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Biomedical subjects

T Gürtner

Publications and source records attributed to T Gürtner.

13 recordsLinked to original sources

[Backache following spinal anesthesia--a neglected problem?].

In a prospective clinical study we followed up 697 patients operated upon under spinal anaesthesia to determine the incidence of, and the factors predisposing to, post-spinal backache. The incidence of post-spinal backache, which occurs in approximately one in seven patients (13.1%) is comparable to that of post-spinal headache. This often neglected additional cause of post-spinal morbidity can be reduced by the use of atraumatic techniques and with small-gauge spinal needles for performing lumbar puncture.

Adolescent↗

[Headache following spinal anesthesia: also a problem of the local anesthetic used?].

In a prospective clinical study we followed 320 patients operated upon in spinal anesthesia. We were especially interested in headache patterns after spinal anesthesia and their causes, with particular reference to the local anesthetic used. Apart from the typical postspinal headache due to low cerebrospinal fluid (CSF) pressure, we found a nontypical pattern which was considerably more prevelant than the classical type. The typical postspinal headache correlated well with procedures (multiple perforations, thicker cannulae) that lower or prolong the reduction of CSF pressure and a history of migraine. The nontypical headache correlated with the use of lignocaine/articaine for spinal anesthesia, possibly due to metabolic and structural factors.

Adolescent↗

[Side effects following intravenous regional anesthesia (IVRA) on the central nervous system and heart rate].

Forty patients undergoing upper limb surgery received intravenous regional anaesthesia (IVRA). Electroencephalographic (EEG) and electrocardiographic (ECG) assessments were performed the day before surgery without any premedication and postoperatively before, during and after the release of the cuff. For IVRA, vasocontrictorfree 0.5% mepivacaine solution at a dosage of 3 mg/kg body wt. was applied, followed by an additional injection of 20 ml 0.9% NaCl solution. The EEG and ECG did not show any evidence of toxical effects on brain function or cardiac rhythm. In response to the sedative property of mepivacaine stages of sleep were observed in all patients following the release of the cuff. Because of this effect on alertness, ambulant patients should not participate actively in traffic.

Adolescent↗

[Gas gangrene].

In spite of surgical, intensive, and hyperbaric oxygen therapy, the gas gangrene is still one of the most dangerous surgical infections. In recent literature, the average mortality is about 50%. The patients die within a few days because of general intoxication. A review of our own results achieved between 1971 and 1981 shows that 50 out of 73 patients with clostridium infection and all 77 patients in whom a gas gangrene was suspected have survived [ 2 ]. For the prognosis and therapy of the gas gangrene, the classification into stages I to IV according to the severity has proved to be useful. The prognosis depends on the incubation period (the shorter the incubation period the worse the prognosis), on the beginning of the treatment and on the site of a primary or secondary gas gangrene. The more distally the gas gangrene is situated in the extremities, the better is the prognosis with regard to mortality and invalidity. An early diagnosis of the gas gangrene is of primary importance. As early as a gas gangrene is suspected because of typical local findings and clinical symptoms, therapeutic measures are immediately necessary (surgery, intensive treatment and hyperbaric oxygen therapy). A transport of more than six hours with prolonged interruption of the treatment will decrease the chances of success even in a "gas gangrene therapy centre".

Gas Gangrene↗

[Neuropathies following hand surgery under supraclavicular plexus anesthesia].

15 cases with pain in the shoulder girdle following an operation in supraclavicular brachial plexus anesthesia are reported. The pain developped after an interval of several days. According to the neurological findings the diagnosis is regarded as neuralgic amyotrophy. Possible causes are discussed.

Anesthesia, Conduction↗