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Biomedical subjects

K Strasser

Publications and source records attributed to K Strasser.

47 records · Page 3Linked to original sources
PubMed1975

[Peridural anesthesia in obstetrics (author's transl)].

In German speaking countries peridural anesthesia in obstetrics has been introduced 25 years ago by Anselmino. Because of the increase of operative delivery and the--however rare--serious complications in the mother the technique has been employed less and less. Now, with the introduction of the catheter technique, which renders lower doses of the anesthetic effective and with improved treatment of complications due to it, the technique has become safer for the mother. Anomalies of the position of the fetal head are not more common than in deliveries without peridural anesthesia. But the more frequent need for low forceps delivery remains, since the strain-reflex is abolished, although motorfunction of lower limbs and abdomen are intact. The safe use of peridural anesthesia requires a considerably increased personnel, since the doctor conducting the delivery is only rarely sufficiently qualified in anesthetics and even then should not have to take the responsibility for both delivery and anesthesia. Since we can consider the technique safe for the mother, its effect on the child is predominant interest. Examination of the acid-base metabolism in the fetal blood from the scalp and umbilical cord post-partum has shown favorable results. The effect of complete painlessness on respiration and blood-gases of the mother is of interest (Strasser, Huch, Huch). Further investigations of the effects on fetal heart frequency and its assessment in supine or constant lateral positioning and of the maternal circulation with modern cardiologic techniques have not yet been concluded. On their results will depend, at least in part, the indication for peridural anesthesia in pregnancies and deliveries at risk. Clinical observations and comparison with deliveries under general anesthesia indicate that catheter peridural anesthesia may be advantageous for the child with diabetes, EPH gestosis and prematurity.

Anesthesia, Epidural↗
PubMed1975

[The effect of lumbar peridural anesthesia with catheter on the maternal and fetal acid-base status and the 1 minute apgar score (author's transl)].

Comparison of 650 deliveries with P.A. and of 928 deliveries without P.A. during the same period. PH from the umbilical artery and 1 minute Apgar score were studied in three groups of patients: 1.) All deliveries, 2.) Spontaneous vaginal deliveries without maternal or fetal risk, 3.) Operative vaginal deliveries. The only significant differences were found among the operative vaginal deliveries: The infants of the peridural group showed a higher incidence of pH-values above 7,2 than those of the non peridural group. Analysis of the maternal acid-base status showed less respiratory alcalosis and less metabolic acidosis in the peridural group. The neonates of this group showed a lower post partum metabolic acidosis than those in the non peridural group.

Acid-Base Equilibrium↗
PubMedDate not supplied

Stapling devices in gastrointestinal surgery.

In a series of 189 patients, 197 operations (251 stapled anastomoses) were performed. U.S. Surgical Corporation instruments (GIA n = 156, EEA n = 36, TA n = 59) were used in surgery of the stomach, pancreas, small and large bowel, and the rates of complications were investigated. The EEA gave 14% complications because of the frequent failure (33%) of the anastomosis after low anterior resection. The reasons for failure were incomplete rings, colonic wall damage and too short rectal stumps. The use of the EEA in esophago-jejunostomy and esophago-gastrostomy was safe and the postoperative course uneventful. The GIA was used in intestinal and colonic surgery and was pleasant and quick to use (right hemicolectomy: 1 hour 40 minutes; sigmoid resection: 1 hour 45 minutes). Complications occurred in the intestine (6%) and colon (7%). Only with GIA stapled anastomoses was there a risk of hemorrhage (2.5%). The incidence of anastomotic leakage (all staplers) was 3.6%; the stapler was responsible for a 2.0% mortality. Weighing up the indications and contraindications of stapling devices, this method presents an advantageous but not indispensable method in gastrointestinal surgery.

Adult↗