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Biomedical subjects

C Bastian

Publications and source records attributed to C Bastian.

9 recordsLinked to original sources
PubMed2000

[Endocrine stress parameters during TIVA with remifentanil or sufentanil].

OBJECTIVE: Increases of heart rate and blood pressure during anaesthesia are interpreted as a response to surgical stimulation, although the endocrine response and the cardiovascular reaction can differ markedly. We compared remifentanil and sufentanil as part of a TIVA for retinal surgery with respect to the endocrine stress responses and haemodynamic reactions. METHODS: After ethics committee approval and informed consent, 22 patients (ASA I-III) scheduled for retinal surgery were included in this patient-blind, randomized, prospective parallel-group study and allocated to one of the two groups receiving TIVA with propofol (4 mg/kg/h) and remifentanil (R-group) 0.25 microgram/kg/min, or sufentanil (S-group) 1 microgram/kg before surgery with dosage adjustments according to haemodynamic parameters. Prolactin, growth hormone, cortisol, epinephrine and norepinephrine were measured 60 min before anaesthesia, 30 min after start of surgery and 30 min after extubation. RESULTS: (Significance level: P < 0.05) Only prolactin increased significantly in both groups during the surgical procedure, the S-group showing a greater increase than the R-group. Cortisol and norepinephrine concentrations decreased during surgery in both groups significantly. Growth hormone and epinephrine concentrations only decreased in the S-group during operation while there was no significant change in the R-group. The blood pressure dropped by about 30% in both groups intraoperatively while there was a tendency towards lower heart rates in the R-group with 58/min vs. 64/min in the S-group (mean). CONCLUSION: The increase of prolactin concentrations could be interpreted as a result of the stimulation of mu 1-receptors. As all other measured stress hormones did not increase in both groups, remifentanil and sufentanil both provide an effective suppression of noxious stimulation induced endocrine response.

Aged↗
PubMed1999

Systemic levels of lidocaine after intracameral injection during cataract surgery.

PURPOSE: To evaluate the systemic concentrations of lidocaine after intracameral injection of a 1% solution during cataract surgery and the safety of this application mode. SETTING: Department of Ophthalmology, Medical University of Lübeck, Lübeck, Germany. METHODS: This prospective study included 10 patients who had phacoemulsification and posterior chamber lens implantation with a self-sealing scleral tunnel incision. Topical anesthesia was achieved using cocaine 10% eyedrops combined with 0.5mL of unpreserved lidocaine 1% injected into the anterior chamber. Blood samples were taken from all patients at predetermined intervals before and during the procedure. Consecutive analysis for lidocaine was performed with gas chromatography. RESULTS: In all samples, serum lidocaine concentrations were below a minimum detectable level of 100 ng/mL. No local or systemic intraoperative or postoperative complications were noted. CONCLUSIONS: Intracameral injection of 0.5 mL lidocaine 1% revealed no systemic therapeutic concentrations. In patients in whom other forms of needle-delivered local anesthesia are contraindicated, intracameral injection of lidocaine should be considered to enhance topical anesthesia.

Adult↗
PubMed1997

Patients you know.

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Adaptation, Psychological↗
PubMed1993

Achieving empowerment through information.

Despite the problems we encountered, which are not uncommon with the development and implementation of any data system, we are confident that our success in achieving our goals is due to the following: establishing a reliable information database connecting several related departments; interfacing with registration and billing systems to avoid duplication of data and chance for error; appointing a qualified Systems Manager devoted to the project; developing superusers to include intensive training in the operating system (UNIX), parameters of the information system, and the report writer. We achieved what we set out to accomplish: the development of a reliable database and reports on which to base a variety of hospital decisions; improved hospital utilization; reliable clinical data for reimbursement, quality management, and credentialing; enhanced communication and collaboration among departments; and an increased profile of the departments and staff. Data quality specialists, Utilization Management and Quality Management coordinators, and the Medical Staff Credentialing Supervisor and their managers are relied upon by physicians and administrators to provide timely information. The staff are recognized for their knowledge and expertise in their department-specific information. The most significant reward is the potential for innovation. Users are no longer restricted to narrow information corridors. UNIX programming encourages creativity without demanding a degree in computer science. The capability to reach and use diverse hospital database information is no longer a dream.

Academic Medical Centers↗
PubMed1988

The effect of halothane, enflurane, and isoflurane on RNA synthesis in isolated rat liver cell nuclei.

The effect of halothane, enflurane, and isoflurane inhaled in vivo on the in vitro transcription in isolated liver cell nuclei was studied in female Wistar rats. After 0.45-0.48 MAC of any of the three anesthetics in oxygen for 18 hours, in vitro RNA synthesis increased, a maximum being found on the third day after inhalation of halothane, on the second day in enflurane, and immediately after cessation of inhalation in the case of isoflurane. A similar stimulation of RNA synthesis was observed in rats given phenobarbital in the drinking water. The possibility that the observed increase in the transcription rate is related with enzyme induction is discussed.

Administration, Inhalation↗
PubMed1986

Infant and child nutrition. Controversies and recommendations.

Infant and child nutrition is a topic of great controversy. Investigators disagree on matters such as breast-feeding versus formula-feeding, proper timing and type of solid supplementation, use of cow's milk, and dietary intake of salt, sugar, and fat. Although study results vary, it appears that breast-feeding has substantial benefits, supplementation with solid foods usually can begin between 4 and 8 months of age, and limitation of salt, sugar, and fat intake is appropriate.

Animals↗