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Biomedical subjects

S Kampe

Publications and source records attributed to S Kampe.

23 records · Page 2Linked to original sources
PubMed2001

Comparison of continuous epidural infusion of ropivacaine and sufentanil with intravenous patient-controlled analgesia after total hip replacement.

We assessed the efficacy of an epidural infusion of ropivacaine 0.1% and sufentanil 1 microg x ml(-1), comparing it with intravenous patient-controlled analgesia using piritramide in this prospective, randomised, double-blind study of 24 ASA physical status I-III patients undergoing elective total hip replacement. Lumbar epidural block using ropivacaine 0.75% was combined with either propofol sedation or general anaesthesia for surgery. Epidural infusion and patient-controlled analgesia were started after surgery. Twelve patients received an epidural infusion of ropivacaine 0.1% and sufentanil 1 microg x ml(-1) at a rate of 5-9 ml x h(-1) and an intravenous patient-controlled analgesia device loaded with saline. Eleven patients received an epidural infusion of saline at the same rate and intravenous piritramide via the patient-controlled analgesia device. Motor block was negligible in both groups. The epidural ropivacaine group had significantly lower visual analogue pain scores at rest 4 h after surgery (p < 0.01), and on movement 4 h (p < 0.01) and 8 h (p < 0.05) after surgery, than the intravenous piritramide group. The piritramide group experienced significantly more adverse events than the epidural group (p < 0.001), especially hypotension (p < 0.01) and vomiting (p < 0.05). Patients in the epidural ropivacaine group were more satisfied with the pain management (p < 0.05). We conclude that the epidural infusion of ropivacaine 0.1% and sufentanil 1 microg x ml(-1) is superior to intravenous opioid by patient-controlled analgesia in preventing pain after total hip replacement, with fewer adverse effects and greater patient satisfaction.

Adolescent↗
PubMed2000

Survival from a lethal blood concentration of cyanide with associated alcohol intoxication.

We present a patient with a lethal blood concentration of cyanide. Additionally, he was found to have an alcohol blood level of 270 mg. dl-1, but made a complete recovery following administration of the antidotes dimethylaminophenol and thiosulphate. It is postulated that the patient may have been able to detoxify himself as a result of metabolism of cyanide to the non-toxic form, thiocyanate.

Adult↗
PubMed1999

Postoperative analgesia with no motor block by continuous epidural infusion of ropivacaine 0.1% and sufentanil after total hip replacement.

UNLABELLED: We assessed the analgesic efficacy of postoperative epidural ropivacaine 0.1% with and without sufentanil 1 microgram/mL in this prospective, randomized, single-blinded study of 30 ASA physical status I-III patients undergoing elective total hip replacement. Lumbar epidural block using 0.75% ropivacaine was combined with either propofol sedation or general anesthesia for surgery. After surgery, the epidural infusion was commenced. Fifteen patients in each group received either an epidural infusion of 0.1% ropivacaine with 1 microgram/mL sufentanil (R + S) or 0.1% ropivacaine without sufentanil (R) at a rate of 5-9 mL/h. All patients had access to i.v. piritramide via a patient-controlled analgesia device. The R + S group consumed six times less piritramide over a 48-h infusion period than the R group (median 12.7 vs 73.0 mg; P < 0.001). Motor block was negligible for the study duration in both groups. Patient satisfaction was excellent. The incidence of adverse events, such as nausea, was similar. We conclude that a continuous epidural infusion of 0.1% ropivacaine with 1 microgram/mL sufentanil is more effective than ropivacaine alone in treating pain after elective hip replacement without motor block. IMPLICATIONS: This is the first randomized study comparing the efficacy of the epidural combination of ropivacaine 0.1% and sufentanil 1 microgram/mL versus plain ropivacaine 0.1% in treating pain after hip replacement. We found that ropivacaine 0.1% and sufentanil 1 microgram/mL led to a sixfold reduction in opioid requirements after total hip replacement by producing a negligible motor block.

Adult↗
PubMed1994

Effects of hypertonic saline hydroxyethyl starch solution on collagen-induced platelet aggregation and ATP secretion.

OBJECTIVE: The purpose of this study was to investigate the effect of hypertonic (NaCl 7.5%) hydroxyethyl starch (HES 6%, molecular weight 200,000) (HHES) as used for small-volume resuscitation on global coagulation parameters and platelet function. DESIGN: Randomized, controlled clinical trial. SETTING: Intraoperative volume loading after induction of general anesthesia. PATIENTS: 27 consecutive patients [mean age 59 (22-76) years, mean body weight 69.8 (46-98) kg] undergoing abdominal surgery were studied. INTERVENTIONS: Global coagulation tests (aPTT: activated partial thromboplastin time; PT: prothrombin time; platelet count; thrombelastography: TEG), platelet aggregation and ATP release were measured before and 10 min after the application of 4 ml.kg-1 of HHES (study group H, n = 14) or HES (control group C, n = 13). RESULTS: The aPTT was prolonged and platelet count was significantly reduced in both study groups. In contrast to the HES group, clot formation time in the TEG was significantly prolonged and the maximum amplitude was reduced in the HHES group. Furthermore, platelet aggregation was significantly slowed down, whereas ATP release significantly increased in the HHES group. CONCLUSION: The changes in global coagulation parameters can be explained by dilutional effects of the infused solution. The hyperosmolar saline compound of the HHES solution obviously contributes to the slowing down of platelet aggregation. Osmotic stress and membrane pleating may aggravate HES-induced changes in membrane fluidity and microviscosity and thus explain this impaired interaction. The increase in ATP release suggests a change in receptor-second messenger interaction for delta granule release.

Abdomen↗