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Biomedical subjects

E Kirchner

Publications and source records attributed to E Kirchner.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Catheter peridural anesthesia with bupivacaine-HCl and bupivacaine-CO2 during extracorporeal shock-wave lithotripsy].

The effects of 0.5% bupivacaine-CO2 and bupivacaine-HCl were tested in a prospective randomised trial on 16 patients who underwent extracorporal shock wave lithotripsy (ESWL) with epidural analgesia. A shorter time of onset of analgesia (3.75 +/- 0.51 min) and a faster distribution of analgesia were noted with bupivacaine-CO2. Hypoalgesic regions were not registered with bupivacaine-CO2 nor with bupivacaine-HCl under shock wave treatment. About thirty minutes after application of either substance a level 1 block according to Bromage was noted, which was not desirable during positioning of the patient on the hydraulic lithotriptor chair. However, toxic blood levels were not reached in either group of patients to any extent.

Anesthesia, Epidural↗
PubMed1986

[Effect of nalbuphine on respiration].

The respiratory depressant effects of 0.25 mg/kg nalbuphine were analyzed in detail in seven healthy volunteers by determining the CO2 response (Read's method) and the mouth occlusion pressure (Whitelaw's method) before and 10, 30 and 60 min after administration of the drug. Minute ventilation VE (PACO2 = 55 mm Hg) decreased after nalbuphine by a maximum of 36.4% (P less than 0.05). Simultaneously, the slope of the right-shifted CO2 response curve was diminished by 21.1% (NS) while the mouth occlusion pressure decreased by 36.3% (P less than 0.05), respectively. There were only slight changes in mean inspiratory flow rate. These findings demonstrate that nalbuphine does not lead to relevant impairment of central respiratory regulation or respiratory mechanics.

Adult↗
PubMed1985

[Comparative investigations on the precipitation behavior of various protein precipitates in organs and tissues].

The differences of the non-precipitable N-quota in blood plasma, liver, intestine, and muscles after treatment with various precipitants reveal data on the height of protein precipitation in the corresponding body fraction. Organs of hens treated with picric acid (1%), trichloroacetic acid (10%), and sulphosalicylic acid were used for the protein precipitation. Because of contradictory literature data as to the most suitable concentration of sulphosalicylic acid a preliminary determination of the most favourable acid concentration was necessary. The application of a 5% solution of sulphosalicylic acid gave the highest precipitation rate depending on the analyzed organs. In the succession picric acid, trichloroacetic acid, and sulphosalicylic acid nitrogen increases in the soluble supernatant. Furthermore, dependences of the protein precipitation on the kind of the analyzed organs were indicated.

Animals↗
PubMed1985

[Behavior of the hypophyseal-adrenal cortex system in inhalation and conduction anesthesia. A review with comparative study].

The effects of halothane anaesthesia or epidural analgesia on the per- and postoperative change in blood concentrations of ACTH, beta-lipotropin, cortisol, dehydroepiandrosterone, aldosterone, glucose, lactate and free fatty acids were investigated in connection with elective orthopaedic surgery. Anaesthesia in man with halothane and nitrous oxide was found to be associated with a significant increase in plasma ACTH levels and beta-LPH levels. Changes in plasma dehydroepiandrosterone were similar to those in plasma cortisol. The elevation of plasma aldosterone during major surgery could be explained as the effect of an increased renin secretion. However, simultaneous increase in plasma cortisol and plasma aldosterone during surgery reflect an additional effect of adrenocorticotropin upon aldosterone secretion.

Adrenal Cortex↗
PubMed1985

[Suppression of the adrenal cortex by infusion of etomidate in general anesthesia].

The effects of anaesthesia with fentanyl and prolonged etomidate infusion (0.8 mg/kg/h) on the peroperative and postoperative change in blood concentrations of aldosterone, cortisol, dehydroepiandrosterone, ACTH, epinephrine, norepinephrine, dopamine, glucose, lactate and free fatty acids (FFA) were investigated in connection with major abdominal surgery. During surgery and anaesthesia with prolonged etomidate infusion no significant alterations in plasma catecholamine concentrations were observed. In contrast, basal plasma levels of ACTH (20.0 +/- 9.5 pg/ml----352.8 +/- 150.8 pg/ml) were elevated in all patients. Despite this endogenous ACTH stimulus, aldosterone (121.8 +/- 19.4 pg/ml----58.4 +/- 10.4 pg/ml) and cortisol (12.3 +/- 2.84 micrograms/dl----5.79 +/- 1.2 micrograms/dl) and dehydroepiandrosterone (2.28 +/- 1.09 ng/ml----1.27 +/- 0.25 ng/ml) levels were markedly depressed in every patient during the perioperative period. Twenty-four hours after surgery the basal steroid values were within or above normal limits.

Abdomen↗
PubMed1985

[Effect of tramadol on ventilatory CO2 response and mouth occlusion pressure].

The respiratory depressant effects of 1.0 and 1.5 mg/kg of tramadol were studied in 14 healthy young persons by determining the CO2 response (Read's method) and the mouth occlusion pressure (Whitelaw's method) before and 10, 30 and 60 min after administration of the drug. The decrease in minute volume VE (PACO2 = 55 mmHg), dependent on dose, ranged between 11,2 and 17,8%. The mean ventilatory response to CO2 decreased after administration of 1.0 and 1.5 mg/kg of tramadol by 15.4 and 25.4% respectively of the normal value. In the same patients, the mouth occlusion pressure responses decreased by 16.1 and 25.6% respectively. There were no significant changes in mean inspiratory flow rate (determined from tidal volume and averaged time of inspiration). These findings demonstrate that tramadol, in contrast to morphine, produces less depression of the ventilatory responses to CO2 in healthy subjects.

Adult↗
PubMed1985

[A clinical study of circulatory depression and pharmacokinetics following peridural anesthesia with bupivacaine 0.75%. Preoperative phase].

In previous study it was demonstrated that the clinical use of bupivacaine 0.75% for peridural anesthesia appears to be without risk. There was seen no toxicity (bradycardia, convulsion, respiratory depression etc) at the measured plasma levels. Very important is the early onset of action of this drug contrary to the other used concentrations. It is useful for a major surgery. Hypotension can be avoided by applying volume transfusion.

Anesthesia, Epidural↗
PubMed1985

[Anaphylactoid shock following Alloferin].

Reports of allergic complications related to Alloferin are very infrequent. We report a case of anaphylactoid reaction to this drug. The diagnosis was confirmed by intradermal testing.

Alcuronium↗
PubMed1985

[Endocrine reaction pattern in abdominal surgical patients as affected by isoflurane anesthesia].

The effects of isoflurane anaesthesia on the per- and postoperative change in blood concentrations of aldosterone, cortisol, dehydroepiandrosterone, insulin, prolactin, thyroxine, t3-uptake, epinephrine, norepinephrine, dopamine, glucose, FFS, lactate, and pyruvate were investigated in connection with major abdominal surgery. Contrary to prolactin levels (8.42 +/- 1.71 ng/ml----46.25 +/- 6.78 ng/ml; p less than 0.001) the plasma concentrations of the adrenal steroids aldosterone, cortisol, and dehydroepiandrosterone sank initially after induction of anaesthesia with thiopentone. However, after skin incision the levels of aldosterone (49.9 +/- 11.6 pg/ml----202.1 +/- 57.6 pg/ml; p less than 0.01), cortisol (16.7 +/- 2.57 ng/dl----25.2 +/- 3.72 ng/dl; p less than 0.01) and DHEA (2.70 +/- 0.99 ng/ml----5.02 +/- 1.03 ng/ml; p less than 0.05) rose significantly. Generally, plasma insulin was not markedly influenced by isoflurane anaesthesia and surgery. No significant alterations in plasma catecholamine concentrations were observed.

Abdomen↗
PubMed1984

[Effect of the neuroleptic fluphenazine dihydrochloride on the cardiovascular system of polytraumatized patients with an alcoholic anamnesis].

Haemodynamic effects in 10 multi-injured patients were registered after a bolus injection of 20 mg fluphenazin-dihydrochloride (Dapotum acutum; Fa. Heyden). Favourable results were seen in pre- and afterload. Parameters such as TTI, TTIB, CE and TI, characterising myocardial oxygen consumption, were also influenced positively. A reduction of mean arterial pressure can be avoided by administering slowly increasing volume and, occasionally, catecholamines. By use of modern monitoring in ICV, thus drug seems to be free from risk.

Adult↗
PubMed1984

[Evaluation of palmar collateral circulation with the Oxygenmet oxygen saturation measurement device].

Assessment of collateral circulation of the palmar arcade prior to percutaneous radial artery cannulation is necessary because a thrombosing radial artery together with insufficient collateral circulation may lead to gangrene of the hand. A new method for assessment of collateral circulation of the palmar arcade by use of a spectrophotometric monitoring device for arterial oxygen saturation is described. This method is contrasted with current methods (Allen's test, Brodsky's test, ultrasound Doppler).

Arteries↗
PubMed1983

Pharmacological activities of the progestin STS 557.

This paper reports on pharmacological properties of 17 alpha-cyano-methyl-17 beta-hydroxy-estra-4, 9-dien-3-one (STS 557), which were obtained from basic screening investigations. At high doses (100 mg/kg i.p.) STS 557 was sedatively active on the CNS, but did not show any narcotic or anticonvulsant activities. A hypothermic effect of STS 557 was found at non-sedative i.p. or oral doses in mice and rats. This was also shown for the standard levonorgestrel, doubtlessly to a lesser extent. The cardiovascular system as well as the renal excretion of urine and electrolytes were unaffected by the test compound. STS 557 was found to stimulate the spontaneous motility of the isolated rat uterus dose-dependently; an antiprogesteronic activity seems to be unlikely. STS 557 did not show any glucocorticoid or antiexudative properties. At oral dose levels of 10 and 50 mg/kg (X 4 days), STS 557 and levonorgestrel caused similar changes in the serum lipids of normolipidemic and hyperlipidemic rats. The concentration of total cholesterol was decreased, that of the FFA was increased. The triglycerides were lowered only in hyperlipidemic animals. All the pharmacological effects of STS 557 appeared at high doses, much higher than te proposed therapeutic ones.

Analgesics↗
PubMed1983

[Barbiturate therapy in neurosurgery].

Thirty patients with an acute midbrain syndrome were treated by high dose barbiturate therapy. Of these patients 19 had a severe head injury. In 8 patients the symptoms of acute midbrain syndrome developed after subarachnoid haemorrhage. In three patients these symptoms were caused by postoperative swelling or ischaemia. The results of those patients, who were treated with barbiturates after head injury were much better than in 16 other patients, who had no barbiturates. The indications for high dose barbiturate therapy in neurosurgery are discussed with reference to other publications and to the pathophysiological effects of barbiturates.

Adolescent↗
PubMed1983

[Effect of thiopental anesthesia on plasma renin, adrenaline and noradrenaline in neurosurgical operations with induced hypotension].

Excessive postoperative blood pressure reactions following surgery of cerebral aneurysms using sodium nitroprusside--induced hypotension can be avoided, if barbiturate-fentanyl-anaesthesia is employed instead of neuroleptanalgesia. Plasma renin activity (PRA), plasma concentration of adrenaline and noradrenaline were determined in 13 patients, undergoing surgery of cerebral aneurysms with induced hypotension (group I) and in 15 patients, who were operated on for brain tumors without hypotension (group II). The PRA was not increased in group II. The blood pressure was normal. In group I the PRA was significantly higher during and after the operation. In both groups adrenaline was not increased significantly. The noradrenaline concentration showed a significant increase in both groups, indicating a peripheral sympathetic stimulation. It is supposed that thiopentone inhibits the depletion of adrenaline and reduces the effect of increased PRA.

Adult↗