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Biomedical subjects

W Sandmann

Publications and source records attributed to W Sandmann.

At least 145 records · Page 8Linked to original sources
PubMed1980

[The effects of different anaesthetic technics on lactate under the course of aorto-femoral bypass operation (author's transl)].

46 measurements of lactate during aorto-femoral bypass-operation were performed under epidural analgesia, halothane- and neurolept anaesthesia. Independent of the metabolic parameters a significantly higher lactate rate was found under halothane anaesthesia than in the two other groups even though - at the same perfusion volume in all three groups - a significantly lower arterial mean pressure and peripheral resistance was measured under halothane- and epidural anaesthesia than under neurolept anaesthesia. The authors come to the conclusion that under aorto-femoral bypass operations a moderate hypotension can be carried out even in patients, showing arterio-sclerotic changes of the vessels, without a significant influence on metabolism.

Aged↗
PubMed1980

[Cardiovascular changes caused by nicotinic acid (author's transl)].

The effect of i. v. administered nicotinic acid was examined in 23 patients. Before the patients had undergone an AFB-operation. 11 cardiovascular parameters were quantitatively examined, calculated and statistically controlled. The authors observed a short but clear decrease of pressure and resistance in the arterial system after the injections of nicotinic acid. The aim of increasing the blood supply to poststenotic regions can however not be attained in this way. The decrease can rather lead to a lack of the blood supply of these regions. The authors could verify that the vascular effect of nicotinic acid is not caused by adrenergic blockade. We are of the same opinion as other authors who maintain that nicotinic acid could be used in the therapy of the "shock lung". It is said that nicotinic acid as a fibrinolytic substance might counteract the Disseminated Intravascular Coagulation and that it could counteract the danger of oedema in the pulmonary system by decreasing pressure and resistance for a short time.

Adult↗
PubMed1980

[Modification of the analgetic effects (buprenorphine, pentazocine, pethidine) on respiration and haemodynamics by epidural, halothane- or neuroleptanaesthesia (author's transl)].

In 38 patients buprenorphine, meperidine and pentazocine were given in a single dose for postoperative pain relief 20 hours after the end of anaesthesia. Measuring the parameters of the high- and low-pressure system as well as the metabolism the authors found that the effects of these analgetic medicaments, intravenously injected were significantly influenced by fentanyl, halothane or diazepam, given under the course of operation. Especially buprenorphine, injected after epidural anaesthesia in combination with diazepam sedation, proved to have a rather negative effect, because it caused a strong depression of respiration and circulation. On the other hand buprenorphine had, given after neuroleptanaesthesia, a neutralizing - and pentazocine and pethidine in combination with neuroleptanaesthesia a stimulating influence on the circulation. After halothane-anaesthesia the effect of the analegtics on the cardiovascular system was, when buprenorphine was given, depressing and when pentazocine was given indifferent. Similar reactions, but more pronounced, could be seen in the epidural group. With certain reservations, caused by the preliminary character of this study, the following conclusions can be drawn for the anaesthetic practice: 1 Choosing analgetic drugs for postoperative pain relief, the anaesthesist has to be aware of the interactions, possibly resulting from the medicaments, given during anaesthesia. 2. The number of medicaments, given during anaesthesia, should be kept small, considering the eventual interactions and the unintentional secondary effects.

Aged↗
PubMed1980

[Cardiovascular changes caused by atropine in epidural-, halothane- and neuroleptanaesthesia (author's transl)].

The authors could verify the heart rate increasing effect of atropine. The different sympathetic and parasympathetic activity caused by the method of operation and the kind of anaesthesia had a modifying effect on the heart frequency increase. In contrast to a small heart rate increase in halothaneanaesthesia, the increase in epidural- and neuroleptanaesthesia was higher. In addition medical treatment with pancuronium modified the effect of atropine. The frequency increase in patients who had got pancuronium was significantly smaller - the basic rate being higher - than in patients who hadn't got pancuronium. Those patients reacted vice versa. The authors found out that by giving 1 mg of atropine a maximum effect could be expected and that there couldnt be spoken of an overdosage.

Anesthesia, Epidural↗
PubMed1980

[Subclavian-carotid transposition in the treatment of obstructive subclavian disease with steal syndrome].

Eleven patients with subclavian steal syndrome underwent end-to-side transposition of the subclavian into the common carotid artery. The post-operative evaluation was done in every case by neurological examination, brachial blood pressure measurement, transcutaneous Doppler examination and by angiography. The operative result of this reconstruction, which was performed mainly on high-risk patients, was excellent. The symptoms of subclavian steal disappeared. In all but one patient the brachial pressure raised to normal. After transposition a blood flow reduction of 20% was measured intraoperatively in the peripheral common carotid artery, while the vertebral blood flow reversed to its natural direction. The peripheral common carotid artery pressure measured simultaneously remained unchanged, and hemodynamic criteria of carotis steal were not detected. The blood flow quality at the anastomosis was measured by the turbulence index in patients with an ideal reconstruction. The amount of blood flow distortion caused by the anastomosis was negligible. Therefore a long patency is expected. In patients with occlusive disease of the proximal subclavian artery we like to recommend the transposition as the procedure of choice, because the method uses one single incision for the extrathoracic exposure and one anastomosis-only without any graft material.

Arterial Occlusive Diseases↗
PubMed1979

[Blood vessel sutures with absorbable suture material: roentgenological, hemodynamic, light and electron microscopy findings. I].

Simple end-to-end anastomoses were performed in the common carotid and femoral arteries and in the jugular and femoral veins of dogs. In other dogs, lateral sutures (running) consisting of absorbable material made from polyglycolic acid were inserted. No occlusions, aneurysms, or infections occurred in the arteries. Without heparin, the patency rate after up to 234 days was 98%. In veins, the observation period was 60 days and a patency rate of 83% was found. All vessels were studied by angiography and by light and electron microscopy. Additionally, an original method of hemodynamic assessment was used (Turbulence Index). The alternating effect of morphological variations in the vessel wall and the degree of blood flow disturbance was evident.

Angiography↗
PubMed1979

[Treatment of late occlusions and stenoses after an aortofemoral bypass operation].

Thirty-three patients with one or several late occlusions in 43 limbs of aortofemoral dacron grafts underwent 56 reconstructions because of impending limb loss. Thrombectomy alone with patch closure was less successful. Excision of the femoral anastomosis, resection of the distal part of the occluded prosthetic limb and replacement by a new velours graft tube together with profundaplasty and further downstream reconstruction revealed the best results. The early reocclusion rate was 10%, the late reocclusion rate was 10%. There was no operative mortality and no amputation. Two late deaths occurred, in one case due to grade III infection with sepsis. Another late graft infection was successfully managed by an extraanatomic bypass and excision of the infected limb. The reasons for late occlusions of aortofemoral grafts were found to be incomplete reconstruction of the outflow tract, technical failure at the time of primary reconstruction and progressive atherosclerosis. Hypertonus was common in all cases with progression of the disease. Technical details of the operative management for late occlusion are presented.

Adult↗
PubMed1978

[The effect of operation, anaesthesia and blood viscosity on haemodynamic during aortofemoral bypass operation (author's transl)].

Cardiac index, total peripheral resistance, blood, plasma and serum viscosity in patients with peripheral vascular disease were measured pre-, intra- and postoperatively. Besides plasma and serum viscosity, most obviously blood viscosity decreased during anaesthesia and operation. The decrease of blood viscosity is caused mainly by the falling haematocrit. Red blood cell aggregation occuring under low-flow conditions is decreased. Thus blood viscosity additionally is diminished at least in the area of low shear rates. Corresponding haemodynamic measurements revealed that decreasing viscosity improves cardiac index and total pressure resistance if normovolaemia exists, but in general is masked by anaesthesia and operation.

Anesthesia↗
PubMed1977

[Postoperative control of blood flow in arterial surgery: results of electromagnetic blood flow measurement (author's transl)].

An electromagnetic blood flow cuff probe was implanted up to 4 days in 50 patients to control basal blood flow through a femoro-popliteal vein graft. Patent grafts showed increasing blood flow due to hyperemia with maximum on the 2. p. op. day. The level of the postoperative hyperemia and the increase of blood flow caused by intraarterial papaverine injection during operation were in the same range. The method and the extension of analgesia influenced the degree of postoperative hyperemia. Pain and blood loss diminuished graft flow. Patients with epidural block and sufficient blood volume produced a significant higher graft flow than patients with morphine analgesia. 2 patients had early occlusion of the graft, 2 others showed occlusion at the distal anastomosis. These complications could be easily detected by blood flow measurement and were successfully corrected in two patients. Moreover, electromagnetic postoperative blood flow control may be helpful in patients with proximal a.v. shunt for hemodialysis.

Arterial Occlusive Diseases↗
PubMed1977

[Experimental findings in liver perfusion measurements using an ultransonic Doppler flowmeter].

1. The ultrasonic doubling method of bloodflow measurement is an experimental easily practicable and very exactly recording measurement arrangement. By this method data of other methods were extended and ensured. 2. Early inquested finding is attested that after inhibition of portal vein bloodflow and after portocaval anastomosis an increased arterial perfusion of liver through a. hepatica is following. Increasing bloodflow of a. hepatica is independent of cardiac output. 3. After diminution of arterial perfusion by occlusion of a. hepatica no increased portal bloodflow is following. 4. It is to suppose an "intrahepatic regulation of liver bloodflow". It seems economical that the perfusion part of the a. hepatica with her higher oxygen content is increasing when the general perfusion is decreasing by diminished portal bloodflow or diminished blood pressure. So far it is impossible to interpret whether this accomodation is based on a difficult "auto-regulation" or is originated pressure passive from the flow together of two systems are staying under different pressure.

Animals↗
PubMed1977

[Surgical aspects in arterial occlusion (author's transl)].

Acute arterial occlusion was found to be the most frequent emergency (10%) among vascular patients of the Department of Surgery of the University of Düsseldorf. Rheumatic heart diseases receded as etiological factors whereas atherosklerotic obstructive diseases exhibited a clear increasing tendency. Operation is urgent if acute ischemia is present. The best method is represented by embolectomy by means of the Fogarty-catheter, if it is performed within the first 6 to 12 hours after or vascular occlusion. Angiography is only indicated if ischemia is not complete or if the cartoid artery or great visceral arteries are involved. In cases of incomplete occlusion embolectomy may be successful even after days and weeks. Mortality after these operations is found to be 18 to 20%, the rate of amputation being 9%. The final results of operative results are better in arterial embolism than in arterial thrombosis.

Arterial Occlusive Diseases↗