Pediatric surgical procedures under local anesthesia have been limited by the pain of injections and, because of low body weight, rapidly reached maximum doses. In subcutaneous infusion anesthesia (SIA) highly diluted local anesthetics are administered by flow- and volume-controlled infusion pumps. This article presents a retrospective review of the use of SIA in children undergoing excision of dermatologic problem lesions. A total of 354 surgical procedures, predominantly excisions of nevi in 271 children (3 months-16 years) were performed in 1999: 67 children were operated on under general anesthesia and 204 children with local anesthesia. For local anesthesia we used SIA with diluted prilocaine and ropivacaine (equivalent mixtures of 0.3%, 0.15%, 0.08%). The 67 children operated on under general anesthesia were younger (mean age 3.05 +/- 2.93 years, median age 2.00 years) than the 204 children who had surgery with SIA (mean age 9.00 +/- 4.2 years, median age 9.00 years). The sizes of excisions under general anesthesia were larger (maximum 1060 cm2, mean 76 +/- 225 cm2, median 7 cm2) than those under SIA (maximum 628 cm2, mean 22 +/- 100 cm2, median 3 cm2). No side effects of local anesthesia were observed in these pediatric procedures. The additional use of ropivacaine resulted in prolonged postoperative analgesia. SIA in children is a well-accepted, safe anesthesia that in some cases offers an alternative to general anesthesia.

Adolescent↗

PubMedDate not supplied

The acoustic reflex at low sensation levels.

The acoustic stapedial reflex, which normally occurs at a hearing level of about 80 dB, can be detected at lower levels by means of preactivation. Two techniques are presented, which allow the detection of reflex activity at intensities from 30 to 50 dB HL. It was the authors' intention to find a way to determine the hearing threshold from the stapedius reflex threshold even in patients, in whom the hearing threshold was not horizontal.

Acoustic Stimulation↗

PubMedDate not supplied

[Need for psychosocial counseling--a comparison of women and men in East and West Germany].

The increasing use of psychosocial medical care by women has resulted in a wider range of counselling facilities for specific problems concerning women over the last few years. According to our survey including the population of both Western and Eastern Germany, however, there is no evidence that women have a greater need for counselling activities than men. Needs for counselling are more freely admitted by women than by men; counselling needs for so-called "women's problems" are more commonly observed in Eastern Germany, whereas male oriented problems predominate in Western Germany. The highest need for counselling exists in the field of "Health" and "Social Security".

Adult↗

PubMedDate not supplied

Determination of hearing threshold for single frequencies from the acoustic reflex.

With preactivation, the threshold of stapedial reflex activity can be lowered by 20-30 dB. From these measures of the normal and reduced reflex threshold, an extrapolation may be performed down to the hearing threshold. Thus, the hearing threshold can be determined for every single frequency from 0.125 to 4 kHz if the reflex is elicitable up to 8 kHz.

Acoustic Stimulation↗