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Biomedical subjects

A Seebauer

Publications and source records attributed to A Seebauer.

4 recordsLinked to original sources
PubMed2002

Ropivacaine 7.5 mg/ml versus bupivacaine 5 mg/ml for interscalene brachial plexus block--a comparative study.

We investigated ropivacaine 75 mg/ml in comparison with bupivacaine 5 mg/ml in patients receiving interscalene brachial plexus block (ISB) and general anaesthesia. In this randomized, double-blind, prospective clinical trial, each patient received an ISB block according to the technique originally described by Winnie and a catheter technique as per Meier. The rapidity of onset and the quality of sensory and motor block were determined. After general anaesthesia had been induced further parameters evaluated were consumption of local anaesthetic, opioid and neuromuscular blocking drug. After arrival in the recovery room, the patients were assessed for intensity of pain using a visual analog scale (VAS). One hundred and twenty patients were included in the study. The onset and development of sensory block was similar in both groups. Development and quality of motor block was also nearly identical for both local anaesthetics. Consumption of neuromuscular blocking drug and opioid did not differ between ropivacaine and bupivacaine. In the recovery room the mean pain score was less than 25 in both groups. There were no significant differences in terms of onset and quality of sensory or motor block during the intraoperative and early postoperative period. In addition we did not identify any side-effects related to the administration of the local anaesthetics. Ropivacaine 7.5 mg/ml and bupivacaine 5mg/ml proved to be nearly indistinguishable when administered for interscalene brachial plexus block.

Adult↗
PubMed1999

[Ambulatory anesthesia: which preoperative screening tests are required].

The volume of preoperative screening investigations for outpatient anaesthesia ranges from few, selectively ordered investigations to extensive routine diagnostic procedures. It seem appropriate to reevaluate benefit and efficacy of routine preoperative assessment programs. The purpose of preoperative diagnostic is to assess the risk of anaesthesia and surgery for the patient. As shown by a number of studies, preoperative screening investigations seldom disclose new pathological findings of clinical relevance. Abnormal laboratory results in otherwise healthy patients rarely alter the anaesthetic management of the patient and are not related to perioperative complications. Extensive use of costly diagnostic procedures considerably increases health care budgets. A more selective approach to order preoperative investigations promises considerable savings. To achieve costeffective evaluation an efficient organisation of properative assessment must be established to avoid costly delay and on day-of-surgery-cancellations. There is no medicolegal obligation to perform routine diagnostic testing. The anaesthetist must be sufficiently informed in time to assess the perioperative risk of the patient and to alter anaesthetic management as necessary. According to the presented studies a clinical history and a through physical examination represent an effective method of screening for the presence of disease. Careful medical history evaluation and physical examination can avoid extensive investigations in apparently healthy individuals and the latter should only be ordered if indicated.

Ambulatory Surgical Procedures↗
PubMed1996

[Cardiovascular effects after bolus administration of cisatracurium. A comparison with vecuronium].

UNLABELLED: Cisatracurium-one of the ten stereoisomers of atracurium-is an intermediate long-acting non-depolarizing neuromuscular blocking agent. Cardiovascular reactions have been described after administration of cisatracurium or vecuronium in surgical patients. METHODS: After approval by our institutional review board, 62 patients (ASA I-II) were randomly assigned to three groups to either receive 3xED95 or 5xED95 of cisatracurium or 3xED90 of vecuronium prior to intubation as a bolus. After oral premedication with 2 mg lormetazepam anaesthesia was induced with thiopental (4-12 mg/kg) and maintained with O2/N2O and isoflurane (1.5%-2%). Six minutes after administration of thiopental, patients received the muscle relaxant. Six minutes later 0.1-0.2 mg fentanyl was given and the trachea was intubated. Heart rate (HR) and blood pressure (BP) were monitored every minute. Changes of heart rate or blood pressure > 20% compared to baseline were defined as clinically significant. RESULTS: After application of the study drug, median values of blood pressure and heart rate were stable. For each muscle relaxant, there were several patients who had statistically significant cardiovascular changes. After 3xED95 cisatracurium, 3 of 21 patients exhibited haemodynamic changes > 20% (2 exhibited hypotension and 1 tachycardia), while in the high-dose cisatracurium group 2 of 21 patients demonstrated a tachycardia that was predetermined to be statistically but not clinically significant. In the vecuronium group, 2 of 20 patients sustained statistically significant hypotension and 1 patient had statistically significant tachycardia. The frequency of all individual cardiovascular changes after the application of the muscle relaxant was not dose-dependent. CONCLUSION: After the administration of cisatracurium in two different doses (3xED95 and 5xED95) or vecuronium (3xED90) only minor cardiovascular changes were observed. Both drugs proved to be safe for use during induction of anaesthesia in patients ASA I-II. With regard to its cardiovascular effects, cisatracurium shares with vecuronium the requirements of an ideal muscle relaxant.

Adolescent↗