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  • 1
    Electronic Resource
    Electronic Resource
    Gefahren milder perioperativer Hypothermie (1999)
    Springer
    Der Anaesthesist 48 (1999), S. 727-732 
    Details
    ISSN: 1432-055X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050777
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  • 2
    Electronic Resource
    Electronic Resource
    Clinical evaluation of a new epidural pressure monitor (1993)
    Springer
    Acta neurochirurgica 125 (1993), S. 169-172 
    Details
    ISSN: 0942-0940
    Keywords: Epidural pressure ; ventricular pressure ; intracranial pressure monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Comparative measuring of epidural pressure using the Spiegelberg probe 1 and ventricular fluid pressure was carried out in 15 neurosurgical intensive-care patients. Deviations in both directions were established, with a trend toward overestimating ventricular pressure in epidural pressure measuring (r=0.77). Individual pulsations, spontaneous wave courses and therapy-induced pressure changes were reflected without delays. There were no complications observed with probe implantation periods for up to 6 days. The system has been shown to be mechanically stable and easy to implant. We believe the device to be fit for trend monitoring of intracranial pressure. As with other epidural pressure monitoring systems, false assessments of ventricular pressure may lead to wrong decisions as to the required therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401846
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  • 3
    Electronic Resource
    Electronic Resource
    The level of neuromuscular block needed to suppress diaphragmatic movement during tracheal suction in patients with raised intracranial pressure: a study with vecuronium and atracurium (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 48 (1993), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The effects of tracheobronchial suction before and after neuromuscular blockade with vecuronium (0.12 mg.kg−1; ED95 X 2; group A) and atracurium (0.4 mg.kg−1; ED95 X 2; group B) on intracranial pressure were studied in 18 neurosurgical patients with a Glasgow Coma Scale 〈 7. Despite adequate sedation, moderate to severe diaphragmatic movements (bucking and coughing) in response to carinal stimulation with significant increases in intracranial pressure (A: 18 SD 7 to 24 SD 8 mmHg; B: 19 SD 7 to 27 SD 5 mmHg) and subsequent decreases in cerebral perfusion pressure (group A: 69 SD 11 to 63 SD 8 mmHg; group B: 63 SD 11 to 59 SD 17 mmHg) could be observed without muscle relaxation. After a bolus dose of vecuronium or atracurium, profound neuromuscular paralysis quantified by the post-tetanic count, was observed after an onset time of 253 SD 72 s (vecuronium) and 159 SD 54 s (atracurium). Slight diaphragmatic movements could be elicited in only two patients in group A and in two patients in group B during tracheal suction; intracranial pressure (group A: 20 SD 8 to 20 SD 8 mmHg; group B: 19 SD 7 to 19 SD 7 mmHg) and cerebral perfusion pressure (group A: 65 SD 13 to 65 SD 13 mmHg; group B: 66 SD 12 to 65 SD 11 mmHg) remained unchanged. When coordinating respiratory therapy in neurosurgical intensive care patients, profound neuromuscular block, quantified by a post-tetanic count of at least 5 for vecuronium and 1 for atracurium, it is necessary to rule out any impact of diaphragmatic movement on intracranial pressure. Repeated neurological evaluation was not inhibited when utilising an intermittent bolus-dose regimen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1993.tb06947.x
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  • 4
    Electronic Resource
    Electronic Resource
    Coeliac plexus block with bupivacaine reduces intestinal dysfunction in neurosurgical ICU patients (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 48 (1993), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Coeliac plexus block, an established method of treatment for pain associated with pancreatitis and cancer, was used in neurosurgical patients with gastrointestinal dysfunction. The study was performed in 16 patients whose gastric reflux volume exceeded 600 ml per day for 3 consecutive days. Patients were allocated to a block group (n = 8) or a control group (n = 8). Coeliac plexus block was accomplished with a modified Moore technique using 50 ml bupivacaine 0.25%. In the block group, gastric reflux volumes for 3 days preceding coeliac plexus block and 3 consecutive days following coeliac plexus block were analysed. In the control group, gastric reflux volumes were observed over a period of 6 days. Mean (Sem) gastric reflux volume decreased significantly following coeliac plexus block from 770 (50) ml to 60 (30) ml (p 〉 0.01). In the control group, gastric reflux remained unchanged over the corresponding periods (730 (60) ml c.f. 670 (50) ml). The response of gastric reflux volume to coeliac plexus block suggests that the mechanism is related to inhibition of sympathetic activity in patients whose sympathetic drive is increased due to the underlying neurological disease, and possibly due to sedation withdrawal symptoms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1993.tb06860.x
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  • 5
    Electronic Resource
    Electronic Resource
    Clonidine: an adjunct in isoflurane N2O/O2 relaxant anaesthesia (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 50 (1995), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We investigated the effect of clonidine in 19 patients having lumbar disc surgery under nitrous oxide/isoflurane/relaxant anaesthesia. The EEG, spinal and cortical somatosensory evoked potentials, and the brainstem auditory evoked potentials were recorded. After equilibration of the general anaesthetic, two successive infusions of clonidine (5μg.kg-1) were given. After the second infusion of clonidine, the plasma concentration increased from 0.2(SEM 0.05) to 6.4(SEM 0.06) ng.ml-1 (p 〈 0.05). In the EEG, δ-activity was maintained, but the β-fraction, and the 95% and 50% spectral frequencies were reduced. Total EEG power progressively decreased from 296(152-397) μV2 to 108(51-240) μV2. The somatosensory evoked spinal potential (N13) decreased in amplitude, (1.77(SEM 0.35) μV to 1.59(SEM 0.35) μV, p 〈 0.05) and increased in latency (14.37(SEM 0.29)ms to 14.69(SEM 0.31)ms, p 〈 0.05). The central conduction time increased from 6.47(SEM 0.16)ms to 6.92(SEM 0.25)ms, ns. There was no effect on the cortical somatosensory potentials, or the brainstem auditory evoked potentials. According to the EEG spectral indices, anaesthesia appeared to deepen despite a reduction in the end expiratory isoflurane concentration from 0.53(SEM 0.07) to 0.28(SEM 0.06)vol%, which indicated a reduction in anaesthetic requirements following clonidine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1995.tb04601.x
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  • 6
    Electronic Resource
    Electronic Resource
    Effect of sufentanil on intracranial pressure in neurosurgical patients (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 46 (1991), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The effects of sufentanil on intracranial pressure, mean arterial pressure, cerebral perfusion pressure and heart rate were studied in 20 neurosurgical intensive care unit patients. Epidural intracranial pressure probes were implanted in patients who suffered head injury, intracerebral haemorrhage or underwent tumour resection. Sufentanil was given intravenously in sequential doses of 0.5, 1.0 and 2.0 μg/kg. Fifteen minutes elapsed after each dose. The patients were allocated to either group 1 (baseline intracranial pressure 〈 20 mmHg) or group 2 (baseline intracranial pressure 〉 20mmHg). Intracranial pressure did not change significantly in either group. Therefore the falls in mean arterial pressure with the highest dose in both groups and with 1.0 μg/kg in group 2, closely reflect corresponding reductions in cerebral perfusion pressure. As sufentanil in itself exerts no effects on intracranial pressure, concomitant haemodynamic changes are the critical factor for an adequate cerebral perfusion pressure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1991.tb09596.x
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