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G Sprotte

Publications and source records attributed to G Sprotte.

17 recordsLinked to original sources
PubMed1995

[An atraumatic needle for continuous epidural and plexus anesthesia].

The needle type introduced by Edward Tuphy for continuous spinal anaesthesia in 1944 is still used as the standard instrument for epidural anaesthesia up to the present day. Puncture of the dura and severance of the epidural catheter are the typical, though fare, complications of this procedure, giving rise to most of the actions brought for damage suffered during obstetric anaesthesia. The cerebral spinal fluid loss caused by thick needles can have serious consequences, including subdural and intracranial haematoma, cranial nerve pareses, labyrinthine hearing impairments and pneumocephalus. Special Sprotte needle for catheter introduction. In spinal anaesthesia and lumbar puncture the Sprotte needle has proven a very suitable instrument for the CSF loss syndrome and, to a large degree, post-spinal headaches. To adapt the atraumatic properties of this needle point for epidural anaesthesia the needle has been equipped with a plastic ramp to direct catheter insertion, and the opening geometry has been slightly modified for epidural application (see Fig. 1). The lateral catheter channel projects into the base of the needle point, which is thus shortened, and the edges of the needle opening are rounded so that the catheters cannot be severed. This needle bears the type designated "Special Sprotte needle" (EP no. 271715, USP no. 4842585). Needle diameter and application fields. The 1.1-mm (19.5 G) needle with 23-G catheter was introduced for epidural anaesthesia and continuous plexus anaesthesia at the Würzburg University Hospital and has proven itself in routine clinical practice. A 20-G version is being tested with a 25-G catheter for continuous spinal anaesthesia at several centers in USA, because finer spinal catheters are not permitted there by the FDA. For continuous spinal anaesthesia this needle has been available without the modified opening geometry since 1989 in sizes 22 G and 24 G and is wide by used in Europe. CSE technique with special and standard Sprotte needles. Spinal analgesia or anaesthesia) can be performed with the special needle and 123-mm-long 27 G or 29 G standard Sprotte needles before placement of the peridural catheter.

Anesthesia↗
PubMed1990

[Experimental studies on peripheral nerve injuries caused by injection needles].

Differences in neural damage due to different injection needles were investigated in vitro on sciatic nerve specimens of adult rabbits. METHODS. Three types of 22-gauge needles were tested: one typical, long-bevelled venous puncture needle; a short bevelled, typical nerve block needle; and a tapered, atraumatic spinal needle. Both sciatic nerves of 50 adult rabbits weighing from 2.5 to 3.0 kg were used for electrophysiological investigations on one side and fluorescence microscopy on the other. ELECTROPHYSIOLOGY. The nerve specimens were placed in an experimental chamber on silver-silver chloride electrodes that were aligned at a distance of 10 mm. Two electrodes at the distal ends of the nerve were used for stimulation by rectangular waves (6-10 v) of 0.01 ms duration. The compound action potential (CAP), its amplitude, and its latency were measured by monopolar recording from four additional electrodes (R1 to R4). Ten nerves were apportioned to each of five groups and the needles were perpendicularly pierced three times in the middle of the nerve trunk at the midpoint between recording sites R2 and R3. THE GROUPS. 1. Long-bevelled needle, the face of the bevel inserted rectangular to the nerve fibers; 2. long-bevelled needle, the face of the bevel parallel to the nerve fibers; 3. short-bevelled needle, the face of the bevel inserted rectangular to the nerve fibers; 4. short-bevelled needle, the face of the bevel parallel to the nerve fibers; 5. tapered, pencil-point needle pierced perpendicularly through the nerve trunk. The amplitude of the CAP was recorded before and after nerve injury from R1 to R4. FLUORESCENCE MICROSCOPY. According to the method described by Steinwall and Olsson, the other five groups of injured nerves were immersed in Evans blue albumin (EBA) and, after washing in saline solution, fixed in 5% formalin. The extent of nerve damage was evaluated by fluorescence microscopy of the glycerol-imbedded frozen sections (longitudinal and transverse). RESULTS. Electrophysiology. After injuring the area between R2 and R3 there was almost no change in the amplitude of the CAP at sites R1 and R2. The amplitude at R3 and R4 was reduced in comparison with the controls. This reduction was most marked in group 1 and very slight in group 5. The percentages of amplitude at R3 after injury compared with control values (mean +/- SD) were 42.2% +/- 22.0% in group 1; 60.9% +/- 18.2% in group 2; 51.0% +/- 22.3% in group 3; 71.0% +/- 18.0% in group 4; and 90.1% +/- 10.9% in group 5. Statistically significant differences were obtained between the tapered, atraumatic needle group and the other four groups (Fig. 3). Fluorescence microscopy. With the tapered injection needle there was the least leakage of EBA, which suggests the least damage to the perineurium, and almost no rupture or tearing of the nerve fibers was observed. In the short- and long-bevelled needles, the damage was reduced when the face of the bevel was inserted parallel to the fibers.

Action Potentials↗
PubMed1987

[An "atraumatic" universal needle for single-shot regional anesthesia: clinical results and a 6 year trial in over 30,000 regional anesthesias].

The so-called "atraumatic" needle was developed by modification of two essential features of the Whitacre Spinal needle. The new atraumatic needle tip is universally suitable for all single-shot techniques of regional anesthesia. This is the result of a 6-year test period with 34,950 applications of 24- and 22-Gauge needles in spinal anesthesia, diagnostic lumbar puncture, peridural anesthesia, plexus anesthesia, peripheral nerve blocks with a Teflon-coated version (unipolar electrostimulation), and lumbar sympathetic and celiac plexus blocks. Postspinal headache was observed following 0.02% of punctures for anesthetic or diagnostic purposes. Transient monosymptomatic nerve damage occurred in 1 case after axillary block (0.009%). No permanent neurological sequelae were observed due to vascular, neural, or dural lesions. In comparison, 10 cases of persistent traumatic nerve damage were reported to be caused by conventional needles during the last decade. An analysis of these cases reveals some reasons for underestimating the risk of neurological sequelae after regional anesthesia. The routine clinical use of this type of atraumatic needle revealed no disadvantages with regard to efficacy of nerve blocks or training of anesthetists. Due to the extremely low incidence of postspinal headache, this needle has been used for spinal therapy and diagnostic lumbar punctures in outpatient pain therapy for 2 years. As of this time, the overall risk of outpatient lumbar puncture cannot be estimated. Our experience should encourage further controlled studies to evaluate criteria for excluding those patients unsuited for outpatient spinal anesthesia and lumbar puncture.

Anesthesia, Conduction↗
PubMed1986

[Combined infusion analgesia--an alternative concept in postoperative pain therapy].

This is to introduce a combined infusion analgesia for postoperative pain treatment. The analgetic efficiency would increase by combining analgetic substances specifically focussed. This method has the enormous advantage not to be limited to the intensive care; it might be applied to any peripheral surgery. Its main and side effects have been tested in 25 gastrectomized patients, postoperatively.

Analgesics↗
PubMed1982

[Morphological changes after permanent nerve block by freezing and ethanol injection of the sciatic nerve of the rabbit (author's transl)].

Permanent nerve blocks by intraneurally injected alcohol are often complicated by alcohol-neuritis. Encouraging clinical experiences with permanent blocks by freezing raises the question whether morphological differences between the nerve lesions could explain the difference in their side effects. On 30 rabbits both sciatic nerves were blocked after surgical preparation. The one by intraneural injection of 0,5 ml of 96% Ethanol, the other by freezing with a cryoprobe. The resulting degeneration and the beginning of recovery of the nerves was followed by histological evaluations of the sciatic nerves during the first 28 days after the blockade. The nerve lesions of both types of blockade were complete. That produced by the cryoprobe was limited to the small area of local freezing, whereas the alcohol-block produced the same type of nerve degeneration but with a wide-spread extension reaching the sacral plexus. We discuss whether this slight morphological difference might be sufficient to explain the higher complication rate of alcohol blocks.

Animals↗
PubMed1981

[Pre- and postoperative analgesia by lumbar plexus anaesthesia (3 in 1 block) in orthopaedics and traumatology (author's transl)].

The 3 in 1 block provides effective analgesia for the greater part of the lower limb. The technique is simple, it requires no special positioning and because of the favorable anatomical situation of the femoral nerve it has a particularly low complication rate. The prompt administration in the acute situation considerably reduces the symptoms and consequences of traumatic shock. One should always bear in mind this effect regional anaesthetic technique in elderly patients with fractured neck of femur. The 3 in 1 block enables almost painfree positioning of the side for the performance of spinal and epidural anaesthesia. Finally the 3 in 1 block can be a most potent method of analgesia in postoperative pain. With its minimal effects on vasomotor tone and bladder function the 3 in 1 block is in many cases preferable to continuous blockade via an epidural catheter.

Analgesia↗
PubMed1981

[Differential peridural analgesia for vaginal delivery. A randomised study of its influence on the progress and mode of delivery (author's transl)].

This randomised study of 611 deliveries deals with the side effects of a modified extradural analgesic technique. The modification is based on a flexible reduction of local anaesthetic concentration (bupivacaine) which allows a reliable analgesia without a marked loss of labour sensation and bearing down reflex. Randomisation was achieved by offering this analgesia to the parturients in an alternating 24 hours rhythm. Statistical comparisons were carried out for the following groups of deliveries: 1. for deliveries on both of the two alternating days (Group A). 2. for deliveries with and without extradural analgesia of the peridural days (Group B). - 3. for all deliveries with and without extradural analgesia (Group C). - 4. For deliveries without extradural analgesia on "peridural days" and on "alternating days" (Group D). - The main subjects of investigation were the duration of the two stages of delivery, the dynamics of both the cervical dilation and the movement of the fetal head and the frequency, modes and causes of operative and instrumental deliveries. The safety of the analgesic technique was investigated by evaluating its influence on the status of the newborn and on the maternal regulation of body temperature and circulation. The results were obtained as follows: 1. In the group of parturients who had chosen extradural analgesia several antenatal factors accumulated which evidently had a greater influence on the course of delivery than the analgesic technique itself. - 2. The low concentration of local anaesthetic adapted to the labour pain produced a sufficient analgesia in almost every case. - 3. The duration of both stages of delivery was not altered directly by this technique. An average increase of the duration of the second stage by 116 minutes was due to postponed indications of instrumental and operative deliveries by analgesia. - 4. There was no influence on the overall frequency of operative and instrumental deliveries. Extradural analgesia, however, significantly reduced the frequency of caesarean sections to the same extent as it increased instrumental deliveries from the bottom of the pelvis. - 5. The extradural analgesia had no influence on the status of the newborn. - 6. The regulatory mechanisms of circulation and body temperature were not altered by this dosage of extradural analgesia.

Adult↗
PubMed1980

[The vacuum jointed bed in intensive care and regional anaesthesia (author's transl)].

The usefulness of the vacuum jointed mattress was tested over a period of one year. Originally intended for first-aid service it has proved an effective aid in regional anaesthesia and surgical operations. In intensive care units the mattress has its merits in a preventing bed sores and keeping the patient in any position desired. Technical improvements would add to its usefulness.

Anesthesia, Conduction↗
PubMedDate not supplied

[Differential anesthetic block].

The concept of differential action of local anaesthetics on nerve fibers of different size is falsified by experiment. The temporal succession of alteration in perception is to be explained by changes at higher levels of integration.

Adult↗