstr-s2-t1",
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{
"id": "DerAnaesthesist.40430674.eng.abstr-s2-t2",
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"text": [
"pectoralis"
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220,
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{
"id": "DerAnaesthesist.40430674.eng.abstr-s2-t3",
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"minor"
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"id": "DerAnaesthesist.40430674.eng.abstr-s2-t4",
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"hard"
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276,
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"care"
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"id": "DerAnaesthesist.40430674.eng.abstr-s2-t8",
"type": "umlsterm",
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"intensive care"
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312,
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{
"id": "DerAnaesthesist.40430674.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"ultrasound"
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},
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},
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"id": "DerAnaesthesist.40430674.eng.abstr-s3-t4",
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"id": "DerAnaesthesist.40430674.eng.abstr-s4-t1",
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"complications"
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"ICU"
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"RUB"
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{
"id": "DerAnaesthesist.40430674.eng.abstr-s6-t2",
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"experimental design"
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DerAnaesthesist.40430683.eng.abstr
|
DerAnaesthesist.40430683.eng.abstr
|
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"Knowledge of normal and impaired pulmonary gas exchange is essential to the anaesthesiologist . Analysis of an arterial blood sample allows evaluation of whether or not pulmonary gas exchange is normal . For this purpose comparison with the oxygenation index or the alveolar-arterial PO2 difference is helpful . Pathological changes of these variables are mainly caused by ventilation-perfusion ( V. A/Q . ) mismatch . In daily practice , venous admixture or intrapulmonary shunt can be calculated using arterial and mixed-venous blood . By analysing arterial and expired PCO2, dead-space ventilation can be determined , but extended analyses of V. A/Q . distribution are not possible in daily practice . However , knowledge of the principles of typical disturbances of pulmonary gas exchange in acute and chronic lung disease allows the use of therapeutic strategies based on the pathophysiological changes ."
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0,
909
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]
}
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] |
[] |
[] |
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DerAnaesthesist.40430699.eng.abstr
|
DerAnaesthesist.40430699.eng.abstr
|
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"Objective . The aim of our review is to summarize relevant data on the perioperative use of anti-ischaemic drugs in patients at risk for or with proven coronary heart disease . Data sources . The accessible medical literature according to current electronic information sources was explored . Results . One in every eight general anaesthetics is administered to a patient at risk for or with proven coronary heart disease . Of these patients , it is estimated that 20% - 40% have perioperative myocardial ischaemia ( PMI ) , the majority being nonsymptomatic . This figure correlates with the occurrence of postoperative cardiac complications and myocardial infarction . The anaesthetist therefore has an important role to play in reducing the rate of perioperative cardiac sequelae . This can be achieved with good control of haemodynamic stability and the timely and appropriate use of antiischaemic drugs . Nitrocompounds ( nitrates , molsidomine ) serve as the gold standard in current angina pectoris treatment . Acting as coronary and systemic vasodilators , they effect an immediate reduction in preload and have been shown to be the drugs of first choice for intraoperative myocardial ischaemia . Beta-blockers reduce the rate of PMI to a greater extent than nitrates . They are also effective in myocardial ischaemia not accompanied by an increased heart rate . Single pre-operative administration of beta-blockers has also been shown to be beneficial in reducing theincidence of perioperative tachycardia , hypertension , and PMI . Consequently , such one-time medication can be considered for previously untreated high-risk patients presenting for surgery . The continuation of oral calcium channel blockers to the morning of surgery also reduces the rate of PMI and myocardial infarction in coronary-bypass patients , and combination with beta-blockers enhances this effect . Intra-operative diltiazem infusions are similarly advantageous in this patient group . In addition to nitrates , calcium antagonists are the drug of choice for coronary vasospasm . Drugs inhibiting platelet aggregation have a particular role in patients with coronary heart disease , however , they also cause increased perioperative bleeding . Consequently , it is recommended that these medications be discontinued 5 - 10 days prior to major surgery , with the exception of high-risk patients . Pilot studies using alpha2-agonists have shown reduced anaesthetic requirements and a reduction in PMI . The perioperative relevance of these drugs is currently being investigated . Conclusions . Beta-blockers , calcium channel blockers , nitrates , and possibly alpha2-agonists lead to reduced rates of PMI and other cardiac complications in risk patients . Current anti-anginal medications , with the exception of anti-platelet agents , should be maintained to the day of surgery and continued as soon as possible thereafter . All of these drugs except anti-platelet agents may also be used intra-operatively , however , possible interactions with anaesthetic agents should be carefully considered ."
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DerAnaesthesist.40430718.eng.abstr
|
DerAnaesthesist.40430718.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430718.eng.abstr-passage-0",
"type": "abstract",
"text": [
"After laparoscopic cholecystectomy , carbon dioxide ( CO2) must be exhaled after resorption from the abdominal cavity . There is controversy about the amount and relevance of postoperative CO2 resorption . Without continuous postoperative monitoring , after laparoscopic cholecystectomy a certain risk may consist in unnoticed hypercapnia due to CO2 resorption . Studies exist on the course of end-expiratory CO2 ( PeCO2) alone over a longer postoperative period of time in extubated patients during spontaneous breathing . The goal of this prospective study was to investigate the amount of CO2 resorbed from the abdominal cavity in the postoperative period by means of CO2 metabolism . Methods . After giving informed consent to the study , which was approved by the local ethics committee , 20 patients underwent laparoscopic cholecystectomy . All patients received general endotracheal anaesthesia . After induction , total IV anaesthesia was maintained using fentanyl , propofol , and atracurium . Patients were ventilated with oxygen in air ( FiO2 0.4 ) . The intraabdominal pressure during the surgical procedure ranged from 12 to 14 mm Hg. Thirty minutes after releasing the capnoperitoneum ( KP ) , CO2 elimination ( V. CO2), oxygen uptake ( V. O2), and respiratory quotient ( RQ ) were measured every minute for 1 h by indirect calorimetry using the metabolic monitor Deltatrac according to the principle of Canopy . Assuming an unchanged metabolism , the CO2 resorption ( V. CO2) at any given time ( t ) can be calculated from V. CO2 ( t ) =V.CO2 ( t ) -RQ ( preop ) V. O2 ( t ) . It was thus necessary to define the patient's metabolism on the day of operation . The first data were collected before surgery and after introduction of the arterial and venous cannulae for a 15-min period . Measuring point 0 was determined after exsufflation of the KP and emptying of the remaining CO2 via manual compression by the surgeon at the end of surgery . Patient's tracheas were extubated and metabolic monitoring started 30 min after release of the KP for 60 min . Simultaneously , a nasal side-stream capnometry probe was placed and the PeCO2 and respiratory frequency ( RF ) were obtained by the Capnomac Ultima ( Datex ) and registered every minute as well . Values were averaged over four periods of 15 min each . An arterial blood gas sample was drawn at the end of every 15-min period . Postoperative pain was scored by a visual analog scale and completed by a subjective index questionnaire on general well-being . All data were analysed by the Friedman or Wilcoxon test ; P 0.05 was considered significant . Results . The findings do not indicate CO2 resorption in the postoperative period after laparoscopic cholecystectomy ( Tables 2 and 3 , Fig . 1 ) . Arterial CO2 as well as PeCO2 were elevated postoperatively ( 45 mm Hg vs. 36 mm Hg intraoperatively ) , while V. CO2 and V. O2 were unchanged when compared to the preoperative measuring period . The postoperative RF was comparable to preoperative values . Calculated CO2 was lower than 10 ml/min and within accuracy of measurements . The postoperative pain index ranged between 3 and 4 , and 3.75 - 15 mg piritramid was administered . All patients feld tired immediately after the operation , but scores improved slightly at the end of the 60-min period of metabolic monitoring . Conclusions . There is no significant resorption of CO2 from the abdominal cavity later than 30 min after releasing the KP . Up to this time , any CO2 remaining in the abdominal cavity after careful emptying by the surgeon has been resorbed and exhaled ."
],
"offsets": [
[
0,
3604
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}
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DerAnaesthesist.40430723.eng.abstr
|
DerAnaesthesist.40430723.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430723.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In addition to laryngoscopy , endotracheal intubation , and other stressful intraoperative phases , hypertension occurs during recovery from anaesthesia , provoking postoperative complications like bleeding and increased intracranial or intraocular pressure . Furthermore , these hypertensive reactions result in life-threatening complications , especially in patients with pre-existing cardiovascular diseases . In this study , the effect of the new , short-acting beta-blocker esmolol given as a single bolus for preventing the increases in blood pressure and heart rate during recovery from anaesthesia and extubation in patients with hypertension was investigated . Patients and Methods . Sixty-three patients with a history of hypertension over a period of more than 6 months and blood pressure ( BP ) more than 150/90 mm Hg undergoing intervertebral-disc , otolaryngologic , or eye surgery were included in the study . The operations were performed during thiopentone-induced isoflurane anaesthesia with relaxation by atracurium . The patients were assigned to three groups after giving witnessed oral informed consent . During the study period they received the study drug twice : ( A ) 30 - 90 s before turning off the nitrous oxide ; and ( B ) 20 - 90 s before extubation . Group I ( placebo ) received placebo each time , group II ( 100 mg esmolol ) placebo at A and 100 mg esmolol i.v. at B , and group III ( 200 mg esmolol ) 100 mg esmolol i.v. each time . After each medication the cardiovascular parameters were measured noninvasively over a period of 10 min every minute and in the following 2 h every 15 min . Results After the first medication systolic and diastolic BP , heart rate ( HR ) , and rate-pressure product ( RPP ) were lower in patients receiving 100 mg esmolol ( Group III ) than in groups I and II . After the second injection the blood pressure was lower in the two groups receiving 100 mg esmolol , than the placebo group ( I : 180.1 +/- 7.4/100.7 +/- 3.6 ; II : 152.8 +/- 5.8/87.9 +/- 3.4 ; III : 157.9 +/- 5.3/91.5 +/- 3.6 mm Hg [ \\=2 min +/- SEM ] ) . The changes in HR ( I : 88.2 +/- 3.8 ; II : 75.6 +/- 2.6 ; III : 72 +/- 3.1 min-1) and RPP ( I : 15,800 +/- 900 ; II : 11,700 +/- 700 ; III : 11,400 +/- 600 ) were similar . In 8 of the 20 patients in group III the HR dropped below 60 - min-1, but in none of these patients did the BP become instable . Conclusions . The sympathoadrenergic reaction during recovery from anaesthesia and extubation can be treated by beta-blocking agents , but such therapy is not without risk because of the long half-life and effects of the therapy on other factors such as postoperative loss of intravascular volume . Esmolol is a new , short-acting , cardioselective beta-blocker with a very short plasma distribution time and an elimination half-life of 9.2 min . Thus , the potential risks of beta-blockers due to half-life are minimised . The results of this study show that a dangerous increase in BP and HR with increased myocardial oxygen consumption can be prevented by a single bolus , and better by a double bolus of 100 mg esmolol . Although bradycardia with HR below 50 - min-1 in 8 patients might indicate a risk of cardiac instability , the systolic BP did not fall below 100 mm Hg , and the episode of bradycardia was so short that there was no risk to the patients ."
],
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0,
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[] |
[] |
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] |
DerAnaesthesist.40430738.eng.abstr
|
DerAnaesthesist.40430738.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430738.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Different anaesthetic procedures that were used during an in vitro fertilisation and embryo transfer ( IVF-ET ) program have been analysed in order to determine their influence on plasma levels of estradiol , progesterone , prolactin , and -endorphin and results of IVF-ET . Methods . Fifty-four patients awaiting transvaginal oocyte aspiration were randomised into three groups : ( 1 ) anaesthesia with ketamine as an induction agent and analgesic ( n=20); ( 2 ) general intubation anaesthesia using thiopentone for induction and enflurane for maintenance ( n=18); and ( 3 ) no anaesthesia ( n=16). Estradiol , progesterone , prolactin , and -endorphin were measured from day 3 to 14 referring to follicle aspiration . Differences between preoperative hormone levels and their intra- and postoperative peaks were analysed using the Kruskal-Wallis test ( P 0.03 ) . The results were corrected using the Holms method ( =0 . 05 ) . Results . No differences were observed in estradiol and progesterone levels ( Figs . 1 , 2 ) . Prolactin levels were 1.4 times higher ( P 0.001 ) when ketamine was used and 2.2 times higher ( P 0.001 ) after short general anaesthesia than in the control group ( Fig . 3 ) . Similar results were observed with respect to -endorphin : in comparison with the control group we found significant elevation by a factor of 2.1 when ketamine was used ( P 0.001 ) . The discrepancy became even more marked with general anaesthesia : -endorphin was 3.9 times higher compared to the controls ( P 0.001 ) ( Fig . 4 ) . Comparing the two groups who were given anaesthetics , prolactin and -endorphin levels were also significantly different ( P 0.001 ) . The IVF procedure itself did not appear to be affected by different anaesthetic procedures during oocyte aspiration ( Table 2 ) . Conclusions . The increased prolactin and -endorphin plasma levels associated with ketamine and general anaesthesia reflect a significant alteration of the observed hormone levels . When anaesthesia is indicated , we try to avoid general intubation anaesthesia in favor of ketamine ."
],
"offsets": [
[
0,
2085
]
]
}
] |
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"anaesthetic"
],
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10,
21
]
],
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}
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},
{
"id": "DerAnaesthesist.40430738.eng.abstr-s1-t2",
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"text": [
"procedures"
],
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22,
32
]
],
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]
},
{
"id": "DerAnaesthesist.40430738.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"fertilisation"
],
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[
67,
80
]
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"embryo"
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85,
91
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92,
100
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"program"
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112,
119
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}
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},
{
"id": "DerAnaesthesist.40430738.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"plasma"
],
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180,
186
]
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},
{
"id": "DerAnaesthesist.40430738.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"estradiol"
],
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197,
206
]
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}
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},
{
"id": "DerAnaesthesist.40430738.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"progesterone"
],
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209,
221
]
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"db_id": "C0033308"
}
]
},
{
"id": "DerAnaesthesist.40430738.eng.abstr-s1-t10",
"type": "umlsterm",
"text": [
"prolactin"
],
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[
224,
233
]
],
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"db_id": "C0033371"
}
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},
{
"id": "DerAnaesthesist.40430738.eng.abstr-s1-t11",
"type": "umlsterm",
"text": [
"-endorphin"
],
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240,
250
]
],
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"db_id": "C0014242"
}
]
},
{
"id": "DerAnaesthesist.40430738.eng.abstr-s1-t12",
"type": "umlsterm",
"text": [
"in vitro"
],
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[
58,
66
]
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},
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"id": "DerAnaesthesist.40430738.eng.abstr-s1-t13",
"type": "umlsterm",
"text": [
"embryo transfer"
],
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85,
100
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},
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"id": "DerAnaesthesist.40430738.eng.abstr-s1-t14",
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"text": [
"in vitro fertilisation"
],
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"oocyte"
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"id": "DerAnaesthesist.40430738.eng.abstr-s3-t3",
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"aspiration"
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"id": "DerAnaesthesist.40430738.eng.abstr-s3-t4",
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"ketamine"
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404,
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"id": "DerAnaesthesist.40430738.eng.abstr-s3-t5",
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"Estradiol"
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600,
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"id": "DerAnaesthesist.40430738.eng.abstr-s3-t12",
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627,
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] |
DerAnaesthesist.40430743.eng.abstr
|
DerAnaesthesist.40430743.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430743.eng.abstr-passage-0",
"type": "abstract",
"text": [
"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 5 , 10 , 15 , and 20 min following opioid administration . Monitoring included a complete invasive haemodynamic and blood gas status . Statistical evaluation was performed by 1- and 2-factorial ANOVA ( P 0.05 ) . Results . Significant time effects ( changes from baseline at the time of measurement ) were observed for heart rate and total peripheral resistance , while significant group ( group-specific differences in the course of values at the different times of measurements ) and time effects were noted for mean pulmonary artery pressure , pulmonary capillary wedge pressure , stroke volume index , and PaO2. No major effects were observed following morphine , fentanyl , alfentanil , tramadol , and nalbuphine . Buprenorphine caused distinct respiratory depression accompanied by an increase in pulmonary vascular tone . Pentazocine and pethidine caused a significant increase in MPAP and peripheral vascular resistance while pethidine also produced marked respiratory depression . Conclusions . For interpretation of the results , factors such as respiratory depression , histamine release , secretion of endogenous catecholamines , and hypoxia-induced pulmonary vasoconstriction have to be discussed . Tramadol , an opioid with moderate potency , seems to offer some advantages due to its minor cardiovascular and respiratory side effects ."
],
"offsets": [
[
0,
2067
]
]
}
] |
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] |
[] |
[] |
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DerAnaesthesist.40430750.eng.abstr
|
DerAnaesthesist.40430750.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430750.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 41-year-old woman with severe juvenile diabetes mellitus suffered from profund hypothermia after loss of thermoregulation in diabetic ketoacidosis . She was found unconscious , without measurable blood pressure ; the electrocardiogram ( ECG ) showed bradycardia of 30/min and the rectal temperature was 23.7 °C. The patient received mechanical ventilation , fluid therapy , warmed gastric lavage , and , unfortunately , inotropic medication . She was transferred to a department of cardiac surgery in order to continue the therapy with cardiopulmonary bypass ( CPB ) . On arrival , the patient had a rectal temperature of 27.3 °C, the ECG showed an absolute arrhythmia with a frequency of 70/min, and the blood pressure was 63/43 mm Hg. We decided to use a rapidly available but not highly invasive venovenous hemofiltration technique for slowly rewarming the patient . Vascular access was achieved by percutaneous femoral vein cannulation with a Shaldon catheter . The hemofiltration system ( Gambro AK-10, Gambro AB , Sweden ) was instituted with a blood flow rate of 200 ml/min . The hemofiltration monitor controls the pumps for filtering and substituting fluid volumes and allows the infusion solutions to be heated up to 40 °C. Sinus rhythm resumed without antiarrhythmic medications at a temperature of 29.5 °C, and within 8 h the patient was rewarmed to 35.5 °C. After treatment of the adult respiratory distress syndrome caused by pneumonia , she was discharged from the intensive care unit to complete treatment with no evidence of any permanent organ damage . We conclude that hemofiltration may be the method of choice for rewarming deeply hypothermic patients when their circulation is preserved . Under these circumstances , it is preferable to external rewarming techniques , as it avoids the disadvantages of temperature afterdrop and rewarming shock . Rewarming rates of 1.5 °C/h seem to be adequate . Hemofiltration systems are more widespread , less invasive , and easier to handle compared to CPB techniques , which should be preferred in situations of prolonged unsuccessful cardiopulmonary resuscitation with cardiac arrest and deep core temperatures ."
],
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0,
2176
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] |
DerAnaesthesist.40430759.eng.abstr
|
DerAnaesthesist.40430759.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430759.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The implementation of an experienced pre-hospital care emergency physician as an on the-scene medical command officer ( MCO ) within the emergency medical service ( EMS ) is an essential prerequisite to guarantee qualified medical supervision during mass-casualty incidents ( MCI ) . The MCO has four basic functions . Within the administration of the EMS system , he is responsible for the medical aspects of strategic planning for the MCI response . During the MCI the MCO is responsible for the overall assessment of the situation , triage , and supervision of medical treatment by physician and non-physician providers . Aside from extensive personal experience in pre-hospital care , the MCO needs special training to be qualified for this position . State EMS laws provide the legal basis for the MCO within the EMS system ."
],
"offsets": [
[
0,
830
]
]
}
] |
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DerAnaesthesist.40430773.eng.abstr
|
DerAnaesthesist.40430773.eng.abstr
|
[
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"id": "DerAnaesthesist.40430773.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Ideal evaluation of neuromuscular blockade can be done by mechanical or electromyographical registration of muscle contractions evoked by ulnar nerve stimulation . Unfortunately , devices needed for such registration are expensive or complicated to set up , and thus are not often used for routine monitoring in anaesthesia . In this study , we describe a simple and low-priced method permitting intra- and postoperative monitoring of neuromuscular blocking agents . The accuracy of plethysmomechanomyography ( PMG ) was evaluated by comparing simultaneous electromyographic ( EMG ) and plethysmographic measurements . Methods . For plethysmographic registration of muscle response to nerve stimulation a simple infusion system is twisted there to five times around one hand and connected to an anaesthetic monitor via a pressure transducer . The drip chamber is fixed about 20 cm above the hand ( Fig . 1 ) . Then , the infusion system is then filled up with physiologic saline solution and the clamp is nearly closed . Electric stimulation can be carried out using any nerve stimulator . Using this method , PMG mainly records the contractions of abductor digiti minimi muscle , but also partly those of the interossei . Evoked muscle contractions cause stretching of the infusion system , which leads to pressure changes proportional to the strength of contraction . The muscle response to \" train-of-four \" ( TOF ) stimulation of the ulnar nerve was recorded simultaneously by EMG and PMG in 11 patients ( ASA class I or II ) undergoing neurosurgical procedures and therefore requiring muscle relaxation . After induction of anaesthesia by injection of etomidate and fentanyl , supramaximal stimulation and control values ( T0) were defined . Anaesthesia was maintained by supplementation with nitrous oxide/oxygen ( 1:2 ) and muscle relaxation was carried out with vecuronium . We used the integrated nerve stimulator of a Datex Relaxograph NMT-100 EMG monitor and proceeded to stimulate the ulnar nerve at the forearm with supramaximal strength . The PMG was registered by a Siemens Siredoc 220 printer connected to a Siemens Sirecust 1281 anaesthetic monitor . First twitch ratio ( T1/T0) and TOF ratio ( T4/T1) were calculated from these recordings . The EMG recordings were made by a Datex Relaxograph NMT-100 monitor , which automatically computes T1/T0 and T4/T1. The comparison of EMG and PMG values was carried out by simple linear regression . Statistical evaluation was performed using analysis of variance . Results . A plethysmographically registered graph of the TOF-evoked muscle response is illustrated in Fig . 2. Simultaneous EMG and PMG recordings of onset and recovery from a nondepolarizing blockade are shown in Fig . 3. A strong positive correlation ( P 0.001 ) of EMG and PMG was found with correlation coefficients of 0.98 for T1/T0 and of 0.97 for T4/T1. The mean difference between values of both methods was 5% , maximally 18% ( T1/T0) and 20% ( T4T1). Conclusions . Mechanomyography and EMG are well established methods of neuromuscular monitoring . Our data demonstrate that PMG provides a reliable measurement of neuromuscular transmission that correlates well with EMG . Since only materials of daily use in anaesthesia are needed , no substantial costs will arise when the plethysmographic method of measurement is used for routine anaesthetic monitoring ."
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DerAnaesthesist.40430780.eng.abstr
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DerAnaesthesist.40430780.eng.abstr
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"id": "DerAnaesthesist.40430780.eng.abstr-passage-0",
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"Axillary block is a common anaesthetic technique for operations on the hand and forearm . In our hospital , with many trainees in anaesthesia , only 250 - 300 axillary blocks per year are performed by about 30 colleagues . This implies a small number of blocks for each anaesthetist . The present study was designed to assess whether it is possible to teach this technique and use it with an adequate degree of success under these conditions . We used a nerve stimulator and studied whether the success of the block under these conditions is independent of anaesthetist's experience in this technique . Furthermore , we examined other factors involved in the success of the block . Methods . The study included 112 patients subjected to elective surgery of the upper extremity ; all received an axillary block . We used a nerve stimulator and injected mepivacaine 1% without adrenaline . The following parameters were recorded : the number of blocks to date performed by the anaesthetist ; the minimal current required for nerve stimulation ; the dose of local anaesthetic ; the time between the end of injection and the beginning of surgery ; the duration of surgery ; and the quality of sensory and motor blockade after 10 , 20 , and 30 min . Sensory blockade was assessed by the pinprick method ( no blockade , analgesia , anaesthesia ) ; motor blockade was judged by comparing the muscle strength of both arms ( no blockade , paresis , paralysis ) . Data were analyzed using the Mann-Whitney test , with P 0.05 considered statistically significant . Results . Of the 112 blocks , 95 ( 85% ) were successful ; 17 ( 15% ) failed and the patients required general anaesthesia . Eight of the successful blocks showed a decrease in analgesic quality after > =70 min and required additional analgesics or general anaesthesia . We found no correlation between the experience of the anaesthetist and the success of the block . The minimal required current for nerve stimulation in the success group was 0.4 mA and differed significantly from the value of 0.6 mA in the failure group ( Table 3 ) . The dose of mepivacaine was higher in the success group ( 5.9 vs. 5.3 mg/kg ) . Complete sensory blockade was more frequently achieved for the median , ulnar , and radial nerves than for the musculocutaneous and cutaneous brachii medialis ( Fig . 3 ) . The frequency of complete sensory blockade ( anaesthesia ) had increased by 21.9% between the 20th and 30th min . Complete motor blockade was less often achieved than sensory blockade ( Fig . 4 ) . Conclusions . Using the method of electrostimulation , the axillary block is an appropriate anaesthetic technique that can be applied in a hospital where each anaesthetist only occasionally performs it . Prior to injection of the local anaesthetic , the current for nerve stimulation should be reduced to 0.5 mA . The time between the end of injection and the beginning of surgery should be no less than 30 min because complete sensory blockade can more often be achieved . The dose of mepivacaine should be no less than 6 mg/kg body weight ."
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DerAnaesthesist.40430786.eng.abstr
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DerAnaesthesist.40430786.eng.abstr
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"Posttraumatic cardiopulmonary resuscitation ( CPR ) is associated with a poor outcome . When evaluating the literature according to the Utstein method , there were only 2 survivors ( 0.18% ) out of 1,135 CPR attempts after trauma ( Table 1 ) . Differences in the study populations and levels of prehospital trauma care led us to analyse the results of a physician-staffed prehospital trauma care system in Cologne . Methods . From January 1987 to December 1990 , a total of 49,054 emergency calls were registered using a standardised protocol . Among 9,595 trauma-related calls , 636 patients were found to be pulseless on arrival of the emergency team , 412 of these were pronounced dead . CPR was initiated in the remaining 224 patients , who comprise the study population ( defined as 100% ) . All patients who were admitted to a hospital were followed using a second protocol . Results . CPR in the field was successful in 68 ( 30.4% ) patients , who were then admitted to a hospital ; 42 of these died within the first 24 h . Four patients ( 1.8% ) could be discharged from hospital alive and were still living 1 year later , 1 with a lasting neurological deficit ( Fig . 1 ) . In 156 ( 69.6% ) cases resuscitative attempts were unsuccessful in the field . Conclusions . Even in a physician-staffed prehospital trauma care system , the chance of surviving a post-traumatic cardiac arrest is minimal . Survival has to be regarded as an individual fate ; the overall results are discouraging . Even though this study analyses the largest population of posttraumatic CPR ever published , prognostic factors could not be identified due to the few survivors . Nevertheless , the result does not justify general omission of CPR after trauma as : ( 1 ) prognostic factors for survival have not been identified thus far ; and ( 2 ) no significant additional costs arise from posttraumatic CPR ."
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] |
DerAnaesthesist.40430835.eng.abstr
|
DerAnaesthesist.40430835.eng.abstr
|
[
{
"id": "DerAnaesthesist.40430835.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In order to assess the significance of drug levels measured in clinical and forensic toxicology as well as for therapeutic drug monitoring ( TDM ) , it is essential that good collections of data are readily available . For more than 400 frequently used drugs therapeutic and , if data were available , toxic and fatal plasma concentrations as well as elimination half-lives were compiled in a table including , e.g. , hypnotics like barbiturates and benzodiazepines , neuroleptics , antidepressants , sedatives , analgesics , anti-inflammatory agents , antihistamines , anti-epileptics , beta-adrenergic antagonists , antibiotics ( penicillins , cephalosporins , aminoglycosides , gyrase inhibitors ) , diuretics , calcium-channel blockers , cardiac glycosides , anti-arrhythmics , anti-asthmatics , angiotensin converting enzyme inhibitors , opioid agonists , and local anaesthetics . Data have been abstracted from published information , both compilations and primary sources , and supplemented with data collected in our own forensic and clinical toxicology laboratories . Wherever possible , ranges for therapeutic plasma concentrations are expressed as trough concentration at steady-state . The range of ( or single ) half-life values given for each drug are chosen to represent the terminal log-linear phase at most . In addition to the assessment of significance of drug levels for the therapeutic monitoring of patients , this list can assist the diagnostic assessment in cases of intoxication ."
],
"offsets": [
[
0,
1505
]
]
}
] |
[
{
"id": "DerAnaesthesist.40430835.eng.abstr-s1-t1",
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"drug"
],
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39,
43
]
],
"normalized": [
{
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"db_id": "C0013227"
}
]
},
{
"id": "DerAnaesthesist.40430835.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"toxicology"
],
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[
85,
95
]
],
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{
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"db_id": "C0040541"
}
]
},
{
"id": "DerAnaesthesist.40430835.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"therapeutic"
],
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[
111,
122
]
],
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{
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"text": [
"drug"
],
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[
123,
127
]
],
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{
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}
]
},
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"id": "DerAnaesthesist.40430835.eng.abstr-s1-t5",
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"text": [
"drug monitoring"
],
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123,
138
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.40430835.eng.abstr-s2-t1",
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"text": [
"drugs"
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253,
258
]
],
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"id": "DerAnaesthesist.40430835.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"therapeutic"
],
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[
259,
270
]
],
"normalized": [
{
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}
]
},
{
"id": "DerAnaesthesist.40430835.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"toxic"
],
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[
302,
307
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0600688"
}
]
},
{
"id": "DerAnaesthesist.40430835.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"plasma"
],
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[
318,
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]
],
"normalized": [
{
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},
{
"id": "DerAnaesthesist.40430835.eng.abstr-s2-t5",
"type": "umlsterm",
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] |
DerAnaesthesist.50440001.eng.abstr
|
DerAnaesthesist.50440001.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440001.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Although the attempts to develop an oxygen-carrying alternative to red blood cells ( RBC ) have spanned the last 100 years , it has proven difficult to develop a clinically useful haemoglobin-based oxygen carrier . Four major problems have been shown to compromise the use of haemoglobin outside the RBC as an oxygen carrier : ( 1 ) the increased oxygen affinity due to the loss of 2,3-diphosphoglycerate ; ( 2 ) dissociation into dimers and monomers with consequent renal and capillary loss of hemoglobin ; ( 3 ) insufficient concentrations of prepared solutions under iso-oncotic conditions , and thereby reduced oxygen-carrying capacity ; and ( 4 ) toxicity . Most of these limitations have been overcome by different modifications of haemoglobin , including pyridoxylation , intra- and intermolecular cross-linking , polymerisation , liposome encapsulation , conjugation to inert macromolecules , and genetic engineering ."
],
"offsets": [
[
0,
926
]
]
}
] |
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DerAnaesthesist.50440024.eng.abstr
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DerAnaesthesist.50440024.eng.abstr
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[
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"id": "DerAnaesthesist.50440024.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Epidurography with contrast medium is used to verify the correct poition of an epidural catheter and to detect malpositioning . There is great variability in the distribution of contrast medium according to the individual morphology of the epidural space and the way it is injected . Results of investigations of the anatomy of the spinal canal and epidural space performed with anatomic specimens , epiduroscopy , and conventional and computed tomographic ( CT ) epidurography are sometimes contradictory . We have performed CT epidurography in approximately 30 patients to date . Insights regarding the distribution of contrast medium in the epidural space can help to interpret conventional epidurographies and to explain special features , such as the \" rail-road-track phenomenon \" or the plica mediana dorsalis . Methods . Patients scheduled for major abdominal operations were studied . Catheters were introduced into the thoracic epidural space on the day before the operation . Conventional epidurographies were performed routinely after insertion of the catheters with a mobile X-ray apparatus , usually in the recovery room , using 5 ml iopamidol ( Solutrast 250 M ) . Selected patients ( good mental state and stable psychic condition ) , after written consent and with approval of the local ethical committee , were investigated with CT epidurography using the same contrast medium ( partly diluted ) . From among the CT scans performed until now , five characteristic images are presented and compared to conventional epidurographies . Results . When small volumes ( 5 mL ) of iopamidol were injected slowly , we regularly observed a railroad-track phenomenon in the AP images of conventional epidurographies . After rapid injection of larger volumes ( 10 - 15 ml ) , the spread was more homogeneous and sometimes outline a lighter zone of contrast distribution in the midline . CT epidurography in these cases ( 5 out of 30 patients ) revealed a plica mediana dorsalis . In the majority of the CT scans of the thoracic epidural space its anterior ( ventral ) compartment was unfilled by contrast medium . According to the findings of several investigators , dura mater and ligamentum longitudinale posterius have grown together , so that an epidural space does not exist in ventral thoracic segments of the spinal canal . In lower thoracic and lumbar segments both structures are separate , and a wide anterior epidural space was present and filled with contrast medium . In other cases the dorsal and dorsolateral epidural space was completely filled , but the contrast medium stopped behind the spinal nerves and surrounding dural sheaths , as if these structures , together with the connective tissue strands between them , formed a membrane that spread in a frontal plane . A railroad-track phenomenon is interpreted in the literature as the X-ray correlate of contrast medium spread in the subdural space , indicating an incorrect catheter position . According to conventional epidurographies and confirmed by CT scans , this feature is also seen regulary in cases with correct catheter position . Small volumes of iopamidol spread preferentially into the wider parts of the epidural space between the gaps of the vertebral arcs , whereas the dura mater and periosteal layers touch at the inner side of the pedicules and laminae , allowing the existence of only a potential epidural space . This rhythmic widening and narrowing of the epidural space is the explanation of the \" railroad track \" in AP contrast epidurographies . Conclusions . CT epidurography is a valuable tool to provide better insight into the morphology of the epidural space when filled with fluid ( contrast medium , local anaesthetics ) , complementing findings using epiduroscopy and anatomic specimens . It stands to reason that this time- and cost-expensive method can never replace conventional epidurographies , but can help to interpret them properly ."
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DerAnaesthesist.50440037.eng.abstr
|
DerAnaesthesist.50440037.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440037.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The Acute Physiology and Chronic Health Evaluation model ( APACHE II , APACHE III ) is used to describe the severity of illness and predict the outcome in critically ill patients . APACHE III , introduced in 1991 , has not yet been validated in Europe . We calculated APACHE II and APACHE III scores in patients after admission to the intensive care unit ( ICU ) and compared the prognostic value on hospital mortality . Method . One hundred fifty patients with stay of over 24 h were enrolled in the study and prospectively and consecutively investigated . APACHE II and III scores were calculated as described by the authors . The mean and median values of the survivors were compared with the non-surviving group ( Mann-Whitney U test ) . Receiver operating characteristics ( ROC analysis ) and the areas under the ROC curves were plotted . Results . Of the 150 patients , 34 died during their hospital stay ( 22.7% ) . The mean and median APACHE II and III scores were significantly higher ( P 0.001 ) in the non-surviving group . The area under the ROC curve was higher for APACHE III ( 0.899 ) compared to APACHE II ( 0.847 ) . Conclusions . APACHE II and APACHE III were both found to have good prognostic value in general ICU patients . Our results suggest that the APACHE III version includes a more precise prediction of hospital mortality than APACHE II . A new aspect of APACHE III is an expanded modification of the Glasgow Coma Scale to assess neurologic derangements ."
],
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1483
]
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[] |
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] |
DerAnaesthesist.50440048.eng.abstr
|
DerAnaesthesist.50440048.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440048.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Surgery by three-dimensional ( 3D ) endoscopy is being used routinely in abdominal surgery and , in special cases , in thoracic surgery ; however , it has not been reported as being used in microlaryngeal surgery . Methods . We inserted a 3-D endoscope into a jet laryngoscope and studied the pressure properties at the tip of the laryngoscope as well as intrapulmonary pressures while applying superimposed high-frequency jet ventilation . The studies were conducted initially using a lung simulator , and then in seven patients undergoing microlaryngeal surgery . Results . Due to the rather large 3-D endoscope , the diameter of the jet laryngoscope was reduced by between 25.2% and 70.9% , depending on its size . The measurements on the lung simulator revealed that reduction of laryngoscope diameter leads to an increase in the following parameters : expiratory resistance , tidal volume , and peak inspiratory pressure . The mean FiO2 was 0.74 +/- 0.1 ; the mean paO2 was 169.2 +/- 80.4 mm Hg ; and the mean paCO2 was 40.9 +/- 2.4 mm Hg. The mean airway pressure was 19 +/- 5.3 mm Hg prior to insertion of the endoscope and 12.3 +/- 6.9 mm Hg after insertion . The mean positive end-expiratory pressure values increased from 2 +/- 0.6 to 3.6 +/- 2.3 mm Hg. Reduction of the working pressure resulted in restoration of the initial inspiratory pressures and tidal volumes . Conclusions . In the clinical application of 3-D endoscopy via a jet laryngoscope , it was possible to achieve sufficient ventilation , inspection of the surgical field , and performance of the surgical procedure . A CO2 laser was used without changing the ventilation regime . Although technical alterations would be desirable for its application to microlaryngeal surgery , it is presently possible to safely use the 3-D endoscope via the jet laryngoscope for microlaryngeal surgery , presenting the surgeon with new possibilities in voice-improving microsurgery of the larynx ."
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},
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] |
DerAnaesthesist.50440061.eng.abstr
|
DerAnaesthesist.50440061.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440061.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Preventive strategies aim to reduce gastric acidity ( H2ms ( sucralfate , antacids , pirenzepine ) and to normalize gastric mucosal microcirculation ( sucralfate , pirenzepine ) . Thus , the most important prophylactic measure is an optimized emergency and ICU regime aiming to improve oxygenation and microcirculation . All specific drugs used for stress ulcer prophylaxis have been shown to be effective in prospective controlled studies . Furthermore , pirenzepine has been found to be superior to H2-antagonists, at least in neurosurgical patients . Insufficient or no data exist to support the use of prostaglandins or omeprazole for stress ulcer prophylaxis . The most important adverse effect of stress ulcer prophylaxis is nosocomial pneumonia due to gastric alkalinization . This may occur in long-term ventilated patients with a gastric pH > 4 and may account for up to 50% of all nosocomial pneumonias in certain groups of patients . Mortality is not influenced by antacids or H2-antagonists, while sucralfate has been shown to reduce mortality , most probably by inhibition of bacterial translocation ."
],
"offsets": [
[
0,
1114
]
]
}
] |
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"measure"
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{
"id": "DerAnaesthesist.50440061.eng.abstr-s2-t3",
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"emergency"
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"id": "DerAnaesthesist.50440061.eng.abstr-s2-t5",
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] |
[] |
[] |
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},
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DerAnaesthesist.50440081.eng.abstr
|
DerAnaesthesist.50440081.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440081.eng.abstr-passage-0",
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"text": [
"On the subject of natriuretic peptides there is a great deal of controversy , and intensive research efforts have been made studying their effects on electrolyte homeostasis . In the early 1980s , a peptide that caused diuresis , natriuresis , and had a relaxant effect on vascular smooth muscle was discovered independently by several groups . This was the breakthrough for the identification of natriuretic peptides , followed by the characterisation of the amino-acid sequences of several species . Synthesis of the peptide , cloning of the encoding gene , identification and characterisation of specific receptors , as well as the development of antibodies and radioimmunoassays were rapidly accomplished . Research on the immunohistochemistry of cardiodilatin/atrial natriuretic peptide ( CDD/ANP ) and the regulation of CDD/ANP gene expression led to detection of the peptide in extra-atrial tissues . Later on , two new peptides were discovered brain natriuretic peptide ( BNP ) and C-type natriuretic peptide ( CNP ) . These peptides share structural features with CDD/ANP with regard to their 17-amino-acid-exhibiting loop bridged by a disulfide bond . Another recently discovered peptide is urodilatin ( URO ) , a renal-borne new member of A-type natriuretic peptide . URO was isolated from human urine and consists of the same sequence as CDD/ANP , containing the 17-amino-acid residue loop of the circulating hormone with 4 additional amino acids located at the NH2-terminus of the peptide . Regarding physiological actions , data strongly support a close association between URO and urinary sodium excretion . The application of URO in animals revealed a stronger diuresis and natriuresis with a lower influence on arterial blood pressure compared to CDD/ANP-99-126. These results were encouraging for the use of URO in clinical trials as a tool to prevent acute renal failure ( ARF ) in patients following heart transplantation and for treatment of incipient ARF in patients following liver transplantation . Summarising the results of these two studies , URO represents a new approach for not only prevention , but also for treatment of ARF following organ transplantation . This opens up new possibilities for the treatment of ARF of other origins in intensive care medicine ."
],
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[] |
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"normalized": []
},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s11-r230-t12.1-t9.3",
"type": "associated_with",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s11-r231-t4.1-t8.1",
"type": "developmental_form_of",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s11-r232-t12.1-t4.2",
"type": "produces",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s11-r233-t6.1-t13.2",
"type": "performs",
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"arg2_id": "DerAnaesthesist.50440081.eng.abstr-s11-t13",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s11-r234-t16.1-t2.1",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s13-r1-t1.1-t3.1",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s13-r2-t3.1-t1.1",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s13-r3-t3.1-t1.1",
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},
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"id": "DerAnaesthesist.50440081.eng.abstr-s13-r4-t2.1-t1.1",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s13-r5-t4.2-t1.1",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s13-r7-t5.1-t1.1",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s13-r8-t1.1-t4.2",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s13-r9-t1.1-t5.1",
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},
{
"id": "DerAnaesthesist.50440081.eng.abstr-s13-r10-t1.1-t3.1",
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"arg2_id": "DerAnaesthesist.50440081.eng.abstr-s13-t3",
"normalized": []
}
] |
DerAnaesthesist.50440092.eng.abstr
|
DerAnaesthesist.50440092.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440092.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The incidence of postoperative myocardial infarction ( MI ) is proportional to the incidence of myocardial ischaemic episodes . Therefore , the prevention of such episodes is of great clinical importance ."
],
"offsets": [
[
0,
205
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"incidence"
],
"offsets": [
[
4,
13
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0220856"
},
{
"db_name": "UMLS",
"db_id": "C0021149"
}
]
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"postoperative"
],
"offsets": [
[
17,
30
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032790"
}
]
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"infarction"
],
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[
42,
52
]
],
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{
"db_name": "UMLS",
"db_id": "C0021308"
}
]
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"incidence"
],
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[
83,
92
]
],
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{
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"db_id": "C0220856"
},
{
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"db_id": "C0021149"
}
]
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"ischaemic"
],
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[
107,
116
]
],
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{
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"db_id": "C0022116"
}
]
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"myocardial infarction"
],
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[
31,
52
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027051"
}
]
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"prevention"
],
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[
144,
154
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0687732"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-r1-t5.1-t3.1",
"type": "degree_of",
"arg1_id": "DerAnaesthesist.50440092.eng.abstr-s1-t5",
"arg2_id": "DerAnaesthesist.50440092.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-r2-t6.1-t3.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.50440092.eng.abstr-s1-t6",
"arg2_id": "DerAnaesthesist.50440092.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-r3-t6.1-t3.1",
"type": "degree_of",
"arg1_id": "DerAnaesthesist.50440092.eng.abstr-s1-t6",
"arg2_id": "DerAnaesthesist.50440092.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-r4-t3.1-t5.1",
"type": "degree_of",
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"arg2_id": "DerAnaesthesist.50440092.eng.abstr-s1-t5",
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},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-r5-t5.1-t3.1",
"type": "associated_with",
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"arg2_id": "DerAnaesthesist.50440092.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-r6-t3.1-t6.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.50440092.eng.abstr-s1-t3",
"arg2_id": "DerAnaesthesist.50440092.eng.abstr-s1-t6",
"normalized": []
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-r7-t3.1-t5.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.50440092.eng.abstr-s1-t3",
"arg2_id": "DerAnaesthesist.50440092.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerAnaesthesist.50440092.eng.abstr-s1-r8-t3.1-t6.1",
"type": "degree_of",
"arg1_id": "DerAnaesthesist.50440092.eng.abstr-s1-t3",
"arg2_id": "DerAnaesthesist.50440092.eng.abstr-s1-t6",
"normalized": []
}
] |
DerAnaesthesist.50440108.eng.abstr
|
DerAnaesthesist.50440108.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440108.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Left ventricular afterload is most accurately represented by left ventricular end-systolic wall stress , but in clinical practice is commonly estimated by the systemic vascular resistance ( SVR ) . End-systolic wall stress can be derived from M-mode and two-dimensional ( 2D ) echocardiograms in combination with systolic arterial pressure ( SAP ) . We tested transoesophageal echocardiography for the assessment of acute left ventricular afterload alterations in ventilated patients requiring cardiovascular support with noradrenaline or nitroglycerine ."
],
"offsets": [
[
0,
555
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440108.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"stress"
],
"offsets": [
[
96,
102
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038435"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"vascular resistance"
],
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[
168,
187
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042380"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"stress"
],
"offsets": [
[
216,
222
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038435"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"echocardiograms"
],
"offsets": [
[
277,
292
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013516"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"systolic"
],
"offsets": [
[
313,
321
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0039155"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"pressure"
],
"offsets": [
[
331,
339
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033095"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"assessment"
],
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[
402,
412
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0028708"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"patients"
],
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[
475,
483
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"noradrenaline"
],
"offsets": [
[
522,
535
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0028351"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"nitroglycerine"
],
"offsets": [
[
539,
553
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0017887"
}
]
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"transoesophageal echocardiography"
],
"offsets": [
[
360,
393
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0206054"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.50440108.eng.abstr-s1-r1-t2.1-t1.1",
"type": "result_of",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s1-r2-t1.1-t2.1",
"type": "result_of",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s1-r3-t1.1-t2.1",
"type": "evaluation_of",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s2-r1-t2.1-t4.1",
"type": "measures",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s2-r2-t2.1-t3.1",
"type": "measures",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s2-r3-t2.1-t1.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s2-r4-t1.1-t2.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r1-t3.1-t4.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t3",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r2-t2.1-t1.1",
"type": "performs",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r3-t1.1-t2.1",
"type": "affects",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r4-t5.1-t3.1",
"type": "analyzes",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t5",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r5-t1.1-t3.1",
"type": "analyzes",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r6-t1.1-t4.1",
"type": "analyzes",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r7-t5.1-t4.1",
"type": "analyzes",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t5",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r8-t4.1-t3.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t4",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r9-t2.1-t5.1",
"type": "performs",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t5",
"normalized": []
},
{
"id": "DerAnaesthesist.50440108.eng.abstr-s3-r10-t5.1-t2.1",
"type": "affects",
"arg1_id": "DerAnaesthesist.50440108.eng.abstr-s3-t5",
"arg2_id": "DerAnaesthesist.50440108.eng.abstr-s3-t2",
"normalized": []
}
] |
DerAnaesthesist.50440119.eng.abstr
|
DerAnaesthesist.50440119.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440119.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Case Report . A 31-year-old pregnant woman had to undergo emergency abdominal surgery due to acute intestinal obstruction . The patient's preoperative history demonstrated multiple allergies as well as abdominal trauma several years before . The physical examination - including sonography of the two fetuses - showed no pathological signs . Anaesthesia was induced intravenously with the operating table tilted to the left side , using routine precautions pre-oxygenation , and rapid sequence intubation , and was maintained unproblematically . About 20 min after the onset of surgery , hypotension , tachycardia , and a drop in oxygen saturation appeared . Volume substitution and the application of vasoactive drugs failed to stabilise the haemodynamic situation . Elevation of the pregnant uterus and increased left tilzing of the operating table did not lead to improvement . The development of eyelid edema led to the diagnosis of an anaphylactic reaction . The patient was treated successfully with epinephrine , antihistamines , and corticosteroids ( prednisolone ) . The suspicion of latex-related allergy was verified postoperatively by radio-allergen-sorbent test ( RAST ) and prick and scratch tests ."
],
"offsets": [
[
0,
1213
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440119.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Case Report"
],
"offsets": [
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] |
DerAnaesthesist.50440143.eng.abstr
|
DerAnaesthesist.50440143.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440143.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The safety of blood and blood components is an important aspect of transfusion medicine . Even if absolute safety of blood products cannot be achieved , this goal has come closer due to significant improvements . These include : ( 1 ) exact donor registration ; ( 2 ) component preparation according to legal requirements and GMP guidelines ; ( 3 ) determination of all relevant diagnostic parameters according to GMP/GLP guidelines ; ( 4 ) adequate storage of products ; and ( 5 ) an often underestimated parameter ensuring safety , strict guidelines for the use of blood products in the treatment of patients . Some of the results of the first Graz Consensus Conference on Transfusion Medicine are presented ."
],
"offsets": [
[
0,
711
]
]
}
] |
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4,
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19
]
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}
]
},
{
"id": "DerAnaesthesist.50440143.eng.abstr-s2-t3",
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"goal"
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DerAnaesthesist.50440154.eng.abstr
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DerAnaesthesist.50440154.eng.abstr
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"Methods . To assess the occupational exposure of the anaesthetist to anaesthetic gases , a total of 1 German and 25 Swiss hospitals were investigated . A Brueel & Kjær Type 1302 multi-gas monitor was used to measure concentrations of nitrous oxide and halogenated anaesthetic agents in the anaesthetist's breathing zone . Measurements were performed during 114 general anaesthetic , 55 of which were in patients under 11 years of age . In these 55 patients , the influence of various factors on the exposure ( time-weighted average concentrations ) was estimated by comparing different data groups . The efficiency of the applied scavenging equipment was examined by surveying the exhalation valve with a leak detector ( type TIF 5600 , TIF Instruments , Miami ) . Results . Sessions with patients under 11 years of age revealed much higher anaesthetic gas exposures compared to older patients . The concentrations of nitrous oxide were on average threefold ( Fig . 1 ) , those of the halogenated anaesthetics fivefold higher ( Fig . 2 ) for the younger patients . In 11- to 16-year-old patients the exposure level was the same as in adult patients . The measurements showed a reduction of 85% in exposure if an efficient scavenging system ( i.e. , no waste gas discharge to room air through the exhalation valve ) or lower fresh gas flow were used ( Fig . 4 ) ; 42% of the inspected scavengers were inefficient , and reduced the exposure on average by only 30% . In operating theatres with a ventilation rate of at least ten air changes per h , the measured concentrations of anaesthetic gases in the inhalation zone of the anaesthetists were reduced more than 50% compared to poorly ventilated rooms ( Figs . 4 and 5 ) . The use of tracheal intubation or laryngeal mask airway ( LMA ) anaesthesia resulted in a reduction of 80% in exposure compared to standard face masks if efficient scavenging was used . The exposures during sessions with inefficiently scavenged Bain coaxial systems or unscavenged semi-open delivery systems of the Jackson-Rees type were tenfold higher than with scavenged rebreathing circuit systems ( Fig . 6 ) . During anaesthesia with IV or double-mask induction , the average levels of inhalation anaesthetics were reduced by about 80% compared to inhalational induction with standard masks ( Fig . 7 ) . The anaesthetist's working technique is a very important factor that strongly influences the concentrations . Poor work practices , like lifting off the face mask with anaesthetic gas flow turned on , increased the exposure of the anaesthetist and other operating room personnel drastically , even if the other conditions ( scavenger and room ventilation ) were good . Discussion . The exposure levels of anaesthetic gases are generally higher during anaesthesia in children up to 10 years of age than in older patients . Nevertheless , the measurements showed that exposure during paediatric anaesthesia can be kept below the recommended limit ( 8-h TWA in Switzerland ) of 100 ppm nitrous oxide and 5 ppm halothane or 10 ppm enflurane or isoflurane . Causes of high exposures were particularly high fresh gas flows often applied without scavenging or together with inefficient scavenging devices and the high part of mask anaesthesia and inhalation induction with a loosely held mask . To achieve an effective reduction of occupational exposure , well-adjusted and maintained scavenging systems and low-leakage work practices are of primary importance . As leakage can never be completely avoided , a ventilation rate of at least ten air changes per h should be maintained in operating rooms and rooms where anaesthesia is induced to keep down concentrations of waste anaesthetic gases . High exposure during mask anaesthesia and inhalation induction can be prevented by further measures . Using a LMA instead of a standard mask reduces the exposure to the same level as endotracheal intubation ."
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] |
DerAnaesthesist.50440171.eng.abstr
|
DerAnaesthesist.50440171.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440171.eng.abstr-passage-0",
"type": "abstract",
"text": [
"By measuring pulse rate ( PR ) , blood pressure ( BP ) , electrical integral skin resistance ( SR ) , and skin surface temperature in different areas , the activity of the sympathetic nerves in spinal anaesthetics of different levels was evaluated . It was found that the sympathetic subsystems for vasomotor and sudomotor activity have their own innervation and that the functionally different effectors also manifest different deficiency reactions in low- and medium-level spinal anaesthesia . Functional sympathetic innervation , however , is unimportant after high sensory spread of spinal anaesthesia . The sympathetic nerves show similar signs of deficiency during administration of centrally acting general anaesthetics . In contrast to these , however , high spinal anaesthesia does not block the vagal component of the autonomic nervous system . The unopposed parasympathetic nerves directly affect the heart and other effectors , which may result in life-threatening cardiovascular reactions with decreases in BP and bradycardia . If high sympathetic blockade is recognized early , such life-threatening situations can be managed successfully . Suitable means of measuring sympathetic activity are the observation of BP , HR , temperature , and particularly SR at the hand . Sympathetic nerve blockade due to spinal anaesthesia first causes a reduction of SR in the lower extremity . In high spinal anaesthesia there is also a loss of sympathetic activity at the hands . Subsequently , hand temperature increases , and finally bradycardia and hypotension occur . The functional reaction of sympathetic activity is indicated by correlation of the vasomotor and sudomotor activities in high and low spinal anaesthesia . Failure of sudomotor activity can be observed on average at least 3 min prior to an increase in acral temperature and 9 min at the hands in cases of high spinal anaesthesia . The maximum increase in temperature in the feet was 4 ° C in high spinal anaesthesia , which was equal to that measured at the hand during centrally acting general anaesthesia ."
],
"offsets": [
[
0,
2080
]
]
}
] |
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DerAnaesthesist.50440178.eng.abstr
|
DerAnaesthesist.50440178.eng.abstr
|
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"Propofol is commercially available as Disoprivan . It is formulated as an aqueous emulsion with 1% 2,6-diisopropylphenol , 10% soya bean oil , 2,5% glycerol and 1.2% egg phosphatide . Since 1986 , propofol has been used as a sedative drug in the ICU and is highly valued for its numerous positive qualities . High effectiveness is combined with excellent control , which is demonstrably still present even after 2 weeks of sedation . This control enables short-term neurological surveillance of the patient and rapid weaning from the respirator once drug administration is stopped . Propofol does not disturb cerebral autoregulation . Depression of spontaneous breathing facilitates the ventilation of intubated patients . As the solution contains lipids , it contributes to parenteral nutrition . All in all , ease of control and rapid response make propofol a highly valued product in ICUs . It is easy to understand why many ICU specialists consider propofol an ideal drug for long-term sedation . The present authors , however , are convinced that certain limitations must be taken into account . First , cardiovascular depression , especially if potentiated by drugs such as - and Ca-entry blockers , may lead to hypotensive episodes . Potential problems ( drug tolerance , hypertriglyceridaemia ) may be revealed in long-term studies . As long as no such studies have been presented , the authors believe that it is too early to consider propofol the ideal drug for long-term sedation ."
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] |
DerAnaesthesist.50440186.eng.abstr
|
DerAnaesthesist.50440186.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440186.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The authors report a tracheal rupture in a 34-year-old patient who was primarily intubated following generalised seizures and loss of consciousness ( Ruesch endotracheal tube ) . Some hours later , she developed high ventilatory airway pressures and subcutaneous and mediastinal emphysema were noted . Reintubation with a high-volume , low-pressure endotracheal tube was planned when it was noted that the ballon of the Ruesch tube was grossly overinflated . Endotracheal tube cuff pressure was measured and found to be greater than 120 cm H2O ( the maximum measurement possible with the manometer ) . The diagnosis of tracheal rupture was confirmed by fiberoptic bronchoscopy . The patient immediately underwent a throacotomy and a 3-cm tear of the pars membranacea of the trachea was sutured with a dural patch . To maintain low airway pressures post-operatively , she remained sedated for 2 days and received a muscle relaxant to permit pressure-controlled ventilation . In this case , it can be concluded that excessive inflation of the endotracheal tube cuff resulted in the tracheal rupture . Other possible causes and results of tracheal rupture are discussed ."
],
"offsets": [
[
0,
1168
]
]
}
] |
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] |
[] |
[] |
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DerAnaesthesist.50440191.eng.abstr
|
DerAnaesthesist.50440191.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440191.eng.abstr-passage-0",
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"After rapid changes in transfusion practice over the past few years , blood conservation techniques have become standard in modern perioperative management . As a result , the amount of homologous blood products transfused has been markedly reduced in some types of surgical procedures . Provided that skilful surgical technique is applied and the use of blood products is restricted , autologous transfusion techniques ( predonation of autologous blood , preoperative plasmapheresis , acute normovolaemic haemodilution , and intra- and postoperative blood salvage ) can be performed with an acceptable risk for patients . In addition , stimulation of erythropoiesis with recombinant human erythropoietin , supplemental iron therapy , and improving haemostasis by aprotinin may further reduce homologous blood requirements . All patients undergoing elective surgery have to be informed about the side effects of transfusion of homologous blood products and the possibility of blood-saving methods . An individual blood conservation plan , based on the patient's status and surgery , the equipment available , and personal experience should be worked out by the responsible anaesthesiologist , whereby a combination of different methods may be most effective . If storage is necessary , autologous blood products should be preparated like homologous products . The feasibility of predonation and retransfusion of autologous blood in patients with infectious diseases like hepatitis or acquired immune deficiency syndrome and the amount of labaratomy testing are still under discussion . Although blood conservation programs are time-consuming and more expensive , they reduce the various risks of using homologous blood products ."
],
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DerAnaesthesist.50440219.eng.abstr
|
DerAnaesthesist.50440219.eng.abstr
|
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"Only 53%-58% of patients with a subarachnoid haemorrhage ( SAB ) following the rupture of a cerebral aneurysm survive without neurological damage . Morbidity and mortality are closely related to the delayed ischaemic neurological deficit due to cerebral vasospasm . The following review gives an account of pathophysiological mechanisms ; the importance of treatment with calcium antagonists , hypervolaemic haemodilution , and induced arterial hypertension is discussed in light of the current literature ."
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0,
507
]
]
}
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[] |
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DerAnaesthesist.50440230.eng.abstr
|
DerAnaesthesist.50440230.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440230.eng.abstr-passage-0",
"type": "abstract",
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],
"offsets": [
[
0,
169
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440230.eng.abstr-s1-t1",
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13
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[] |
[] |
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DerAnaesthesist.50440242.eng.abstr
|
DerAnaesthesist.50440242.eng.abstr
|
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"id": "DerAnaesthesist.50440242.eng.abstr-passage-0",
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623
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DerAnaesthesist.50440250.eng.abstr
|
DerAnaesthesist.50440250.eng.abstr
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},
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{
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},
{
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},
{
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},
{
"id": "DerAnaesthesist.50440250.eng.abstr-s1-r28-t3.1-t12.1",
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},
{
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},
{
"id": "DerAnaesthesist.50440250.eng.abstr-s1-r31-t7.1-t10.1",
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},
{
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},
{
"id": "DerAnaesthesist.50440250.eng.abstr-s2-r2-t3.1-t1.1",
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{
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},
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},
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},
{
"id": "DerAnaesthesist.50440250.eng.abstr-s2-r8-t2.1-t3.1",
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},
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"id": "DerAnaesthesist.50440250.eng.abstr-s2-r9-t6.1-t2.1",
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},
{
"id": "DerAnaesthesist.50440250.eng.abstr-s2-r10-t1.1-t2.1",
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},
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},
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"id": "DerAnaesthesist.50440250.eng.abstr-s2-r12-t5.1-t2.1",
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},
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"id": "DerAnaesthesist.50440250.eng.abstr-s2-r14-t3.1-t5.1",
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{
"id": "DerAnaesthesist.50440250.eng.abstr-s2-r15-t6.1-t1.1",
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},
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"type": "evaluation_of",
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},
{
"id": "DerAnaesthesist.50440250.eng.abstr-s2-r17-t3.1-t5.1",
"type": "result_of",
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},
{
"id": "DerAnaesthesist.50440250.eng.abstr-s2-r18-t2.1-t1.1",
"type": "interacts_with",
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"arg2_id": "DerAnaesthesist.50440250.eng.abstr-s2-t1",
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}
] |
DerAnaesthesist.50440284.eng.abstr
|
DerAnaesthesist.50440284.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440284.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Objectives . The purpose of this study was to check the precision of the Draeger vaporizer model 19.3 when filled with three different preparations of isoflurane ."
],
"offsets": [
[
0,
163
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440284.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Objectives"
],
"offsets": [
[
0,
10
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018017"
}
]
},
{
"id": "DerAnaesthesist.50440284.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"vaporizer"
],
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[
81,
90
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042325"
}
]
},
{
"id": "DerAnaesthesist.50440284.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"isoflurane"
],
"offsets": [
[
151,
161
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022180"
}
]
}
] |
[] |
[] |
[] |
DerAnaesthesist.50440288.eng.abstr
|
DerAnaesthesist.50440288.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440288.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This randomized , double-blind , multicentre , parallel-group study compared the efficacy and safety of an intravenous dose of ondansetron 4 mg for the prevention of postoperative nausea and vomiting ( PONV ) with metoclopramide 10 mg and placebo in patients undergoing major gynaecological surgery . A total of 1044 patients ( 465 ondansetron , 462 metoclopramide , 117 placebo ) received study medication immediately prior to induction of anaesthesia and were included in the analysis of data . The proportion of patients experiencing no emesis and no nausea or provided with rescue antiemetic medication , the number of emetic episodes , and the duration and severity of nausea were recorded during the 24-h period after recovery . Significantly more patients who received ondansetron had no emetic episodes ( 44% ) than those who received metoclopramide ( 36% , P=0.049) or placebo ( 25% , P 0.001 ) . A higher proportion of patients receiving ondansetron ( 32% ) did not experience nausea ( metoclopramide 24% , P=0.009; placebo 16% , P 0.001 ) . Significantly fewer patients in the ondansetron group required rescue medication or were withdrawn due to treatment failure ( P 0.05 ) . In the ondansetron group the total number of emetic episodes , the median time to the first emetic episode or treatment failure , and the duration and severity of nausea were reduced significantly compared with metoclopramide or placebo ( P 0.05 ) . The safety profile was similar for each treatment group ."
],
"offsets": [
[
0,
1496
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t1",
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"text": [
"safety"
],
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[
94,
100
]
],
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{
"db_name": "UMLS",
"db_id": "C0036043"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"ondansetron"
],
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[
127,
138
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0061851"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"prevention"
],
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[
152,
162
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0687732"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"postoperative"
],
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[
166,
179
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032790"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"nausea"
],
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[
180,
186
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027497"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"vomiting"
],
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[
191,
199
]
],
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{
"db_name": "UMLS",
"db_id": "C0042963"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"PONV"
],
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[
202,
206
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0520909"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"metoclopramide"
],
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[
214,
228
]
],
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{
"db_name": "UMLS",
"db_id": "C0025853"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"placebo"
],
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[
239,
246
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032042"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t10",
"type": "umlsterm",
"text": [
"patients"
],
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[
250,
258
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t11",
"type": "umlsterm",
"text": [
"surgery"
],
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[
291,
298
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038894"
},
{
"db_name": "UMLS",
"db_id": "C0038895"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t12",
"type": "umlsterm",
"text": [
"postoperative nausea"
],
"offsets": [
[
166,
186
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0520904"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s1-t13",
"type": "umlsterm",
"text": [
"gynaecological surgery"
],
"offsets": [
[
276,
298
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038902"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"patients"
],
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[
317,
325
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"ondansetron"
],
"offsets": [
[
332,
343
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0061851"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"metoclopramide"
],
"offsets": [
[
350,
364
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025853"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"placebo"
],
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[
371,
378
]
],
"normalized": [
{
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"db_id": "C0032042"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s2-t5",
"type": "umlsterm",
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"medication"
],
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[
396,
406
]
],
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"db_id": "C0013227"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"analysis"
],
"offsets": [
[
478,
486
]
],
"normalized": [
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"db_id": "C0002778"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s3-t1",
"type": "umlsterm",
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"patients"
],
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[
515,
523
]
],
"normalized": [
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"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"emesis"
],
"offsets": [
[
540,
546
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042963"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"nausea"
],
"offsets": [
[
554,
560
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027497"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"antiemetic"
],
"offsets": [
[
585,
595
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003297"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"medication"
],
"offsets": [
[
596,
606
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013227"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"emetic"
],
"offsets": [
[
623,
629
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013973"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"nausea"
],
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[
674,
680
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027497"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s3-t8",
"type": "umlsterm",
"text": [
"period"
],
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[
711,
717
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025344"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
754,
762
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"ondansetron"
],
"offsets": [
[
776,
787
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0061851"
}
]
},
{
"id": "DerAnaesthesist.50440288.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"emetic"
],
"offsets": [
[
795,
801
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013973"
}
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DerAnaesthesist.50440291.eng.abstr
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DerAnaesthesist.50440291.eng.abstr
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"Induced hypotension is defined as a reduction in mean arterial blood pressure to 50-60 mm Hg in normotensive subjects . The aim of induced hypotension is to decrease intraoperative blood loss , decrease the need for blood transfusions and improve operating conditions . Most studies indicate that induced hypotension can decrease intraoperative blood loss by 50% in many surgical procedures ; however , some studies report that blood loss is not significantly reduced . Current methods of induced hypotension are based on the use of rapid and short-acting vasodilators as primary agents ( nitroprusside , nitroglycerine , urapidil ) , supplemented by volatile anesthetics ( isoflurane ) and/or -blockers ( esmolol ) to improve effect , reduce dosage and prevent side effects ( reflex tachycardia , tachyphylaxis , rebound hypertension ) . Proper positioning of the patient and controlled ventilation aid in reducing blood loss . Major risks of induced hypotension are a reduction in blood flow ( i.e. ischaemia ) of vital organs ( brain , myocardium ) and elevation of intracranial pressure in neurosurgical patients . Thus , major contraindications of induced hypotension are severe coronary artery disease , hypertension combined with arteriosclerosis of cerebral vessels and increased intracranial pressure in patients with cerebral disease . Complications are rare in otherwise healthy patients , but may be higher in elderly patients and those with underlying organ dysfunction . Therefore , careful assessment and selection of patients , together with consideration of the potential complications , appropriate choice of drugs and invasive beatby-beat monitoring , are essential for the safe practice of induced hypotension ."
],
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[] |
[] |
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DerAnaesthesist.50440312.eng.abstr
|
DerAnaesthesist.50440312.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440312.eng.abstr-passage-0",
"type": "abstract",
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"Postoperative vomiting is induced by different mechanisms such as age , anaesthetic technique and medications , postoperative analgesia , and surgical traction on the extra-ocular muscles . The influence of anticholinergic premedication and the use of benzodiazepines as factors affecting the incidence of vomiting is controversial . In a prospective , randomised , single-blind study we examined two different treatments with regard to postoperative pain , vigilance , and vomiting in young children undergoing strabismus repair . Methods . After institutional ethical committee approval , informed written consent was obtained from all parents . The children were randomly assigned to three groups : ( 1 ) paracetamol ( P ) - 17 patients who received 250-500 mg paracetamol rectally ( dependent on body weight ) immediately after intubation of the trachea ; ( 2 ) bupivacaine ( B ) - 17 patients who received two drops 0.5% bupivacaine hydrochloride on the conjunctiva of the eye ( s ) being corrected following intubation of the trachea and again 10 min after intubation . After the surgeon had exposed the extra-ocular muscle and before readaptation of the conjunctiva , two drops of the same solution were applied again each time directly on the muscle ; and ( 3 ) controls ( C ) - 16 patients who received rectal paracetamol after completion of the operation but before extubation . The children were premedicated with 0.05 mg/kg flunitrazepam sublingually . After 0.25 mg atropine i.v. , anaesthesia was induced with 0.1 mg/kg vecuronium , 5 mg/kg thiopentone , 1.5 vol% enflurane , and N2O/O2 50:50 . When the trachea was intubated anaesthesia was maintained with enflurane as required and 70% N2O in oxygen . Extubation was performed only if the patient could touch or did not tolerate the tube . Oral diet was allowed 6 h after extubation at the earliest . Examination of vigilance and analgesia . The degrees of vigilance and pain were evaluated preoperatively and after extubation over 24 h using two different scales . Evaluation of the scales was performed during the first 3 postoperative h at 12 different time points ( Figs . 1 , 2 ) and 6 , 12 , and 24 h after extubation . The evaluation was conducted by nursing staff who were blinded to the treatment ( single-blind study ) . Postoperative analgesia consisted of 250-500 mg rectal paracetamol ( all patients ) . Parametric data were expressed as mean +/- SD , and comparisons were made with the one-way analysis of variance . Fisher's exact test was applied to ordinal data . P 0.05 indicates a statistically significant difference . Results . Two patients ( P ) were excluded from the study postoperatively because of refusing rectal paracetamol in spite of pain and postoperative infection of the upper airways , which had manifestated on the afternoon of the operative day . No significant differences were found between the three groups in patient characteristics ( Table 1 ) . The quantity of enflurane administered , rate , postoperative consumption of rectal paracetamol , and postoperative emesis were highest in the control group ( Tables 2 , 3 ) , but the incidence of postoperative vomiting ranged only between 13% and 24% ( Table 3 ) . Children with preoperative paracetamol needed more time to fulfill the criteria to \" stick out the tongue \" and \" recognising the mother \" . Vigilance . The time to postoperative crying or screaming and restlessness was shorter in the control group . The values reached significant difference at 10 min ( P ) and 25 min ( P and B ) after extubation compared with the other groups ( Fig . 1 ) . Analgesie . At 5 , 10 , and 150 min after extubation pain was significantly higher in patients in the control group ( Fig . 2 ) . Conclusions . Intraoperative administration of rectal paracetamol or topical 0.5% bupivacaine was most effective in the treatment of postoperative pain for strabismus surgery in younger children ."
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] |
DerAnaesthesist.50440319.eng.abstr
|
DerAnaesthesist.50440319.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440319.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The physiological pattern of regional pulmonary blood flow is mainly determined by the relationship of pulmonary arterial , venous , and alveolar pressures [ 12 , 32 ] . Changes in alveolar pressure and pulmonary geometry may therefore be expected to influence regional perfusion , which is a key determinant of pulmonary gas exchange . Unilateral thoracotomy is usually performed with the patient in the lateral decubitus position . The present study examined the influence of mechanical factors on regional pulmonary blood flow distribution in rabbits in the lateral decubitus position during normoxia and unilateral hypoxia ."
],
"offsets": [
[
0,
628
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440319.eng.abstr-s1-t1",
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"blood"
],
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48,
53
]
],
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{
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},
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{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s1-t2",
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"text": [
"pressures"
],
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[
146,
155
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s2-t1",
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"pressure"
],
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[
190,
198
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s2-t2",
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"perfusion"
],
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[
270,
279
]
],
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{
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}
]
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{
"id": "DerAnaesthesist.50440319.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"gas"
],
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[
322,
325
]
],
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{
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"db_id": "C0017110"
}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"regional perfusion"
],
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[
261,
279
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0031006"
}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"pulmonary gas exchange"
],
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[
312,
334
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s3-t1",
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"text": [
"thoracotomy"
],
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[
348,
359
]
],
"normalized": [
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"patient"
],
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[
390,
397
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"decubitus"
],
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[
413,
422
]
],
"normalized": [
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"blood"
],
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[
519,
524
]
],
"normalized": [
{
"db_name": "UMLS",
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},
{
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},
{
"db_name": "UMLS",
"db_id": "C0005835"
}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"distribution"
],
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[
530,
542
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"rabbits"
],
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[
546,
553
]
],
"normalized": [
{
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"db_id": "C0034493"
}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-t4",
"type": "umlsterm",
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"decubitus"
],
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[
569,
578
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"hypoxia"
],
"offsets": [
[
619,
626
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0242184"
}
]
}
] |
[] |
[] |
[
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{
"id": "DerAnaesthesist.50440319.eng.abstr-s3-r1-t2.1-t1.1",
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{
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{
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},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-r2-t1.2-t5.1",
"type": "causes",
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},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-r3-t5.1-t1.2",
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{
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},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-r6-t5.1-t4.1",
"type": "degree_of",
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},
{
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},
{
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"normalized": []
},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-r10-t4.1-t5.1",
"type": "degree_of",
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},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-r11-t1.1-t4.1",
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},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-r12-t5.1-t2.1",
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},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-r13-t1.2-t4.1",
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},
{
"id": "DerAnaesthesist.50440319.eng.abstr-s4-r14-t4.1-t1.2",
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"normalized": []
}
] |
DerAnaesthesist.50440328.eng.abstr
|
DerAnaesthesist.50440328.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440328.eng.abstr-passage-0",
"type": "abstract",
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"In animal models authors have dealt with the question of whether hypotension alone can cause an acute-phase response even in the absence of marked blood loss and trauma . Sodium nitroprusside ( SNP ) , which was employed in the animal models , is also used to induce hypotension in humans . Since no data are available on human subjects plasma concentrations of interleukin-6 ( IL-6), an important mediator of the acute-phase response , were studied in patients during SNP infusion for induction of hypotension ."
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{
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{
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{
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},
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{
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},
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},
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},
{
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{
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},
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{
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{
"id": "DerAnaesthesist.50440328.eng.abstr-s3-r16-t4.1-t6.1",
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},
{
"id": "DerAnaesthesist.50440328.eng.abstr-s3-r17-t3.1-t1.1",
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"id": "DerAnaesthesist.50440328.eng.abstr-s3-r18-t6.1-t3.1",
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}
] |
DerAnaesthesist.50440334.eng.abstr
|
DerAnaesthesist.50440334.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440334.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The aim of this study was to compare the intubating conditions of a mivacurium-induced neuromuscular block 90 s after a divided administration with three different methods of induction of anaesthesia ."
],
"offsets": [
[
0,
201
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440334.eng.abstr-s1-t1",
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"text": [
"aim"
],
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[
4,
7
]
],
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{
"db_name": "UMLS",
"db_id": "C0108800"
}
]
},
{
"id": "DerAnaesthesist.50440334.eng.abstr-s1-t2",
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"administration"
],
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[
128,
142
]
],
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}
]
},
{
"id": "DerAnaesthesist.50440334.eng.abstr-s1-t3",
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"methods"
],
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[
164,
171
]
],
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{
"db_name": "UMLS",
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{
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}
]
},
{
"id": "DerAnaesthesist.50440334.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"neuromuscular block"
],
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[
87,
106
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0235062"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.50440334.eng.abstr-s1-r1-t3.2-t2.1",
"type": "isa",
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},
{
"id": "DerAnaesthesist.50440334.eng.abstr-s1-r2-t3.2-t1.1",
"type": "measures",
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},
{
"id": "DerAnaesthesist.50440334.eng.abstr-s1-r3-t3.2-t1.1",
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}
] |
DerAnaesthesist.50440339.eng.abstr
|
DerAnaesthesist.50440339.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440339.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patchy analgesia and incomplete motor blockade sometimes occur during surgery of the upper limb under axillary brachial plexus blockade . To avoid these problems , we sought an alternative approach to the brachial plexus to guarantee reliable anaesthesia . Based on anatomic studies , we undertook a prospective clinical study with 175 patients ."
],
"offsets": [
[
0,
346
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-t1",
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"analgesia"
],
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[
7,
16
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-t2",
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"text": [
"surgery"
],
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[
70,
77
]
],
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}
]
},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-t3",
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],
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91,
95
]
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"id": "DerAnaesthesist.50440339.eng.abstr-s1-t4",
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"upper limb"
],
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[
85,
95
]
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]
},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-t5",
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],
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111,
126
]
],
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},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s2-t1",
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],
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[
205,
220
]
],
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}
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},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s3-t1",
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"anatomic"
],
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266,
274
]
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"id": "DerAnaesthesist.50440339.eng.abstr-s3-t2",
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336,
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312,
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{
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"db_id": "C0008972"
}
]
}
] |
[] |
[] |
[
{
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"type": "adjacent_to",
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},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-r2-t5.1-t2.1",
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},
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},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-r4-t5.1-t4.1",
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},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-r5-t2.2-t2.1",
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},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-r6-t1.1-t2.1",
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},
{
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"normalized": []
},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-r8-t5.1-t1.1",
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{
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},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-r10-t5.1-t2.2",
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"normalized": []
},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s1-r11-t4.1-t2.1",
"type": "issue_in",
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"normalized": []
},
{
"id": "DerAnaesthesist.50440339.eng.abstr-s3-r1-t1.1-t3.1",
"type": "performs",
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"arg2_id": "DerAnaesthesist.50440339.eng.abstr-s3-t3",
"normalized": []
}
] |
DerAnaesthesist.50440345.eng.abstr
|
DerAnaesthesist.50440345.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440345.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Gamma-hydroxybutyric acid ( GHB ) is a naturally occurring transmitter in the mammalian brain , related to sleep regulation and possibly to energy balance in diving or hibernating animals . It has been used for almost 35 years as an intravenous agent for induction of anaesthesia and for long-term sedation . Its convincing pharmacological properties , without serious adresse effects on circulation or respiration , are compromised by its unpredictable duration of action . This is not a major problem with long-term sedation during ICU treatment . GHB has been used with good results for sedation of patients with severe brain injury , where it compares favourably with barbiturates . In animal studies , it seems to possess a protective action against hypoxia on a cellular and whole organ level . However , in some experimental animals GHB has been shown to produce seizure-like activities , and the compound is being used to produce absence-like seizures . GHB has been used in our ICU for years to provide adequate sedation for patients under controlled ventilation or for patients figthing the respirator during spontaneous respiration . No serious side effects were observed in these patients , while in some patients under haemodialysis hypernatraemia and metabolic alkalosis developed ; both were reversible after discontinuation of GHB and restriction of additional sodium input ( Somsanit , the commercially available GHB preparation in Germany , contains 9.2 mmol sodium/g ; the daily dose averages 20-40 g GHB , i.e. 180-370 mmol sodium ) ."
],
"offsets": [
[
0,
1554
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440345.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"acid"
],
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[
21,
25
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0001128"
}
]
},
{
"id": "DerAnaesthesist.50440345.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"brain"
],
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[
88,
93
]
],
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{
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"db_id": "C0153633"
},
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{
"db_name": "UMLS",
"db_id": "C0496899"
}
]
},
{
"id": "DerAnaesthesist.50440345.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"regulation"
],
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113,
123
]
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DerAnaesthesist.50440369.eng.abstr
|
DerAnaesthesist.50440369.eng.abstr
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[
{
"id": "DerAnaesthesist.50440369.eng.abstr-passage-0",
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"text": [
"The occurrence of severe head injury , isolated or in connection with polytrauma , is a challenge for all physicians working in emergency care at the scene of an accident or afterwards in hospital care . It is an advantage to have a basic knowledge of neurological assessment . The Glasgow Coma Scale is widely used in this context ; we refer to mild , moderate , and severe injuries . It is very important to recognise concomitant injuries , which occur in about 40% of cases . As coexisting hypoxaemia and hypotension have an adverse effect on the time course of head injury by inducing secondary brain damage , it is essential in therapy to quickly restore the vital body functions . Unconscious patients are tracheally intubated and ventilated . Forced hyperventilation over a lengthy period seems to have an unfavourable effect on outcome . Anaesthetic drugs and adjuvant therapies are used that do not increase intracranial vessel diameter and consequently intracranial pressure ( ICP ) . This applies to all i.v. anaesthetics , sedatives , and opioids , as long as no respiratory depression occurs . Ketamine has been useful for many years at the scene of an accident . An existing low blood pressure ( BP ) is raised while a significantly increased BP is moderately lowered . It is necessary to have adequate cerebral perfusion pressure ( CPP ) , which is defined as mean BP minus ICP . In cases of polytrauma with heavy bleeding , e.g. , from the liver or spleen , the blood loss must be stopped before the neurosurgeon begins . Excessive i.v. administration of Ringer's lactate should be avoided . Today , the routine use of osmodiuretics , e.g. , mannitol , is not indicated . It has not yet been possible to show that using corticosteroids is definitely beneficial in human brain trauma ; there may be a positive effect in connection with spinal trauma . New therapies are being investigated , such as increasing CPP , administering AMPA/NMDA-antagonists , 21-aminosteroids , or hypertonic-hyperoncotic solutions . However , they have not as yet been proven effective for general clinical use or clinical use et al."
],
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}
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DerAnaesthesist.50440395.eng.abstr
|
DerAnaesthesist.50440395.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440395.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Pregnancy causes substantial changes in the cardiovascular system : cardiac output ( 40%-50% ) and blood volume ( 40% ) increase whereas systemic peripheral resistance and arterial pressure decrease . The rise in progesterone and estrogen levels accompanying pregnancy stimulates the renin-angiotension-aldosterone system . Increased prostaglandin production follows renin activation ; simultaneously , the arterial vessels show diminished angiotension sensitivity . The result is pronounced vasodilatation . Heart disease remains the most important nonobstetric cause of maternal death . The physiological changes in the cardiovascular system during pregnancy influence cardiac diseases in different ways . Pregnancy , labor , and delivery appear to be well tolerated in gravidae with an atrial septal defect , ventricular septal defect , and patents ductus arteriosus . Sometimes congestive heart failure occurs and appropriate medical therapy is necessary . Pregnant women with uncorrected cyanotic congenital heart disease ( Eisenmenger's syndrome , tetralogy of Fallot ) constitute a high-risk group because of right ventricular insufficiency and hypoxic attacks . The consequences for anaesthesia in parturients with congenital heart disease are discussed . The symptoms of acquired mitral or aortic stenosis are aggravated by the physiological changes in the cardiovascular system during pregnancy ; the clinical symptoms of valve insufficiency are ameliorated by vasodilatation . Peripartum cardiomyopathy clinically shows similar features to idiopathic dilated cardiomyopathy . The basis of treatment is the same as that of congestive heart failure , with the therapeutic spectrum ranging from diet to heart transplantation . Women with hypertrophic cardiomyopathy tolerate pregnancy , labor , and delivery surprisingly well . Vaginal delivery is possible , but epidural anaesthesia is contraindicated . Hypertensive disorders associated with pregnancy are classified into three groups : chronic , treatment , and preeclamptic hypertension . Whereas chronic and transient hypertension do not affect the outcome of pregnancy appreciably , pre-eclampsia presents a potential danger to mother and fetus . Pre-eclamptic hypertension is accompanied by low cardiac output and plasma volume . An upregulation of angiotension receptors enhances vascular reactivity , with the consequence of high peripheral resistance . For antihypertensive therapy hydralazine , -methyldopa , and magnesium sulfate are the drugs of choice . A generalised recommendation of anaesthesia for the pre-eclamptic gravida cannot be made because both general and epidural anaesthesia have risks of severe side effects ."
],
"offsets": [
[
0,
2696
]
]
}
] |
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"id": "DerAnaesthesist.50440395.eng.abstr-s1-t7",
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"id": "DerAnaesthesist.50440395.eng.abstr-s2-t1",
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"progesterone"
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"estrogen"
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"id": "DerAnaesthesist.50440395.eng.abstr-s2-t3",
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] |
[] |
[] |
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DerAnaesthesist.50440405.eng.abstr
|
DerAnaesthesist.50440405.eng.abstr
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"The quality , result , and prognosis of neurosurgery relies heavily on the anaesthetic technique . Many different classes of drugs have been used during neurosurgical anaesthesia . This article reviews the use of intravenous ( IV ) propofol as an alternative to volatile anaesthetic techniques . Anaesthesia requirements for neurosurgical procedures are elaborated upon in the first part of the article . The priority of neuroanaesthesia is to preserve neuronal function by avoiding complications such as hypoxia , hypercarbia , and cardiovascular instability . Thereafter , the chosen anaesthetic technique should minimally interfere with cerebral autoregulation and CO2 responsiveness , while brain relaxation is encouraged by decreasing the cerebral metabolic rate for oxygen ( CMRO2) and cerebral blood flow ( CBF ) . In addition , the anaesthetic technique should be associated with rapid and predictable recovery in the operating theatre in order to allow early evaluation of the surgery . The second part of the article describes IV techniques for neurosurgery as an alternative to volatile anaesthetics , all of which increase CBF , cerebral blood volume , and intracranial pressure ( ICP ) in a dose-related manner and diminish cerebral autoregulation and interfere with cerebrovascular CO2 reactivity . Nitrous oxide has a stimulant effect on cerebral metabolism and is associated with an increase in CBF . On the other hand , all IV agents except ketamine are associated with decreases in CMRO2 and are cerebral vasoconstrictors . For this reason , it is rational to use them for the induction and maintenance of anaesthesia for neurosurgery as part of a total IV anaesthetic technique . The third part of the article focuses on propofol as the newest representative of IV anaesthetics . It is a sedative-hypnotic agent that has a pharmacokinetic-dynamic profile ideally suited for continuous infusion . Propofol reduces ICP , CBF , and CMRO2. Animal models have suggested the possibility of cerebral protection . The responsiveness of the cerebral circulation to alterations in arterial blood pressure is maintained . Evaluating propofol for major neurosurgery demonstrated good quality and depth of anaesthesia , excellent brain relaxation , and minimal surgical bleeding . In conclusion , total IV anaesthesia with propofol has proven to be a valid alternative to conventional thiopentone-isoflurane anaesthesia for intracranial surgery ."
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] |
DerAnaesthesist.50440410.eng.abstr
|
DerAnaesthesist.50440410.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440410.eng.abstr-passage-0",
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"text": [
"At present , phosphodiesterase III inhibitors are commonly used for the treatment of low cardiac output states . Despite their positive inotropic and lusitropic effects , these drugs are still under discussion because of certain adverse effects like thrombopaenia , elevation of transaminases , abdominal disregulation , and excessive periphereal vasodilatation . As a consequence , more cardioselective phosphodiesterase inhibitors were developed with the aim of reducing these adverse effects . One of them , enoximone ( Marion Merrell Dow , Fig . 1 ) , an imidazole derivative , has nearly no influence on platelets and abdominal organ function . In addition , in many studies vasodilatation was found to be absent . Recently a new substance , R80122 ( Janssen , Belgium , Fig . 1 ) , was developed . First experimental studies showed high cardioselectivity of this substance . The aim of this study was to compare the haemodynamic effects of enoximone and R80122 in patients with ischaemic heart disease ."
],
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[
0,
1009
]
]
}
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] |
DerAnaesthesist.50440417.eng.abstr
|
DerAnaesthesist.50440417.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440417.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The present study compared the effects of propofol/alfentanil versus isoflurane anaesthesia on cerebral vascular reactivity to changes in carbon dioxide ( CO2) using transcranial Doppler sonography ( TCD ) ."
],
"offsets": [
[
0,
207
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440417.eng.abstr-s1-t1",
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"isoflurane"
],
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[
69,
79
]
],
"normalized": [
{
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}
]
},
{
"id": "DerAnaesthesist.50440417.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"carbon"
],
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[
138,
144
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.50440417.eng.abstr-s1-t3",
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"text": [
"sonography"
],
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[
187,
197
]
],
"normalized": [
{
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"db_id": "C0041618"
}
]
},
{
"id": "DerAnaesthesist.50440417.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"carbon dioxide"
],
"offsets": [
[
138,
152
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007012"
}
]
}
] |
[] |
[] |
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"id": "DerAnaesthesist.50440417.eng.abstr-s1-r8-t3.1-t1.1",
"type": "analyzes",
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"arg2_id": "DerAnaesthesist.50440417.eng.abstr-s1-t1",
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},
{
"id": "DerAnaesthesist.50440417.eng.abstr-s1-r9-t2.1-t1.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.50440417.eng.abstr-s1-t2",
"arg2_id": "DerAnaesthesist.50440417.eng.abstr-s1-t1",
"normalized": []
}
] |
DerAnaesthesist.50440423.eng.abstr
|
DerAnaesthesist.50440423.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440423.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The introduction of flow-directed pulmonary artery ( PA ) catheters has helped to improve our knowledge of cardiovascular physiology . There have been several developments of this equipment in recent years , including continuous monitoring of mixed-venous O2 saturation ( Sv\\=O2) and cardiac output ( CO ) . The high purchase price , however , is an obstacle to its use in the critically ill. The aim of the present study was to analyse the actual costs of these devices in comparison to standardly used intermittent monitoring of Sv\\=O2 and CO ."
],
"offsets": [
[
0,
546
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"artery"
],
"offsets": [
[
44,
50
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003842"
}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"catheters"
],
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[
58,
67
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0085590"
}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"knowledge"
],
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[
94,
103
]
],
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{
"db_name": "UMLS",
"db_id": "C0376554"
}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"physiology"
],
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[
122,
132
]
],
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{
"db_name": "UMLS",
"db_id": "C0031842"
},
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"pulmonary artery"
],
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[
34,
50
]
],
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{
"db_name": "UMLS",
"db_id": "C0034052"
}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"cardiovascular physiology"
],
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[
107,
132
]
],
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{
"db_name": "UMLS",
"db_id": "C0007227"
}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"developments"
],
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[
159,
171
]
],
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{
"db_name": "UMLS",
"db_id": "C0243107"
},
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"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"equipment"
],
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[
180,
189
]
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{
"db_name": "UMLS",
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"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"cardiac output"
],
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[
284,
298
]
],
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{
"db_name": "UMLS",
"db_id": "C0007165"
}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"price"
],
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[
326,
331
]
],
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{
"db_name": "UMLS",
"db_id": "C0080045"
},
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"use"
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[
366,
369
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{
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{
"id": "DerAnaesthesist.50440423.eng.abstr-s3-t3",
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"aim"
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[
397,
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{
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},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s3-t4",
"type": "umlsterm",
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"costs"
],
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[
448,
453
]
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{
"db_name": "UMLS",
"db_id": "C0010186"
},
{
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},
{
"db_name": "UMLS",
"db_id": "C0220812"
}
]
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"devices"
],
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[
463,
470
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{
"db_name": "UMLS",
"db_id": "C0699733"
},
{
"db_name": "UMLS",
"db_id": "C0220819"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-r1-t1.1-t4.1",
"type": "issue_in",
"arg1_id": "DerAnaesthesist.50440423.eng.abstr-s3-t1",
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},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-r2-t1.1-t6.1",
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{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-r4-t4.2-t6.1",
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},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-r5-t6.1-t4.1",
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},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-r6-t2.1-t4.1",
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},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-r7-t1.1-t4.2",
"type": "location_of",
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"normalized": []
},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s1-r8-t4.2-t6.1",
"type": "result_of",
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},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s2-r1-t2.1-t2.2",
"type": "uses",
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},
{
"id": "DerAnaesthesist.50440423.eng.abstr-s2-r2-t2.1-t1.1",
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{
"id": "DerAnaesthesist.50440423.eng.abstr-s2-r3-t2.1-t1.1",
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{
"id": "DerAnaesthesist.50440423.eng.abstr-s2-r4-t2.1-t1.1",
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"arg2_id": "DerAnaesthesist.50440423.eng.abstr-s3-t1",
"normalized": []
}
] |
DerAnaesthesist.50440429.eng.abstr
|
DerAnaesthesist.50440429.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440429.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The study aimed to evaluate whether superimposed high-frequency jet ventilation ( SHFJV ) is a useful tool in intensive care medicine to ventilate patients with pulmonary insufficiency ."
],
"offsets": [
[
0,
186
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"ventilation"
],
"offsets": [
[
68,
79
]
],
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{
"db_name": "UMLS",
"db_id": "C0042491"
},
{
"db_name": "UMLS",
"db_id": "C0035203"
}
]
},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-t2",
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"care"
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[
120,
124
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{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-t3",
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"medicine"
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125,
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-t4",
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"patients"
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147,
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}
]
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{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-t5",
"type": "umlsterm",
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"intensive care"
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[
110,
124
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{
"db_name": "UMLS",
"db_id": "C0085559"
}
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"pulmonary insufficiency"
],
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[
161,
184
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{
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}
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{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-t7",
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"high-frequency jet ventilation"
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[
49,
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"db_name": "UMLS",
"db_id": "C0019540"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r1-t4.1-t2.1",
"type": "performs",
"arg1_id": "DerAnaesthesist.50440429.eng.abstr-s1-t4",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r2-t7.1-t1.2",
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},
{
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{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r6-t6.1-t1.2",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r7-t4.1-t5.1",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r8-t6.1-t2.1",
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{
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{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r11-t2.1-t4.1",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r13-t1.1-t6.1",
"type": "result_of",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r14-t6.1-t7.1",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r15-t6.1-t1.1",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r16-t7.1-t5.1",
"type": "isa",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r17-t1.2-t6.1",
"type": "result_of",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r18-t7.1-t4.1",
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{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r19-t6.1-t5.1",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r20-t1.1-t2.1",
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"id": "DerAnaesthesist.50440429.eng.abstr-s1-r21-t7.1-t3.2",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r22-t4.1-t7.1",
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"arg2_id": "DerAnaesthesist.50440429.eng.abstr-s1-t7",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r23-t1.2-t2.1",
"type": "issue_in",
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"arg2_id": "DerAnaesthesist.50440429.eng.abstr-s1-t2",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r24-t3.2-t1.2",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r25-t6.1-t2.1",
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},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r27-t7.1-t6.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.50440429.eng.abstr-s1-t7",
"arg2_id": "DerAnaesthesist.50440429.eng.abstr-s1-t6",
"normalized": []
},
{
"id": "DerAnaesthesist.50440429.eng.abstr-s1-r28-t5.1-t1.2",
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] |
DerAnaesthesist.50440436.eng.abstr
|
DerAnaesthesist.50440436.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440436.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The absorption of large volumes of irrigation fluid is a major problem in transurethral prostatic surgery ( TUR-P ) . Various indicators have been tested to monitor fluid absorption with regard to continuous registration and sufficient accuracy . The volumetric fluid balance is not suitable as a routine method because of its inaccuracy . Easily accessible parameters are unspecific because of surgical bleeding ( haematocrit [ Hct ] ) , or are interfered with by physiological counter-regulatory actions ( serum sodium [ Na ] concentration ) . In 1986 Hulten et al. suggested adding 2% ethanol to the irrigation fluid as a marker and investigated it intermittently in the expired air with an alcohol-test appliance . In a prospective clinical study of 17 patients undergoing TUR-P under spinal anaesthesia , expiratory concentrations of alcohol that was added to the irrigation fluid ( 2% ethanol in Purisole , Fresenius , Bad Homburg ) were monitored . Gas was continuously sampled from the nasopharynx through a nasal cannula and the ethanol concentration was measured using a modified diverting anaesthetic gas monitor ( Normac , Datex , Helsinki ) that allows continuous as well as early detection of the absorbed irrigation fluid with reliable accuracy for clinical use . In addition , at intervals of 10 minutes we measured blood alcohol , endtidal alcohol ( Alcotest 7110 , Drauml ; ger , Luebeck ) , haematocrit , serum Na concentration , and blood gases . Sixty-eight measurements were obtained from the 17 patients . As shown in other studies , serum Na ( r2 = 0.68 ) and Hct ( r2 = 0.39 ) correlated poorly with the irrigation fluid as determined by serum alcohol levels . In contrast , the expiratory alcohol measurements with the alcotest 7110 ( r2 = 0.93 ) and Normac devices ( r2 = 0.85 ) were closely related . Continuous monitoring of the expiratory alcohol concentration with a Normac monitor closely reflects blood alcohol concentrations , and may hence serve as a useful semiquantitative monitor of irrigation fluid absorption during TUR-P ."
],
"offsets": [
[
0,
2063
]
]
}
] |
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] |
DerAnaesthesist.50440445.eng.abstr
|
DerAnaesthesist.50440445.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440445.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Although the local anaesthetic prilocaine is less cardio- and neurotoxic than lidocaine , it bears the disadvantage of the formation of methaemoglobin by the metabolite o-toluidine . Prilocaine is often successfully used , especially for the blockade of the brachial plexus , but one problem of this technique is the failure rate of 3-10% , with the consequence that general anaesthesia after administration of prilocaine is frequently necessary . Methaemoglobin formation after prilocaine administration has been thoroughly investigated . Nothing is known , however , about the interactions of prilocaine and the induction of general anaesthesia relative to methaemoglobinaemia ."
],
"offsets": [
[
0,
680
]
]
}
] |
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DerAnaesthesist.50440473.eng.abstr
|
DerAnaesthesist.50440473.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440473.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The conventional multichannel electroencephalogram is quite inconvenient for long-term monitoring in the operating theatre or intensive care unit . Recording of the EEG would be easier if a small number of channels was sufficient . Aiming at reduction of channels , leads from different regions of the scalp were analysed visually and with regard to their spectral content ."
],
"offsets": [
[
0,
374
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440473.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"electroencephalogram"
],
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[
30,
50
]
],
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{
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"db_id": "C0086205"
}
]
},
{
"id": "DerAnaesthesist.50440473.eng.abstr-s1-t2",
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"care"
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[
136,
140
]
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]
},
{
"id": "DerAnaesthesist.50440473.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"operating theatre"
],
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[
105,
122
]
],
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{
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"db_id": "C0029064"
}
]
},
{
"id": "DerAnaesthesist.50440473.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"intensive care"
],
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[
126,
140
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{
"id": "DerAnaesthesist.50440473.eng.abstr-s1-t5",
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"intensive care unit"
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126,
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},
{
"id": "DerAnaesthesist.50440473.eng.abstr-s2-t1",
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"EEG"
],
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[
165,
168
]
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{
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}
]
},
{
"id": "DerAnaesthesist.50440473.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"scalp"
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[
302,
307
]
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{
"db_name": "UMLS",
"db_id": "C0036270"
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] |
[] |
[] |
[
{
"id": "DerAnaesthesist.50440473.eng.abstr-s1-r1-t1.1-t2.1",
"type": "affects",
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{
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DerAnaesthesist.50440478.eng.abstr
|
DerAnaesthesist.50440478.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440478.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patients and methods . We have studied mid-latency auditory evoked potentials ( MLAEP ) during general anaesthesia with sufentanil in ten patients scheduled for elective major urological surgery . Anaesthesia was induced with sufentanil 2-3 µg/kg; for maintenance of anaesthesia a further bolus of sufentanil ( 1-2 µg/kg) 10 min before the start of surgery ( skin incision ) was given . MLAEP were recorded before and 10 min after the last sufentanil bolus on the vertex ( positive ) and mastoids on both sides ( negative ) . Latencies of the peaks V , Na , Pa , Nb , and P1 ( ms ) and amplitudes Na/Pa , Pa/Nb , and Nb/P1 ( µV) were measured ."
],
"offsets": [
[
0,
644
]
]
}
] |
[
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20
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"sufentanil"
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[
120,
130
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{
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138,
146
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{
"id": "DerAnaesthesist.50440478.eng.abstr-s2-t3",
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"text": [
"surgery"
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[
187,
194
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{
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]
},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"evoked potentials"
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60,
77
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"db_id": "C0015214"
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{
"id": "DerAnaesthesist.50440478.eng.abstr-s2-t5",
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"text": [
"general anaesthesia"
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95,
114
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138,
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s2-t7",
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"text": [
"auditory evoked potentials"
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[
51,
77
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"db_name": "UMLS",
"db_id": "C0015215"
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"sufentanil"
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[
226,
236
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],
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{
"id": "DerAnaesthesist.50440478.eng.abstr-s3-t2",
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"maintenance"
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252,
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s3-t3",
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"sufentanil"
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298,
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s3-t4",
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"surgery"
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"skin"
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[
359,
363
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"db_id": "C0037267"
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s4-t1",
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"sufentanil"
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440,
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s4-t2",
"type": "umlsterm",
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488,
496
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],
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{
"db_name": "UMLS",
"db_id": "C0024903"
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}
] |
[] |
[] |
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{
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{
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},
{
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s2-r13-t6.1-t2.1",
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{
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{
"id": "DerAnaesthesist.50440478.eng.abstr-s2-r15-t2.1-t3.2",
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},
{
"id": "DerAnaesthesist.50440478.eng.abstr-s2-r16-t5.1-t3.2",
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{
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{
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{
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{
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{
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{
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{
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{
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{
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] |
DerAnaesthesist.50440483.eng.abstr
|
DerAnaesthesist.50440483.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440483.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Friedreich's disease is a very rare neurological disorder that causes degeneration of the posterior roots of the spinal nerves and progresses to the anterior roots , even in young adults . Hospital emergency teams face the question of choice of anaesthesia in such patients should general anaesthesia be preferred to regional anaesthesia . We report a 36-year-old patient with spino-cerebellar heredoataxia ( Friedreich's disease ) who underwent a proctological procedure after administration of spinal anaesthesia with 3 mg hyperbaric bupivacaine in a sitting position . Both the intra- and post-operative courses were unremarkable ; in particular , with regard to the underlying neurological disease , no complications were observed ."
],
"offsets": [
[
0,
736
]
]
}
] |
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{
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49,
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},
{
"id": "DerAnaesthesist.50440483.eng.abstr-s1-t3",
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"posterior"
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90,
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{
"id": "DerAnaesthesist.50440483.eng.abstr-s1-t4",
"type": "umlsterm",
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"nerves"
],
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[
120,
126
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},
{
"id": "DerAnaesthesist.50440483.eng.abstr-s1-t5",
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"anterior"
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149,
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"adults"
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180,
186
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"db_id": "C0001675"
}
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},
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"id": "DerAnaesthesist.50440483.eng.abstr-s1-t7",
"type": "umlsterm",
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"neurological disorder"
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36,
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"id": "DerAnaesthesist.50440483.eng.abstr-s1-t8",
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113,
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{
"id": "DerAnaesthesist.50440483.eng.abstr-s2-t1",
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}
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{
"id": "DerAnaesthesist.50440483.eng.abstr-s2-t2",
"type": "umlsterm",
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"emergency"
],
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198,
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"id": "DerAnaesthesist.50440483.eng.abstr-s2-t3",
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"choice"
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235,
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"id": "DerAnaesthesist.50440483.eng.abstr-s2-t5",
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"id": "DerAnaesthesist.50440483.eng.abstr-s2-t6",
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"id": "DerAnaesthesist.50440483.eng.abstr-s3-t2",
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] |
[] |
[] |
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] |
DerAnaesthesist.50440486.eng.abstr
|
DerAnaesthesist.50440486.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440486.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patients who have undergone cardiac surgery with use of extracorporeal circulation frequently reveal marked hypovolaemia in spite of a highly positive fluid balance . This is thought to be due to transient microvascular damage and extravascular fluid shift . Further volume replacement to achieve haemodynamic stability in the postoperative period may cause fluid overload and congestive heart failure . The present study was designed to investigate whether this fluid overload could be avoided by using a hypertonic-hyperoncotic solution ( group I : HHL , 10% hydroxyethylstarch 200/0 . 5 in 7.2% saline ) instead of two different standard colloid solutions ( group II : HA , 5% albumin ; group III : HES , 6% hydroxyethylstarch in 0.9% saline ) ."
],
"offsets": [
[
0,
748
]
]
}
] |
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8
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"surgery"
],
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43
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"fluid balance"
],
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[
151,
164
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"db_id": "C0016284"
}
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},
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"id": "DerAnaesthesist.50440486.eng.abstr-s2-t1",
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"transient"
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],
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],
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{
"id": "DerAnaesthesist.50440486.eng.abstr-s3-t2",
"type": "umlsterm",
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"postoperative"
],
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"id": "DerAnaesthesist.50440486.eng.abstr-s3-t3",
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"type": "umlsterm",
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},
{
"id": "DerAnaesthesist.50440486.eng.abstr-s3-t5",
"type": "umlsterm",
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],
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},
{
"id": "DerAnaesthesist.50440486.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
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"id": "DerAnaesthesist.50440486.eng.abstr-s4-t2",
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],
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}
]
}
] |
[] |
[] |
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] |
DerAnaesthesist.50440493.eng.abstr
|
DerAnaesthesist.50440493.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440493.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Pulse contour cardiac output ( PCCO ) is an easily applicable method for continuous measurement of cardiac output in critically ill patients . Calculation of stroke volume is possible by analysing the area under the systolic part of the arterial pulse pressure waveform together with an individual calibration factor ( Zao ) to account for the individually variable vascular impedance . Since vascular impedance is potentially affected by altered vascular tone , it was the aim of the present study to examine the validity of PCCO in ICU patients receiving various dosages of a variety of vasoactive drugs ."
],
"offsets": [
[
0,
607
]
]
}
] |
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{
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5
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"id": "DerAnaesthesist.50440493.eng.abstr-s1-t2",
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"contour"
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6,
13
]
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{
"id": "DerAnaesthesist.50440493.eng.abstr-s1-t3",
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"method"
],
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[
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"patients"
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132,
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},
{
"id": "DerAnaesthesist.50440493.eng.abstr-s1-t6",
"type": "umlsterm",
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],
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[
14,
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{
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]
},
{
"id": "DerAnaesthesist.50440493.eng.abstr-s1-t7",
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},
{
"id": "DerAnaesthesist.50440493.eng.abstr-s1-t8",
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{
"id": "DerAnaesthesist.50440493.eng.abstr-s2-t1",
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"stroke"
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164
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}
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},
{
"id": "DerAnaesthesist.50440493.eng.abstr-s2-t2",
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"systolic"
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216,
224
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{
"id": "DerAnaesthesist.50440493.eng.abstr-s2-t3",
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},
{
"id": "DerAnaesthesist.50440493.eng.abstr-s2-t4",
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},
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"id": "DerAnaesthesist.50440493.eng.abstr-s2-t5",
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"calibration"
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},
{
"id": "DerAnaesthesist.50440493.eng.abstr-s2-t6",
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},
{
"id": "DerAnaesthesist.50440493.eng.abstr-s2-t7",
"type": "umlsterm",
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"stroke volume"
],
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158,
171
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"id": "DerAnaesthesist.50440493.eng.abstr-s3-t1",
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{
"id": "DerAnaesthesist.50440493.eng.abstr-s3-t2",
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},
{
"id": "DerAnaesthesist.50440493.eng.abstr-s3-t3",
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{
"id": "DerAnaesthesist.50440493.eng.abstr-s3-t5",
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"db_id": "C0013227"
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}
] |
[] |
[] |
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DerAnaesthesist.50440501.eng.abstr
|
DerAnaesthesist.50440501.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440501.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The use of autotransfusion devices is an established method of reducing the need for homologous transfusions in surgery [ 3 , 11 , 13 ] , but technical factors still contraindicate the washing and concentration of blood volumes smaller than 300 ml . Therefore , haemoconcentration of small volumes of salvaged blood , as usually found in paediatric surgery , is considered to be a complicated and questionable practice [ 5 ] . Whereas these amounts of blood loss are easily tolerated by adults , they may necessitate homologous transfusions in paediatric surgery . In a prospective study , we investigated whether a simple technical modification in the processing of salvaged blood could facilitate the use of autotransfusion devices , especially in children ."
],
"offsets": [
[
0,
760
]
]
}
] |
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"id": "DerAnaesthesist.50440501.eng.abstr-s4-r8-t1.1-t2.1",
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DerAnaesthesist.50440531.eng.abstr
|
DerAnaesthesist.50440531.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440531.eng.abstr-passage-0",
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"text": [
"The choice of appropriate anaesthesia in a more or less seriously ill patient requires detailed information on the risk and tolerance of each specific anaesthetic regimen . The objective of this prospective , randomised clinical trial was to test the hypothesis that three regimens of general anaesthesia - neurolept- ( NLA ) , balanced ( BAL ) , and intravenous propofol anaesthesia ( IVA ) - differ with regard to safety and comfort . The criteria for the intraoperative safety and postoperative comfort of the patients were the incidents , events and complications ( IEC ) that required medical treatment as well as the evaluation of postoperative complaints by the patients according to the IEC list and patient questionnaires of the German Society of Anaesthesia and Critical Care Medicine ( DGAI ) ."
],
"offsets": [
[
0,
805
]
]
}
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"anaesthetic"
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151,
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"BAL"
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"id": "DerAnaesthesist.50440531.eng.abstr-s2-t6",
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"text": [
"general anaesthesia"
],
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285,
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"id": "DerAnaesthesist.50440531.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
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209,
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"id": "DerAnaesthesist.50440531.eng.abstr-s3-t3",
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"type": "umlsterm",
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{
"id": "DerAnaesthesist.50440531.eng.abstr-s3-t5",
"type": "umlsterm",
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"complications"
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"id": "DerAnaesthesist.50440531.eng.abstr-s3-t6",
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"IEC"
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{
"id": "DerAnaesthesist.50440531.eng.abstr-s3-t12",
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"id": "DerAnaesthesist.50440531.eng.abstr-s3-t13",
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"id": "DerAnaesthesist.50440531.eng.abstr-s3-t14",
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"id": "DerAnaesthesist.50440531.eng.abstr-s3-t15",
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{
"id": "DerAnaesthesist.50440531.eng.abstr-s3-t17",
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{
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"db_id": "C0010337"
}
]
}
] |
[] |
[] |
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},
{
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{
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] |
DerAnaesthesist.50440545.eng.abstr
|
DerAnaesthesist.50440545.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440545.eng.abstr-passage-0",
"type": "abstract",
"text": [
"After cardiac surgery , transient renal dysfunction often occurs . Regional differentiation of these processes is possible only using invasive techniques , including renal biopsy . Approximately 30 different plasma protein components have been identified in the urine of healthy individuals by means of qualitative and quantitative immunochemical methods . The detection of microalbuminuria has high diagnostic relevance for the early diagnosis of renal damage at a reversible stage . One typical urinary protein is Tamm-Horsfall protein ( THp ) . After histochemical staining of human kidney sections , activity is seen in the loop of Henle and initial distal tubule . The assay of -1 microglobulin ( MG ) in urine is considered one of the most efficient laboratory parameters for the diagnosis of tubular lesions . Serum concentrations of -1 MG are less dependent on extrarenal changes than are those of other low-molecular-weight proteins . -2 MG is also one of the standards used in recent years for diagnostic relevance . Urinary albumin excretion , normaly less than 30 mg per day , sometimes increases after glomerular damage . Some renal function tests are used daily in many intensive care units , e.g. creatinine clearance ( CCr ) or urea and sodium excretion . Renal dysfunction should , however , be further examined to localise regional damage and to seek new clinical standards in addition to the conventional tests ."
],
"offsets": [
[
0,
1431
]
]
}
] |
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"id": "DerAnaesthesist.50440545.eng.abstr-s6-t3",
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] |
[] |
[] |
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] |
DerAnaesthesist.50440552.eng.abstr
|
DerAnaesthesist.50440552.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440552.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Oxygen uptake ( V. O2) and carbon dioxide elimination ( V. CO2) can be measured with an indirect calorimeter ; this method is well established in routine monitoring of ICU patients to evaluate metabolic state as a reflection of stress . In various experimental studies it was demonstrated that anaesthetics can influence whole-body metabolism . The purpose of this study was to examine whether indirect calorimetry can be used intraoperatively during routine anaesthesia and whether presumable changes in metabolism can be detected immediately . Abdominal aortic cross-clamping changes circulation , nutritional supply of the lower extremities and thus V. O2 and V. CO2. We therefore used this operation for our study ."
],
"offsets": [
[
0,
719
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440552.eng.abstr-s1-t1",
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],
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0,
6
]
],
"normalized": [
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},
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}
]
},
{
"id": "DerAnaesthesist.50440552.eng.abstr-s1-t2",
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"carbon"
],
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[
27,
33
]
],
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{
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"db_id": "C0007009"
}
]
},
{
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"method"
],
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[
116,
122
]
],
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},
{
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}
]
},
{
"id": "DerAnaesthesist.50440552.eng.abstr-s1-t4",
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"ICU"
],
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[
168,
171
]
],
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}
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},
{
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"patients"
],
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[
172,
180
]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.50440552.eng.abstr-s1-t6",
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"text": [
"stress"
],
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[
228,
234
]
],
"normalized": [
{
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}
]
},
{
"id": "DerAnaesthesist.50440552.eng.abstr-s1-t7",
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"text": [
"carbon dioxide"
],
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[
27,
41
]
],
"normalized": [
{
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}
]
},
{
"id": "DerAnaesthesist.50440552.eng.abstr-s2-t1",
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],
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[
294,
306
]
],
"normalized": [
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}
]
},
{
"id": "DerAnaesthesist.50440552.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"metabolism"
],
"offsets": [
[
332,
342
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025519"
},
{
"db_name": "UMLS",
"db_id": "C0025520"
}
]
},
{
"id": "DerAnaesthesist.50440552.eng.abstr-s3-t1",
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[] |
[] |
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DerAnaesthesist.50440566.eng.abstr
|
DerAnaesthesist.50440566.eng.abstr
|
[
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0,
384
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}
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] |
[] |
[] |
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DerAnaesthesist.50440573.eng.abstr
|
DerAnaesthesist.50440573.eng.abstr
|
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"id": "DerAnaesthesist.50440573.eng.abstr-passage-0",
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"Background . Propanidid was widely used as a short-acting i.v. anaesthetic until it was withdrawn due to severe haemodynamic side effects . It was presumed that anaphylactoid reactions with massive histamine release were caused by the solvent cremophor rather than by propanidid itself . A new liposomal preparation of propanidid was examined in this animal study and compared with propanidid in cremophor solution and with propofol ."
],
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[
0,
434
]
]
}
] |
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198,
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"id": "DerAnaesthesist.50440573.eng.abstr-s4-t1",
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] |
[] |
[] |
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] |
DerAnaesthesist.50440581.eng.abstr
|
DerAnaesthesist.50440581.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440581.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Breathing filters or heat and moisture exchangers ( HME ) , which are placed between a tracheal tube and the Y-piece , allow reuse of breathing tubes without changing between operations . During low-flow and minimal-flow anaesthesia , condensed water accumulates in the breathing circuit . An evaluation of the volume of condensed water is given ( Fig . 1 ) . It may be possible that water flows onto the filter surface , for example , when the breathing tubes are lifted . The water permeability of such breathing filters and HME was tested . For the experiments , a commercial breathing circuit and ventilator ( Draeger Sulla 808+Ventilog) and patient model ( Fig . 2 ) were used ; 12 breathing filters/HMEs of different manufacturers were tested . Only 3 filters were not permeable to the test volume of 20 ml water . The authors suggest the water volume be checked routinely and the breathing tubes be emptied if necessary ."
],
"offsets": [
[
0,
928
]
]
}
] |
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"id": "DerAnaesthesist.50440581.eng.abstr-s1-t2",
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"operations"
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{
"id": "DerAnaesthesist.50440581.eng.abstr-s2-t1",
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"text": [
"water"
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"id": "DerAnaesthesist.50440581.eng.abstr-s3-t1",
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"text": [
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"id": "DerAnaesthesist.50440581.eng.abstr-s6-t2",
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"text": [
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{
"id": "DerAnaesthesist.50440581.eng.abstr-s7-t2",
"type": "umlsterm",
"text": [
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"id": "DerAnaesthesist.50440581.eng.abstr-s10-t2",
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] |
[] |
[] |
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}
] |
DerAnaesthesist.50440585.eng.abstr
|
DerAnaesthesist.50440585.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440585.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Adverse effects of resuscitation due to closed-chest cardiac massage are common , and the incidence is increased when an incorrect technique is used . Nevertheless , thrombolytic therapy of a myocardial infarction can become necessary even after cardiopulmonary resuscitation ( CPR ) . In these patients , the risk of thrombolytic therapy-induced bleeding is immanent ."
],
"offsets": [
[
0,
369
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-t1",
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"resuscitation"
],
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[
19,
32
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{
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"db_id": "C0035273"
}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"closed-chest"
],
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[
40,
52
]
],
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{
"db_name": "UMLS",
"db_id": "C0039992"
}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"massage"
],
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[
61,
68
]
],
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{
"db_name": "UMLS",
"db_id": "C0024875"
}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"incidence"
],
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[
90,
99
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],
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{
"db_name": "UMLS",
"db_id": "C0220856"
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{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"technique"
],
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[
131,
140
]
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{
"db_name": "UMLS",
"db_id": "C0025664"
}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"Adverse effects"
],
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[
0,
15
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{
"db_name": "UMLS",
"db_id": "C0001688"
}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"cardiac massage"
],
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[
53,
68
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],
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{
"db_name": "UMLS",
"db_id": "C0018807"
}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"thrombolytic"
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166,
178
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-t2",
"type": "umlsterm",
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"therapy"
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179,
186
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{
"db_name": "UMLS",
"db_id": "C0087111"
},
{
"db_name": "UMLS",
"db_id": "C0039798"
}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"infarction"
],
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[
203,
213
]
],
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{
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"db_id": "C0021308"
}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-t4",
"type": "umlsterm",
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"resuscitation"
],
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[
262,
275
]
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{
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}
]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-t5",
"type": "umlsterm",
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"CPR"
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[
278,
281
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{
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]
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-t6",
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166,
186
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"db_id": "C0040044"
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-t7",
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192,
213
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-t8",
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"cardiopulmonary resuscitation"
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246,
275
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],
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},
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"id": "DerAnaesthesist.50440585.eng.abstr-s3-t1",
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"patients"
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295,
303
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],
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s3-t2",
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310,
314
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s3-t3",
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318,
330
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s3-t4",
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[
310,
317
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0035647"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r1-t5.1-t6.1",
"type": "result_of",
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{
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},
{
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{
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r5-t5.1-t3.1",
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{
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{
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{
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{
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r11-t3.1-t5.1",
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r12-t4.1-t3.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r13-t6.1-t5.1",
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r14-t4.1-t5.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r15-t4.1-t2.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r16-t6.1-t3.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r17-t1.1-t6.1",
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"arg2_id": "DerAnaesthesist.50440585.eng.abstr-s2-t6",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r18-t6.1-t1.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r19-t1.1-t5.1",
"type": "associated_with",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s1-r20-t2.1-t3.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r1-t2.1-t7.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r2-t7.1-t2.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r3-t2.1-t6.1",
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"arg2_id": "DerAnaesthesist.50440585.eng.abstr-s2-t6",
"normalized": []
},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r4-t2.1-t5.1",
"type": "associated_with",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r5-t2.1-t4.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r6-t1.1-t7.1",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r7-t1.1-t2.1",
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r8-t2.1-t7.1",
"type": "degree_of",
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},
{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r9-t7.1-t2.1",
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{
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r11-t7.1-t6.1",
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r12-t7.1-t5.1",
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{
"id": "DerAnaesthesist.50440585.eng.abstr-s2-r13-t7.1-t4.1",
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"id": "DerAnaesthesist.50440585.eng.abstr-s2-r14-t2.1-t8.1",
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"normalized": []
}
] |
DerAnaesthesist.50440590.eng.abstr
|
DerAnaesthesist.50440590.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440590.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Epidemiologic studies have shown that trace concentrations of inhalation anaesthetics polluting the air of operating theatres could have deleterious effects on the personnel's health . Nitrous oxide ( N2O) oxidises vitamin B12 and thus decreases DNA production by inactivation of methionine synthase . Therefore , the United States and most European health authorities recommend threshold values to protect against potential health risks . These values range from 25 to 100 ppm , expressed as time-weighted averages ( TWA ) . There is a lack of data concerning measurements of trace concentrations under defined conditions . The aim of this study was to quantify levels of N2O in a recovery room ( RR ) with an air conditioning system ."
],
"offsets": [
[
0,
736
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440590.eng.abstr-s1-t1",
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"text": [
"Epidemiologic"
],
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[
0,
13
]
],
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"db_name": "UMLS",
"db_id": "C0014508"
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{
"id": "DerAnaesthesist.50440590.eng.abstr-s1-t2",
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"concentrations"
],
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[
44,
58
]
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{
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"db_id": "C0086045"
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{
"id": "DerAnaesthesist.50440590.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"inhalation"
],
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[
62,
72
]
],
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"db_id": "C0004048"
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"id": "DerAnaesthesist.50440590.eng.abstr-s1-t4",
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] |
DerAnaesthesist.50440613.eng.abstr
|
DerAnaesthesist.50440613.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440613.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Oesophageal malposition of an endotracheal tube is among the leading causes of anaesthesia incidents . While clinical manoeuvres for detection of tube malposition are unreliable , monitoring ( i.e. capnography ) can prevent such incidents . The problem is particularly important in prehospital care , where capnography is not ( yet ) widely available . We tested three devices used for differentiating oesophageal from endotracheal intubation : 1. Non-CO2dependent Oesophageal Detector Device ( ODD ) as described by Pollard and Wee , 2. Semi-quantitative chemical disposable capnometer EasyCAP ( Nellcor ) , 3. Non-quantitative infrared miniaturised capnometer MiniCAP ( MSA ) ."
],
"offsets": [
[
0,
679
]
]
}
] |
[
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"Oesophageal"
],
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[
0,
11
]
],
"normalized": [
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"db_id": "C0014852"
}
]
},
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"id": "DerAnaesthesist.50440613.eng.abstr-s1-t2",
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"text": [
"causes"
],
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[
69,
75
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0015127"
}
]
},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s3-t1",
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"text": [
"care"
],
"offsets": [
[
294,
298
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0150499"
}
]
},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"devices"
],
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[
369,
376
]
],
"normalized": [
{
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},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-t2",
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"text": [
"oesophageal"
],
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[
402,
413
]
],
"normalized": [
{
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}
]
},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-t3",
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"text": [
"intubation"
],
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[
432,
442
]
],
"normalized": [
{
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"db_id": "C0021925"
}
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},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-t4",
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"Non-CO2dependent"
],
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[
448,
464
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],
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{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"Oesophageal"
],
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[
465,
476
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0014852"
}
]
},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"Device"
],
"offsets": [
[
486,
492
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0699733"
},
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-t7",
"type": "umlsterm",
"text": [
"Wee"
],
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"id": "DerAnaesthesist.50440613.eng.abstr-s4-t8",
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] |
[] |
[] |
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{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-r14-t6.1-t3.1",
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{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-r15-t3.1-t1.1",
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{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-r16-t8.1-t6.1",
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},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-r17-t3.1-t6.1",
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"arg2_id": "DerAnaesthesist.50440613.eng.abstr-s4-t6",
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},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-r18-t4.1-t5.1",
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},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-r19-t8.1-t1.1",
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},
{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-r20-t3.1-t1.1",
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"id": "DerAnaesthesist.50440613.eng.abstr-s4-r21-t1.1-t3.1",
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{
"id": "DerAnaesthesist.50440613.eng.abstr-s4-r22-t5.1-t8.1",
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"arg2_id": "DerAnaesthesist.50440613.eng.abstr-s4-t8",
"normalized": []
}
] |
DerAnaesthesist.50440631.eng.abstr
|
DerAnaesthesist.50440631.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440631.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Objective . To demonstrate the safety of autologous blood donation in an obstetric practice ."
],
"offsets": [
[
0,
93
]
]
}
] |
[
{
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"Objective"
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[
0,
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"db_id": "C0018017"
}
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},
{
"id": "DerAnaesthesist.50440631.eng.abstr-s2-t1",
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"text": [
"safety"
],
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31,
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]
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]
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{
"id": "DerAnaesthesist.50440631.eng.abstr-s2-t2",
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"blood"
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"db_name": "UMLS",
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}
]
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{
"id": "DerAnaesthesist.50440631.eng.abstr-s2-t3",
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"blood donation"
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52,
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]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005794"
}
]
}
] |
[] |
[] |
[] |
DerAnaesthesist.50440634.eng.abstr
|
DerAnaesthesist.50440634.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440634.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The following double-blind , randomised study dealt with three questions : ( 1 ) Is a multidimensional psychometric rating scale suitable for the measurement of mood before anaesthesia ? ( 2 ) What are the effects of the new benzodiazepine-like drug zolpidem on preoperative mood compared with phenobarbital ? ( 3 ) Is the combination with Promethazine suggestive ?"
],
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[
0,
365
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440634.eng.abstr-s1-t1",
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"text": [
"psychometric"
],
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103,
115
]
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"id": "DerAnaesthesist.50440634.eng.abstr-s1-t2",
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"scale"
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[
123,
128
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"id": "DerAnaesthesist.50440634.eng.abstr-s1-t3",
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"measurement"
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146,
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]
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{
"id": "DerAnaesthesist.50440634.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"mood"
],
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[
161,
165
]
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{
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}
]
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{
"id": "DerAnaesthesist.50440634.eng.abstr-s2-t1",
"type": "umlsterm",
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"benzodiazepine-like"
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"id": "DerAnaesthesist.50440634.eng.abstr-s2-t2",
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"drug"
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]
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"db_id": "C0013227"
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{
"id": "DerAnaesthesist.50440634.eng.abstr-s2-t3",
"type": "umlsterm",
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"zolpidem"
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"id": "DerAnaesthesist.50440634.eng.abstr-s2-t4",
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"mood"
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275,
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},
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"id": "DerAnaesthesist.50440634.eng.abstr-s2-t5",
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"phenobarbital"
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294,
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"db_id": "C0031412"
}
]
},
{
"id": "DerAnaesthesist.50440634.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"Promethazine"
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[
340,
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"db_id": "C0033405"
},
{
"db_name": "UMLS",
"db_id": "C0699545"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.50440634.eng.abstr-s1-r1-t3.1-t4.1",
"type": "measurement_of",
"arg1_id": "DerAnaesthesist.50440634.eng.abstr-s2-t3",
"arg2_id": "DerAnaesthesist.50440634.eng.abstr-s2-t4",
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},
{
"id": "DerAnaesthesist.50440634.eng.abstr-s1-r2-t3.1-t4.1",
"type": "measures",
"arg1_id": "DerAnaesthesist.50440634.eng.abstr-s2-t3",
"arg2_id": "DerAnaesthesist.50440634.eng.abstr-s2-t4",
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},
{
"id": "DerAnaesthesist.50440634.eng.abstr-s1-r3-t1.1-t4.1",
"type": "measures",
"arg1_id": "DerAnaesthesist.50440634.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440634.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.50440634.eng.abstr-s1-r4-t1.1-t3.1",
"type": "measures",
"arg1_id": "DerAnaesthesist.50440634.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440634.eng.abstr-s2-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440634.eng.abstr-s1-r5-t1.1-t2.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.50440634.eng.abstr-s3-t1",
"arg2_id": "DerAnaesthesist.50440634.eng.abstr-s2-t2",
"normalized": []
}
] |
DerAnaesthesist.50440651.eng.abstr
|
DerAnaesthesist.50440651.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440651.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Oxygen radicals and oxygen radial mediators are thought to be important components in the development of acute lung injury , sepsis , and multiple organ failure . Injured patients , patients with pulmonary diseases , and multiple trauma patients also showed an elevated lipid peroxidation , indicating increased oxidant stress . N-Acetylcysteine ( NAC ) has been used as an antioxidant in a wide variety of experiments . NAC has been suggested to act by raising concentrations of cysteine , and hence glutathione , and by scavenging of oxidant species [ 1 , 11 , 17 , 29 ] . The present study was designed to investigate whether the application of NAC in intubated patients has an effect on concentrations of reduced glutathione in plasma and bronchoalveolar lavage fluid ( BAL ) and on the lipid peroxidation products malondialdehyde and conjugated dienes . Because NAC has been widely used as a mucolytic drug for the treatment of lung diseases , the influence on tracheobronchial mucus was studied , too ."
],
"offsets": [
[
0,
1008
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Oxygen"
],
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[
0,
6
]
],
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{
"db_name": "UMLS",
"db_id": "C0030054"
},
{
"db_name": "UMLS",
"db_id": "C0184633"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"oxygen"
],
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[
20,
26
]
],
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{
"db_name": "UMLS",
"db_id": "C0030054"
},
{
"db_name": "UMLS",
"db_id": "C0184633"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"mediators"
],
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[
34,
43
]
],
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{
"db_name": "UMLS",
"db_id": "C0127400"
}
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},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"development"
],
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[
90,
101
]
],
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{
"db_name": "UMLS",
"db_id": "C0243107"
},
{
"db_name": "UMLS",
"db_id": "C0020119"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"lung"
],
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[
111,
115
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0024109"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"injury"
],
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[
116,
122
]
],
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{
"db_name": "UMLS",
"db_id": "C0175677"
},
{
"db_name": "UMLS",
"db_id": "C0021501"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"sepsis"
],
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[
125,
131
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0243026"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"acute lung injury"
],
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[
105,
122
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0242488"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"multiple organ failure"
],
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[
138,
160
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0026766"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
171,
179
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"patients"
],
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[
182,
190
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"diseases"
],
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[
206,
214
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0012634"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"trauma"
],
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[
230,
236
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021501"
},
{
"db_name": "UMLS",
"db_id": "C0043251"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"patients"
],
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[
237,
245
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"lipid"
],
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[
270,
275
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0023779"
}
]
},
{
"id": "DerAnaesthesist.50440651.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
"oxidant"
],
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[
312,
319
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0085403"
}
]
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DerAnaesthesist.50440687.eng.abstr
|
DerAnaesthesist.50440687.eng.abstr
|
[
{
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0,
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[] |
[] |
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DerAnaesthesist.50440695.eng.abstr
|
DerAnaesthesist.50440695.eng.abstr
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[
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[] |
[] |
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] |
DerAnaesthesist.50440700.eng.abstr
|
DerAnaesthesist.50440700.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440700.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In clinical practice , the administration of supplementary albumin often depends on the measured plasma concentration of total protein ( TPC ) . A TPC of less than 5 g/dl is generally accepted as an indication for albumin therapy , assuming an albumin concentration of less than 2.5 g/dl . However , a physiological relation between TPC and albumin cannot be expected in critically ill patients , and thus , measurement of TPC may be misleading as an indicator for the use of albumin . Therefore , we investigated the sensitivity and specificity of TPC testing for diagnosing hypoalbuminaemia requiring treatment ."
],
"offsets": [
[
0,
614
]
]
}
] |
[
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41
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"id": "DerAnaesthesist.50440700.eng.abstr-s1-t2",
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"albumin"
],
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59,
66
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{
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}
]
},
{
"id": "DerAnaesthesist.50440700.eng.abstr-s1-t3",
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"plasma"
],
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"protein"
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"albumin"
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214,
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},
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"id": "DerAnaesthesist.50440700.eng.abstr-s2-t2",
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"therapy"
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222,
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"id": "DerAnaesthesist.50440700.eng.abstr-s2-t3",
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"id": "DerAnaesthesist.50440700.eng.abstr-s2-t4",
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{
"id": "DerAnaesthesist.50440700.eng.abstr-s3-t1",
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341,
348
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"id": "DerAnaesthesist.50440700.eng.abstr-s3-t2",
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},
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"id": "DerAnaesthesist.50440700.eng.abstr-s3-t4",
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"id": "DerAnaesthesist.50440700.eng.abstr-s3-t7",
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371,
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{
"id": "DerAnaesthesist.50440700.eng.abstr-s4-t5",
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518,
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],
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{
"db_name": "UMLS",
"db_id": "C0036668"
}
]
}
] |
[] |
[] |
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] |
DerAnaesthesist.50440705.eng.abstr
|
DerAnaesthesist.50440705.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440705.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This case report describes cerebral monitoring of intracranial haemodynamics using transcranial Doppler sonography ( TCD ) and jugular bulb oxygen saturation ( SjO2) by fiberoptic jugular bulb oximetry during cardiac arrest following cardiac surgery involving cardiopulmonary bypass ( CPB ) . CPB for aortic valve replacement and coronary artery bypass grafting was performed in a 63-year-old patient previously operated upon for heart disease . Mean blood flow velocity was measured in the middle cerebral artery using a bidirectional 2 MHz TCD system . SjO2 was measured using a fiberoptic thermodilution catheter placed in the right jugular bulb via the right internal jugular vein under radiographic control . At the end of the operation , low cardiac output syndrome and cardiac arrest occurred , which required reopening of the thorax and cardiopulmonary resuscitation ( CPR ) until CPB could be resumed . Following extrathoracic cardiac resuscitation , systolic \" spikes \" , loss of the diastolic flow profile , and no increase in SjO2 were recorded by the monitors , indicating cerebral circulatory arrest . However , a normal flow profile with increasing diastolic portions and an increase in SjO2 to 52% were seen following optimisation of the open thorax cardiac resuscitation . This monitoring may be able to give information to optimise therapy during CPR to avoid ischaemic cerebral injury ."
],
"offsets": [
[
0,
1405
]
]
}
] |
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DerAnaesthesist.50440709.eng.abstr
|
DerAnaesthesist.50440709.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440709.eng.abstr-passage-0",
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"text": [
"A pre-term infant weighing 900 g , gestational age 25 weeks , developed an acute abdomen . Intravenous lines had been inserted previously in the left ( silasticcatheter ) and right ( 24 G cannula ) saphenous veins in the neonatal intensive care unit . During surgical exploration , a perforation of the terminal ileum was found . The operation consisted in partial resection of the perforated ileum with an end-to-end anastomosis and a double-lumen colostomy . Major blood loss during the procedure caused serious haemodynamic problems . Despite transfusion of erythrocyte ( 100 ml ) , thrombocytes ( 75 ml ) , and albumin ( 50 ml ) , the patient developed bradycardia and hypotension . Administration of atropine , adrenaline , and calcium IV had no effect . The operation could be finished only with extrathoracic resuscitation . When the drapes were removed , livid , swollen lower limbs raised the suspicion of an acute thrombosis of the inferior vena cava . After insertion of a 24 G IV cannula into a vein of the right upper arm , the circulation stabilised after rapid transfusion of 40 ml blood and 25 ml thrombocytes and resuscitation was successful . Paediatricians and anaesthesiologists must consider the risk of thrombosis of the vena cava . If venous lines in the lower limbs are not visible to the anaesthesiologist during the operation , venipuncture of veins of an upper limb is recommended before starting the surgical procedure . Due to the high incidence of vena cava thrombosis caused by central venous lines and the difficulty of peripheral venipuncture in pre-termintanty , a safe venous line should be inserted if necessary by pre-operative venesection ."
],
"offsets": [
[
0,
1678
]
]
}
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[] |
[] |
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DerAnaesthesist.50440743.eng.abstr
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DerAnaesthesist.50440743.eng.abstr
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[
{
"id": "DerAnaesthesist.50440743.eng.abstr-passage-0",
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"The possibility that a patient during general anaesthesia is aware of the operation going on and aware of severe pain that might be remembered postoperatively must be very alarming to patients and anaesthetists alike . Furthermore , there is experimental evidence showing that conscious recall of intraoperative events is only the tip of an iceberg ; it seems very probable that there is even a higher incidence of unconscious perception during general anaesthesia . Therefore , the following stages of intraoperative awareness must be distinguished : ( 1 ) conscious awareness with explicit recall and with severe pain ; ( 2 ) conscious awareness with explicit recall but no complaints of pain ; ( 3 ) conscious awareness without explicit recall and possible implicit recall ; ( 4 ) subconscious awareness without explicit recall and possible implicit recall ; ( 5 ) no awareness . The incidence of conscious awareness with explicit recall and severe pain has been estimated at less frequent than 1/3000 general anaesthetics . Conscious awareness with explicit recall but no complaints of pain has been reported in the literature with an incidence of 0.5-2%. With 7-72% , conscious awareness without explicit recall and possible implicit recall shows a very wide range of variation and its occurrence probably depends on the anaesthetic drugs used . Subconscious awareness with possible implicit recall has an incidence of up to 80% , but there are many methodological problems in demonstrating implicit memory of intraoperative events . Reports of intraoperative awareness do not come exclusively from cardiac surgery and obstetrics , but also from all other operative specialities . Postoperatively , patients who experienced intraoperative awareness may develop a so-called post-traumatic stress syndrome . Symptoms involve re-experiencing the event awake or in dreams , sleep disturbances , depression , avoidance of stimuli associated with the event . The probability of the development of the post-traumatic stress syndrome seems to coincide with the experience of severe pain . When a patient complains of intraoperative awareness postoperatively the anaesthesiologist should discuss the event frankly with the patient . When the symptoms of the post-traumatic stress syndrome persist a psychotherapy should follow . Causes for intraoperative awareness may be : equipment failure , too-light anaesthesia , e.g. for a caesarean section or for emergency surgery in severely injured or polytraumatized patients , during cardiac surgery , bronchoscopy or difficult intubation . There is interindividual variability in anaesthetic effect ; for example , chronic drug or alcohol abuse or overweight may make increased anaesthetic doses necessary . They are at risk for intraoperative awareness . Some general anaesthetics or anaesthetic procedures , e.g. the combination of a relaxant and N2O, opioid mono-anaesthetics , or opioids combined with benzodiazepines , seem to involve a higher risk of intraoperative awareness than do volatile anaesthetics . The bases of litigation are medical malpractice , breach of contract by the anaesthesiologist or lack of informed consent from the patient . Therefore , patients who are at risk of intraoperative awareness should be given detailed information on this special risk before the operation ."
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DerAnaesthesist.50440755.eng.abstr
|
DerAnaesthesist.50440755.eng.abstr
|
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[] |
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DerAnaesthesist.50440761.eng.abstr
|
DerAnaesthesist.50440761.eng.abstr
|
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"id": "DerAnaesthesist.50440761.eng.abstr-passage-0",
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"Various in vitro models have been introduced for comparative examinations of post-dural-puncture trauma and measurement of liquor leakage through puncture sites . These models allow simulation of subarachnoid , but not of peridural , pressure . A new two-chamber-model realizes the simulation of both subarachnoid and peridural pressure and allows observation of in vitro punctures with video-documentation . Frame grabbing and ( computer-aided ) image analysis show new aspects of spinal puncture effects . Therefore , post-dural-puncture trauma and retraction can be objectively visualized by this method , which has not previously been demonstrated ."
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[] |
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"normalized": []
},
{
"id": "DerAnaesthesist.50440761.eng.abstr-s5-r4-t1.1-t3.1",
"type": "measures",
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"arg2_id": "DerAnaesthesist.50440761.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440761.eng.abstr-s5-r5-t3.1-t2.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.50440761.eng.abstr-s5-t3",
"arg2_id": "DerAnaesthesist.50440761.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.50440761.eng.abstr-s5-r6-t2.1-t3.1",
"type": "evaluation_of",
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"arg2_id": "DerAnaesthesist.50440761.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.50440761.eng.abstr-s5-r7-t1.1-t2.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.50440761.eng.abstr-s5-t1",
"arg2_id": "DerAnaesthesist.50440761.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.50440761.eng.abstr-s5-r8-t3.1-t1.1",
"type": "conceptual_part_of",
"arg1_id": "DerAnaesthesist.50440761.eng.abstr-s5-t3",
"arg2_id": "DerAnaesthesist.50440761.eng.abstr-s5-t1",
"normalized": []
}
] |
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