Biomedical subjects

G Hossli

Publications and source records attributed to G Hossli.

At least 37 records · Page 2Linked to original sources

PubMed1977

[Anaesthesia with flunitrazepam (rohypnol) and fentanyl for geriatric patients (author's transl)].

Favorable clinic experiences with an anaesthetic involving rohypnol (flunitrazepam) and fentanyl led to an investigation of the haemodynamic effect of this procedure in a group of 9 geriatric patients, aged from 86 to 95 years. Anaesthesia was induced with 0.5 mg rohypnol and 0.1 to 0.2 mg fentanyl depending on the narcotic effect of rohypnol, intubation was performed under relaxation with suxamethonium and long term relaxation was achieved with pancuronium. The patients were normoventilated with nitrous oxide/oxygen. The individual values of the changes in cardiac output and total peripheral resistance showed a great variation. There was a significant correlation between the relative changes in mean arterial pressure and total peripheral resistance (r = 0.69, p less than 0.05) but no correlation between mean arterial pressure and cardiac output (r = 0.09). This indicates that the pronounced drop in arterial pressure which occurred in 4 patients can be explained by a decrease in total peripheral resistance. Careful dosage of the drugs, in particular of fentanyl, and knowledge of adequate measures to treat a decrease in blood pressure if it occurs, appears to be a prerequisite for the use of this type of anaesthesia in poor risk patients.

Age Factors↗

PubMed1977

[Hematological studies on changes caused by warming of the blood with microwaves].

Our examinations have shown, that through warming of blood with the micro-wave device "Haemotherm" there were no serious haematological alterations to be proved. The "Haemotherm" device can therefore be recommended as a useful and riskless equipment for warming blood in the usually used plastic covers during massive transfusions.

Blood Coagulation↗

PubMed1976

[Malignant hyperthermia: attempt at an early diagnosis by means of determination of creatine phosphokinase (CPK) and its isoenzymes].

Creatinphosphokinase (CPK) was elevated in sera of patients with malignant hyperthermia and in sera of some of their relatives. Only the MM-isoenzyme (but not the MB- or the BB-isoenzyme) could be detected by paperchromatographic analysis. In some of the patients elevation of muscle aldolase was also observed. Thus, the appearance of the BB-isoenzyme in sera of patients with malignant hyperthermia, as described by another group of investigators, was not confirmed. No specific screening method exists as yet to detect patients with a high risk of developing this often lethal reaction to anesthesia. However, in patients without muscle disease or trauma and without prior i.m. injections, myocardial infarction or major physical strain, elevation of CPK in serum should be interpreted as meaning that malignant hyperthermia may develop during anesthesia. The pathophysiology of malignant hyperthermia is discussed.

Creatine Kinase↗

PubMed1976

[Effect of volume substitution with dextran on the haemodynamics under enflurane anaesthesia in geriatric patients (author's transl)].

The haemodynamic effect of enflurane has been examined in two groups of geriatric patients, one with and the other without preanaesthetic administration of 15 mg/kg of 1,8% dextran in lactated Ringer's solution. All the patients have been immobilized for 2 to 3 days before they were operated for an orthopaedic procedure. The administration of the colloidal solution led only to minor cardiovascular alterations: a rise of central venous pressure by 6 +/- 1 (+/- S.E.M.) cm H2O, an increase of mean arterial pressure by 6 +/- 2%, an increase of cardiac output by 10 +/- 4%. Heart rate decreased by 5 +/- 4% and total peripheral resistance by 12 +/- 5%. The cardiovascular depressant effect of enflurance was markedly attenuated by the preanaesthetic volume administration. Mean arterial pressure decreased during anaesthesia by only 16 +/- 3%, as compared with a decrease of 25 +/- 7% in the control group, cardiac output remained virtually unchanged (-3 +/- 9% vs. -37 +/- 5% in the controls) and total peripheral resistance decreased not significantly by 10 +/- 12%, while it rose in the controls by 20 +/- 8%. These findings support the hypothesis that the particular sensitivity of geriatric patients towards the depressant effects of anaesthetics is at least partially due to a compensated hypovolaemia which occurs as a physiological adaptation to immbolization. Enflurane appears as a suitable anaesthetic for geriatric patients, if proper measures for preanaesthetic volume substitution are taken.

Age Factors↗

PubMed1975

[Effect of ethrane on the circulatory parameters of geriatric patients (author's transl)].

The cardiovascular effects of enflurane in geriatric patients have been compared with the effects of this anaesthetic agent in a group of young patients. The degree of cardiovascular depression in geriatric patients was much greater than in the young patients despite the smaller inspired concentration of enflurane necessary to produce a similar depth of anaesthesia. In comparison with halothane and neuroleptanaesthesia, enflurane produced the greatest decrease in cardiac output. The mean arterial pressure, however, was quite well maintained due to a simultaneous increase in total peripheral resistance.

Adult↗

PubMed1974