PubMed Health⌕ Search

Biomedical subjects

M S Hüttel

Publications and source records attributed to M S Hüttel.

At least 19 recordsLinked to original sources
PubMed1996

[Rational transfusion therapy. A study of transfusion practice and possibilities of optimization in elective coronary bypass surgery].

The objective of the study was to evaluate the effect of intervention on physicians' transfusion behavior in elective coronary artery bypass grafting (CABG). We analyzed transfusion data on 176 patients who underwent primary elective CABG during two periods, either before (phase one, n = 102) or after (phase two, n = 74) intervention. The intervention was based on cooperation with the involved department of cardiac surgery, interviews of the surgeons and anaesthesiologists ordering blood, and concurrent audit of transfusion practice using a blood order form. The proportion af patients receiving allogenic transfusions decreased from 90% in phase one to 58% in phase two and the total use of blood components was reduced from an average of 6.3 units/patient to 2.7 units/patient, p < 0.01. Indications for transfusion documented in the medical record increased from 19% in phase one to 63% in phase two. It is concluded that intervention on physicians' transfusion behavior can improve the transfusion therapy in patients who undergo elective CABG.

Adult↗
PubMed1993

Immunological and hormonal responses to lung surgery during one-lung ventilation.

The effects of lung surgery performed during one-lung ventilation and the associated endocrine stress response on natural killer (NK) cell activity and the distribution of white blood cells in peripheral blood were studied in 10 patients with malignant lung tumours. Patients were anaesthetized with general anaesthesia combined with thoracic epidural anaesthesia. The endocrine response was measured as changes in serum cortisol, plasma adrenaline and noradrenaline. A significant decrease of NK cell activity was found post-operatively accompanied by leucocytosis, neutrophilia and lymphopenia. Significant increases in serum cortisol were demonstrated at the end of operation and throughout the study period. Plasma adrenaline increased significantly during one-lung ventilation with a gradual normalization post-operatively. Plasma noradrenaline increased significantly during the whole post-operative course. In conclusion, lung surgery was accompanied by similar changes in NK cell activity, leucocyte and differential counts, serum cortisol and plasma adrenaline levels as demonstrated after other types of major surgery. The elevated noradrenaline level post-operatively is a new observation that may be specific for lung surgery.

Adult↗
PubMed1987

Natural killer cell activity in patients undergoing minor gynaecological surgery.

Natural killer (NK) cell activity was investigated in 24 patients who were undergoing minor gynaecological surgery performed during neurolept, halothane or spinal anaesthesia. The endocrine response to anaesthesia and surgery was monitored using serum cortisol and plasma catecholamine estimations. The surgical trauma was insufficient to elicit an endocrine stress response. No changes in NK cell cytotoxicity occurred in any group during premedication, anaesthesia or surgery. Post-operatively the NK cell activity fell transiently in the two groups that received general anaesthesia (P less than 0.05), whereas no reduction was found in the group that was given spinal anaesthesia. The results indicate that minor surgery induces only small variations in NK cell cytotoxicity and no conclusions can be made, therefore, concerning the influence of different anaesthetic techniques on NK cell cytotoxicity.

Anesthesia, General↗
PubMed1986

Plasma concentrations of flunitrazepam (Rohypnol) following oral and sublingual administration.

Flunitrazepam (Rohypnol) 2.0 mg was given as a single dose by the oral or sublingual route to ten volunteers using a cross-over design. Plasma concentrations of the drug were measured by gas-liquid chromatography for up to 6 hours after administration. The highest mean concentration occurred 45 min after administration irrespective of route. No significant differences were found between the two treatments at any time. Since the sublingual route compares favorably with other routes of administration, these findings suggest that sublingual flunitrazepam is valuable for premedication.

Administration, Oral↗
PubMed1986

[Postspinal headache. Is 24-hour flat bedrest a preventive measure?].

Spinal anaesthesia was performed with a 22-gauge needle on 112 consecutive patients above fifty years of age admitted for transurethral surgery. Patients were randomly allocated to either 24 h of recumbency (group A) or ambulation as soon as the spinal had worn off (group B). Postspinal headache was found in 14% of the patients in the recumbency group and in 11% of the patients in the group of early ambulation. There were no differences between the groups regarding incidence, time of onset and duration of postspinal headache. Based on the literature and the present investigation, early ambulation is therefore recommended.

Anesthesia, Spinal↗
PubMed1985

Buprenorphine-supplemented anaesthesia. Influence of dose on duration of analgesia after cholecystectomy.

Fifty-one patients undergoing cholecystectomy received a single dose of buprenorphine 4.5-12 micrograms kg-1 at induction. Median duration of analgesia after surgery was 6 h. Multiple regression analysis showed the duration of analgesia to be slightly dependent on the age of the patient. No relationship was found between the duration of analgesia and the weight-related dose of buprenorphine, the age, sex or body weight of the patient, the duration of anaesthesia, or the dose of droperidol or thiopentone administered.

Adjuvants, Anesthesia↗
PubMed1985

Sublingual flunitrazepam for premedication.

The clinical effects of a standard 2 mg flunitrazepam tablet given sublingually for premedication were evaluated in a group of 50 patients undergoing otorhinolaryngologic surgery. A comparable group of 49 patients received 10 mg of diazepam orally. The degree of sedation and anxiety was assessed objectively and subjectively before induction of anaesthesia. Flunitrazepam produced better sedation judged by the observer as well as by the patients. There was less anxiety in the flunitrazepam group but this was not statistically significant. Side effects were few and patient acceptability high. Sublingual premedication using flunitrazepam could be a useful alternative to other forms of premedication.

Administration, Oral↗
PubMed1985

Subclavian venous catheterization in children.

During a 12-month period, infraclavicular subclavian catheterization, using a Seldinger technique, was attempted on 77 occasions in 54 children with a median age of 2 years (range newborn to 10 years). General anaesthesia was used in the majority of cases, and catheterization was successful in 74 cases (96%). The initial catheter tip position was satisfactory in 81% of the cases, and catheters remained in situ for a median period of 7 days (range 1-28 days). There were few complications. Providing extensive experience in subclavian venous cannulation is gained in the adult, there is in our experience no minimal age or size which should limit the use of a subclavian vein catheter.

Catheterization↗
PubMed1984

Venous sequelae following the injection of etomidate or thiopentone i.v.

The frequency of local venous reactions after the injection i.v. of etomidate or thiopentone was studied in 61 patients undergoing surgery for prolapsed lumbar disc. Of the patients who received etomidate, 24% developed thrombophlebitis in the period after operation (up to 14 days). Of the patients who received thiopentone, 4% developed thrombophlebitis in the period after operation. Pain on injection occurred in 24% of the patients receiving etomidate, but there was no correlation between pain on injection and the subsequent thrombophlebitis.

Adult↗
PubMed1984

Natural killer cell activity in patients undergoing upper abdominal surgery: relationship to the endocrine stress response.

Natural killer (NK) cell activity and the endocrine response during and after parietal cell vagotomy were studied in two groups of patients receiving either epidural analgesia extending from S5 to Th4 + general anaesthesia (Group I), or general anaesthesia (Group II). NK cell activity of unseparated mononuclear cells in peripheral blood was measured against K-562 target cells in a 51Cr-release assay. NK cell activity increased in the same way in both groups in relation to premedication, anaesthesia and surgery (P less than 0.01). Postoperatively, the activity fell significantly on the first day (P less than 0.01), but returned to preoperative levels on day 3 (Group I) and day 5 (Group II). The endocrine response measured, except for adrenaline and prolactin, differed between Group I and II. In Group I, plasma noradrenaline and serum cortisol increased insignificantly throughout the observed period--compared to the preoperative level--whereas a significant increase in both hormones was found in Group II during surgery and in the postoperative period. A significant increase in plasma adrenaline and serum prolactin was found in both groups during anaesthesia and surgery. The findings indicate that NK cell activity during upper abdominal surgery is modified in almost the same way during two different anaesthetic techniques, one of which partly seemed to block the endocrine surgical stress response. The fluctuations in NK cell activity were not correlated to the changes measured in hormone concentrations.

Abdomen↗