Biomedical subjects
Publications and source records attributed to U Jost.
As there are still contradictions in the literature on the efficacy of different solvents to reduce venous pain after the injection of methohexital we restudied this problem. In an earlier investigation normal saline proved superior to distilled water. We now found that injection of an opioid prior to methohexital and addition of lidocaine to the methohexital solution leads to a strong reduction in the incidence of pain.
By digital subtraction angiography (DSA), diagnostic statements can be made even with low concentrations of contrast medium. Despite the increasing dilution of contrast medium, a definite statement on mediastinal vessel condition is possible in direct visualisation of the arm veins up to the vena cava superior as well as of collaterals using peripheral injection of the contrast medium. Two case histories show that the investigator has definite criteria at his disposal enabling him to forgo frustrating puncture attempts in the area of the vena subclavia, vena jugularis interna and vena anonyma in case of suspected thrombotic vessel closure after long-term parenteral nutrition.
Alfentanil (R 39 209, Rapifen), a new short-acting narcotic analgesic, has been used in five modifications of routine anaesthesia. The results of these observations are discussed, as well as the haemodynamic and pharmacokinetic data reported in literature. Rapid onset and short duration of action due to a short elimination half-life time and a low distribution volume offer new possibilities in anaesthesiology. In premedicated patients the drug provides analgesia for very short lasting procedures and can supplement hypnotics like etomidate, short-acting barbiturates and benzodiazepines, e.g. midazolam. Thus it becomes possible to obtain a very pleasant anaesthesia under controlled or assisted ventilation with nitrous oxide/oxygen for procedures of a short or mean duration without further need for volatile anaesthetics.
45 healthy young women received 50 mg Ranitidin as soon as the anaesthetist was informed that general anaesthesia was necessary for an obstetric manoeuvre. During the procedure the gastric contents were analysed quantitatively and the pH values were measured. In the parturient women, the Ranitidin effect was not attained within thirty minutes, contrary to the results obtained in male volunteers. Neutralisation was not obtained in male volunteers. Neutralisation was not obtained in all of the patients even within sixty minutes. Hence, intravenous Ranitidin cannot prevent acid aspiration in non-elective obstetric surgery if employed as the only precaution.
We report two cases of thrombosis of the internal jugular vein which occurred after prolonged cannulation of the vein by a Shaldon-catheter for acute haemodialysis. In one case this complication provoked cerebral oedema and death of the patient. In the second case the thrombosis of the internal jugular vein was confirmed by autopsy and documented by photography but did not affect the fate of the patient. Yoffa's supraclavicular approach to the subclavian vein is discussed as an alternative.
A case of severe respiratory distress syndrome in a healthy young woman is reported which occurred after administration of fenoterol during therapy for premature labour. The pathomechanisms are discussed in accordance with experimental data and case reports in the literature.
Five cases of post narcotic delirium, somnolence or coma are interpreted as central anticholinergic syndromes as they were reversed by physostigmine. There is to date no information whether the drug combinations midazolam/fentanyl, benzoctamine/buprenorphine and etomidate/carticaine may act as central anticholinergic agents.
A case of complete obstruction of an endotracheal tube is reported. This occurred each time the cuff was inflated and was caused by softening of the plastic material in the region of the cuff itself.
Accidental drowning caused asphyxia which without active intervention leads to hypoxemic lesions of the entire organic system, the brain being the weakest spot. Contrary to earlier ideas derived from animal experiments, differentiation into the various pathomechanisms of drowning is irrelevant for emergency treatment and intensive medical aftercare. In all cases, arterial hypoxemia with its consequences are the main problem. Whereas in serious cases the victim of drowning is of necessity given modern intensive treatment, there is a danger for the less severe cases of "near-drowning" that intensive treatment does not appear essential at first and consequently they are usually neglected.
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The effect of thiopentone, etomidate and flunitrazepam on cerebral energy metabolism was investigated in the male Wistar rat. Brain cortex was deep-frozen in situ under steady state conditions (normotension, normothermia, normoxia and normocapnia) of a standardized anaesthesia. Anaesthesia with thiopentone led to an decrease in glycolytic flux on the level of the hexokinase and/or phosphofructokinase reaction as well as reduced citric acid cycle intermediates. The brain cortex levels of high-energy phosphates however are unchanged thus indicating an adequate supply of energy for the brain. Similar results were obtained when anaesthesia was induced with etomidate and flunitrazepam. In spite of the fact that flunitrazepam seemed not to influence the phosphofructokinase reaction an equivalent hypnotic dose of each drug led to comparable metabolic effects in the brain cortex.
60 persons were asked to perform external cardiac massage on two phantoms by the arm-hand and leg-heel method respectively. This leg-heel method does not offer any special advantages over the arm-hand technique if the helper is tired; nor is it easier to learn. Because of its general applicability the latter method should remain the standard technique taught, especially as laymen are apt to become confused by a multiplicity of methods.
Iron-free parenteral nutrition following neurosurgery and vascular surgery leads to a loss of the known diurnal rhythm of the serum iron level. This fact is discussed in view to the post-operative pathophysiology and in view of the speculations on the reasons for this diurnal rhythm.
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A new method for monitoring deep body temperature is described. It is based on the establishment, by means of electronic appliances, of a zone without heatflow from the deep tissues. The method is simple and the results compare favourably with those obtained by other procedures for measuring core temperature. The uses of this transcutaneous mehtod are discussed and its advantages and reliability in the operating theatre and intensive care unit are emphasized. It becomes less reliable if it is employed during and after extracorporeal circulation in hypothermia on account of the temperature gradient.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.