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Biomedical subjects

H Stoeckel

Publications and source records attributed to H Stoeckel.

At least 91 records · Page 5Linked to original sources
PubMed1980

[Dantrolen solution of high active substance concentration. Preliminary communication (author's transl)].

The effectivity of treatment of a dramatically progressing malignant hyperthermia with Dantrolen depends, inter alia, on the easy production and applicability of the preparation. The modification described in this article, of an intravenously injectable Dantrolen solution which contains 10.0 mg active substance in 1.0 ml of a mixture of ethanol, glycerin and water, seems to meet these conditions, as established by experimental investigation.

Animals↗
PubMed1980

[Pharmacokinetics of etomidate in man (author's transl)].

The pharmacokinetic behaviour of etomidate was investigated in 7 patients. A method for the analysis of etomidate is described using gas-liquid chromatography for separation and alkali flame ionization detection. The lower limit of detection for etomidate in plasma was 0.005 microgram/ml. The pharmacokinetic behaviour of etomidate after an intravenous bolus injection of 20 mg may be described in terms of an open two-compartment model. The plasma half-life of etomidate was in the alpha-phase about 3 minutes, the biological half-life of the beta-phase was about 70 minutes. The total volume of distribution was calculated at 165 litres. The total plasma clearance amounted to 1600 ml/min. These pharmacokinetic data were used to establish an intravenous infusion scheme for etomidate.

Aged↗
PubMed1980

[Infusion model for etomidate (author's transl)].

An intravenous infusion scheme was established in five healthy volunteers on the basis of pharmacokinetic analysis as described by J.G. Wagner. Concentrations of etomidate in plasma were measured by gas chromatography after solvent extraction. The monitoring of EEG background activity was used for the correlation to the pharmacodynamic effect. The minimal plasma level producing an hypnotic effect was about 0.3 microgram/ml) etomidate. An infusion model was developed for a therapeutic plasma concentration of 0.5 microgram/ml etomidate. An initial fast constant-rate infusion (8 mg/min) was followed by an infusion with 0.8 mg/min for the entire duration of the application. The measured plasma levels coincided fairly well with the predicted steady state plasma levels and were accompanied by a distinct hypnotic effect in all volunteers.

Adult↗
PubMed1980

[Regional anaesthesia in haemophiliacs (author's transl)].

Since the middle of 1976 spinal and peridural anaesthesia are also being used for orthopaedic surgery of the lower extremities in haemophilic persons, the most important pre-requisites for the use of these techniques are: that it is a case of genuine haemophilia, that the deficiency is fully made up before and during anaesthesia and that the most important coagulation parameters are closely watched in co-operation with the Hemophilia Centre during the entire period. 46 haemophiliacs were given spinal and epidural anaesthesia via a catheter. A great advantage of these long-acting techniques is that less analgesics are needed during the postoperative period. Continuous peridural anaesthesia ensures freedom from pain without interfering with motoricity. The treatment of contractures of the joint by active and passive exercises has thus a better chance of success. Provided factors VIII/IX were kept normal there have so far not been any haemophilia-related haemorrhages into the spinal canal or cord or neurological disturbances that could be attributed to these anaesthetic techniques.

Adolescent↗
PubMed1980

[Investigations on several EEG-parameters as indicators of the state of anaesthesia the median - a quantitative measure of the depth of anaesthesia (author's transl)].

32 cases with Etomidate-, Ethrane- and Fentanyl-application have been investigated in order to evaluate a common EEG-index indicating the depth of anaesthesia. The following parameters are regarded: the mean amplitude, the relative parts of the powerspectrum for the frequency bands 0.5--2 Hz, 2--5 Hz, 5--8 Hz, 8--13 Hz, 13--24 Hz, alpha-delta-index, the beta-delta-index, the median of the powerspectrum. The median of the powerspectrum gains the best correlation to anaesthetic depth for adequate anaesthesia, which is determined by the common clinical vegetative signs. Anaesthesia which is unnecessarily deep is better indicated by a biparametric representation of both median and mean amplitude.

Anesthesia, General↗
PubMed1980

[Changes in the secretion of growth hormone in severely injured persons (author's transl)].

The secretion of growth hormone was studied in 25 severely injured persons during the adaptive and convalescent stage. The ages of the patients varied between 9--65 years. During the first few days after the trauma hormone concentrations rose to up to 7--15 times their normal upper limits (about 10 mU/l). In some cases the hormone levels subsequently fell to the lower limits of normal. No attempt was made to calculate average values and the reasons for the omission are stated. The results are discussed with reference to the metabolic condition of the severely injured persons.

Adolescent↗
PubMed1979

Pharmacokinetics of fentanyl as a possible explanation for recurrence of respiratory depression.

The pharmacokinetics of fentanyl are complicated by an additional increase in plasma concentration during the elimination phase of the drug. We have confirmed that fentanyl is excreted in the gastric juice and reabsorbed from the alkaline medium of the small intestine. In addition, the stomach wall in rats has an important storage capacity for fentanyl. A maximum of about 20% of the dose was found in the stomach wall after i.v. injection. In man the resected part of the stomach contained 16% of the dose, 10 min after injection. These observations could be important in explaining the occurrence of respiratory depression in the period after operation.

Adult↗
PubMed1979

[Influences of different anaesthetic techniques on serum levels of hepatic enzymes and of bilirubin (author's transl)].

The influence of four different types of anaesthesia -- halothane and enflurane inhalation anaestheis, neurolept analgesia and epidural analgesia with single shot technique -- on the serum levels of GOT, GPT, GLDH, LDH, AP, LAP, gamma-GT, total protein and bilirubin was examined in 104 comparable cases undergoing gynaecological surgery. A significant increase in GOT, GPT, GLDH, AP, and gamma-GT levels was observed between the 6th and 9th postoperative day with all types of anaesthesia. The serum levels remained elevated until the 15th postoperative day. There was no significant difference between the four types of anaesthesia as regarded their effects on the serum constituents investigated. The same applied to the serum CHE activity which reached a minimum on the 3rd postoperative day followed by a steady rise. The results indicate that the postoperative changes of the liver enzyme pattern are not related to the type of anaesthesia used. Bilirubin was elevated on the first postoperative day, then dropped rapidly and stayed below the pre-operative values until the 12th postoperative day. There was no difference between the four types of anaesthesia. Glucuronisation of bilirubin may be inhibited initially by the anaesthetic agents. The subsequent rapid fall of the bilirubin levels may be the result of enzyme induction.

Alanine Transaminase↗
PubMed1979

[The effects of "atraumatic" surgery in halothane anaesthesia and neurolept analgesia on the liver enzyme pattern (author's transl)].

The influence of general anaesthesia for operations devoid of substantial tissue traumas on the postoperative pattern of hepatic enzymes was studied in 40 patients undergoing ophthalmologic surgery. 20 had neurolept analgesia, 20 had halothane anaesthesia. The duration of anaesthesia, age of the patients and their previous history corresponded fairly closely to those of a group of patients who had gynaecological operations and were the subject of a previous study. In contrast to the latter group total protein, cholinesterase, GOT, GPT, LDH, GLDH, AP, LAP and gamma-GT remained normal up to 12 days after the operation. The exception were changes in the total bilirubin levels which were similar to those observed in the gynaecological cases. Possible causes are discussed.

Adult↗
PubMed1979

[Gas chromatographic determination of the solubility coefficient for volatile anaesthetics (author's transl)].

For the determination of the solubility coefficient of volatile anaesthetics in Schindler's liquid culture, modified by Karzel, a gas-chromatographic analysis with direct-injection-method was used. A well defined volume with a known concentration of the anaesthetic was added to a vessel with known volume. After equilibration the concentration of the inhalational anaesthetics was determined in the liquid at various temperatures. The solubility coefficient and the temperature coefficient were then calculated from these data. We obtained the following solubility coefficients at -4 degrees C (37 degrees): for halothane 1,07 (0,77), for enflurane 1,14 (0,70), for methoxyflurane 4,92 (3,23) and for isoflurane 1,13 (0,82). In Schindler's liquid culture modified by Karzel the values at 24 degrees (37 degrees) were: for halothane 1,33 (0,92), for enflurane 1,32 (0,87), for methoxyflurane 6,61 (4,48) and for isoflurane 1,19 (0,98). The temperature coefficient for this temperature range were in water (in Schindler's liquid culture) for halothane: -2,31 . 10(-2) K(-1) (-3,15 . 10(-2) K(-1)), for methoxyflurane: -13,0 . 10(-2) K(-1) (-16,48 . 10(-2) K(-1)), for enflurane: -3,38 . 10(-2) K(-1) (-3,46 . 10(-2) K(-1)) and for isoflurane: -2,38 . 10(-2) K(-1) (-1,62 . 10(-2) K(-1)).

Anesthetics↗
PubMed1979

[Indications and value of chest radiography in patients with respiratory insufficiency (author's transl)].

Chest X-rays of patients with respiratory insufficiency provide different information depending on the stage of the disease. The indications for chest radiography should, therefore, be determined by whether the examination is intended to establish the diagnosis and causes of the respiratory disease, to arrive at the differential diagnosis or test the efficacy of treatment.

Adolescent↗
PubMed1978

[Anaesthesia and immunology (author's transl)].

There is evidence of immunosuppressive influence of trauma/operation and anesthesia. The human immunological system is outlined as a complex functioning apparatus with humoral and cellular factors. The influence of operation and/or anesthesia on immunocompetence has been demonstrated by animal studies, in vitro examinations and clinical investigations. The analysis of these results and their significance for an impairment of the immunological surveillance of the patient is tried to be elucidated. There should be payed attention to the clinical consequences, especially in patients on high risk.

Anesthesia↗
PubMed1978

[Diaplacentar transfer of local anaesthetics (author's transl)].

A very rapid resorption of the amide-type local anaesthetic agents most commonly used in obstetrics results in detectable plasma levels in mother and fetus within 5 to 10 minutes, respectively, after peridural anaesthesia. The various local anaesthetics differ from each other as far as their protein-binding capacity and the resulting ratios of umbilical vein to maternal blood levels are concerned. The feto-maternal ratio is inversely correlated to the degree of protein-binding. Both, the protein-binding capacity and the feto-maternal ratio do not indicate the total amount of the anaesthetic transferred across the placenta. In contrast to measurements of the plasma concentrations only the measurement of the anaesthetic in the fetal tissue would give an exact information about the fetal uptake of local anaesthetics. Several observations hint at the possibility that there are interactions between local anaesthetics and other drugs: A competitive displacement of local anaesthetics from their protein binding sites resulting in an increase in the unbound fraction is suggested. Since the feto-maternal equilibration exists only for the unbound fraction interactions of local anaesthetics with simultaneously administered drugs should be taken into consideration.

Anesthetics, Local↗
PubMed1975

[Changes in cerebral blood flow and oxidative cerebral metabolism after extensive acute head trauma (author's transl)].

Total cerebral blood flow and oxidative cerebral metabolism were measured at normal pCO2, hypocapnia and hypercapnia in 15 unconscious patients in the acute phase after head trauma. In the basal position (normal CO2) measurements were within normal limits and did not correspond to the severity of the clinical picture. But on altering arterial pCO2 there were market changes in oxidative cerebral metabolism, which suggests an abnormal cerebral regulatory mechanism. Measurement of the same functions 14 days later indicated, on the one hand, persistence of changes, but, on the other, a return to normal of previously markedly elevated cerebral glucose uptake. Comparing cerebral blood flow and metabolism between patients who survived and those who died in the acute phase after brain damage, there were no significant differences.

Adult↗
PubMed1975

The effect of carbon dioxide on cerebral blood flow and cerebral metabolism in dogs.

In 11 normally oxygenated, normotensive mongrel dogs, blood flow and oxidative metabolism of the brain was studied during normocapnia and during respiratory alkalosis and respiratory acidosis. During respiratory alkalosis (mean PaCO2 17.8 mm Hg) CBF decreased significantly from 61.0 to 33.9 ml/100 g/min (44%) while arteriovenous-substrate differences increased and the rates of oxygen and glucose metabolism remained constant. Cerebral venous-arterial difference of lactate was increased significantly as compared with the resting state. During hypercapnia CBF increased significantly from 61.0 (resting state) to 115.7 ml/100 g/min (89%) (mean PaCO2 64.7 mm Hg). The arteriovenous-substrate differences decreased while the cerebral metabolic rates remained constant. The data show that the relationship between PaCO2 and CBF in the range 20-65 mm Hg PaCO2 is expressed by a linear relationship: y = 2.88 + 1.69x; in this range, the oxidative metabolism of the brain is unchanged and the increased cerebral lactate production in respiratory alkalosis is not necessarily linked to tissue hypoxia.

Acidosis, Respiratory↗