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Biomedical subjects

J Pfeiffer

Publications and source records attributed to J Pfeiffer.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Methohexital/alfentanil-thiopental/alfentanil for total intravenous anesthesia for direct laryngoscopy with 100% O2 jet ventilation].

For the direct laryngoscopy and microscopic examination of the larynx with exploratory excision and pulpectomy using low frequency jet-ventilation with 100% oxygen we used total intravenous anaesthesia with a strong acting opioid and a barbiturate. Because the achievement of sufficient reflexes and a high degree of vigilance postoperatively are to be aimed, Methohexitone (M) and Thiopentone (T) were investigated in the regard of the suppression of vigilance in the postoperative period. 40 patients were randomly assigned to the group M (n = 20) or T (n = 20). The evening before operation, an intelligence test and a syndrome-short-test (SST) were performed for the measurement of attention and memory (functional psychosis). The patients received 2 mg Flunitrazepam orally and transdermal Scopolamine. On the day of operation the patients received 1 mg Lormetazepam orally for premedication. Anaesthesia was induced with 2 mg Alcuronium, 1 mg Alfentanil, 1.4 mg/kg bodyweight M respectively 5 mg/kg bodyweight T and 1.4 mg/kg bodyweight Succinylcholine. Immediately before laryngoscopy the patients received 2-4 mg Alfentanil. Muscle relaxation was achieved by an infusion with Succinylcholine using relaxometry. Methohexitone respectively Thiopentone were administered by infusion depending on clinical signs indicating insufficient anaesthesia. The following parameters were measured: Blood pressure, heart rate, duration of operation and anaesthesia, parameters of vigilance 30, 60 and 120 minutes after operation (SST) and the ability of performance. The groups were comparable with respect to all data except the parameters of vigilance. The patients receiving M were significantly more vigilant 30 min., 60 min. (SST) and 120 min (SST) after the end of anaesthesia than patients receiving T (p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Attempts to influence movement disorders in hemiparetics.

Step duration, measured in hemiparetic patients walking on a circular path, showed that step duration of the affected foot is usually longer. Functional electrical stimulation of the peroneal nerve in the swing phase of the step (eliminating foot drop) shortened step duration in the majority of cases. Hypnosis induced by the verbal fixation technique was used in hemiparetic patients (a) to ascertain whether the patient's mobility would increase during hypnosis and to determine (in positive cases) whether this approach might be used to predicting the effect of rehabilitation performed by classical methods; (b) to use hypnosis as a method of auxiliary treatment. The general finding was that the extent of movements of the hemiparetic upper extremity considerably improved during and immediately after hypnosis. This effect could be observed both at the level of severe impairment (at the beginning of treatment) and during the later stages when mobility greatly improved due to rehabilitation and recovery.

Arm↗
PubMed1987

Experience with minimal therapy of low back pain.

A group of 20 patients suffering from repeated low back pain with radicular symptomatology in area L5 or S1 was followed-up during an acute attack, without use of some kind of analgetics or only in very reduced quantity. The protective function of pain and especially low back pain had been explained to the patients. The patients were instructed to engage in all movements which do not provoke pain, or if so, at an easily bearable level. They may have to walk with a scoliotic posture or to crawl. The average time of vertebrogenic pain attacks treated with analgetics lasted longer than the ones with minimal drug therapy.

Analgesics↗
PubMed1987

[Ro 15-1788 antagonizes reliably the Benzodiazepine effect after Flunitrazepam combination anesthesias].

INTRODUCTION: The imidazobenzodiazepine Ro 15-1788 has been shown to block the central effects of benzodiazepines without severe side effects in animals studies and human volunteers. Benzodiazepine premedication and benzodiazepine/opioid combinations are often used in anesthesiology. A prolonged benzodiazepine action in combination with narcotics can cause problems in the postoperative period such as respiratory depression or aspiration of gastric contents due to reduced vigilance. Therefore, a reversal of the central effects of benzodiazepines can be of advantage postoperatively. This study was designed to compare the efficacy of Ro 15-1788 and placebo in reversing the central effects of flunitrazepam used to induce and maintain general anesthesia. METHODS STUDY DESIGN: double blind, parallel groups, randomized, placebo-controlled study. 60 patients of both sexes aged 20-65 years, ASA class I-II, who were to undergo elective surgery under general anesthesia with an estimated duration of 90-150 min. Study procedure: Evening premedication: 1-2 mg flunitrazepam orally. Morning premedication: 7.5 mg midazolam orally. Monitoring: blood pressure, heart rate, and ECG continuously. Induction of anesthesia: 0.2 mg fentanyl, 0.03-0.04 mg/kg flunitrazepam, 0.1 mg/kg pancuronium. Endotracheal intubation, mechanical ventilation. Maintenance of anesthesia: N2O/O2 = 2:1, fentanyl, pancuronium, and flunitrazepam depending on clinical response. At the end of surgery and after decurarization (neostigmine 2.5 mg and atropine 0.5 mg) and oxygenation the patients were extubated. Now Ro 15-1788 or placebo in a 5% glucose solution (in the case of Ro 15-1788: 1 ml = 0.1 mg active drug) were administered.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Behavior of adrenaline, noradrenaline, blood pressure and heart rate in intubation in relation to different doses of fentanyl].

In 24 patients undergoing ENT surgery the reactions of blood pressure, heart rate and plasma catecholamines were studied during standardized induction of anaesthesia as well as after additional fentanyl administration of 0.1 or 0.2 mg before intubation. In the control group (n = 8) six measurements were performed, i.e. one minute before and after the administration of the drugs for induction, as well as immediately after the insertion of the laryngoscope and one minute after intubation. In the reference groups two measurements were performed: before induction of anaesthesia and one minute after intubation, in the period of maximal circulatory reaction. 0.1 or 0.2 mg were administered in the fentanyl groups (n = 8 in each) after precurarization before injecting thiopentone. The blood pressure was measured by oscillometry, the heart rate was recorded by an ECG monitor, and the plasma catecholamines were determined by a radio-enzymatic method. In the control group without fentanyl only a rise in heart rate was observed in the induction period until laryngoscopy. After the insertion of the laryngoscope the increase in systolic and diastolic blood pressures, heart rate and plasma noradrenaline levels were marked. One minute after intubation these parameters rose again. The adrenaline concentration hardly changed during the entire period of induction. The administration of 0.1 mg fentanyl proved to be insufficient to depress the sympathoadrenergic reaction during intubation. Although plasma catecholamines did not rise, a marked increase in blood pressure and heart rate could not be avoided. The difference compared to 0.2 mg fentanyl was significant in the parameters blood pressure and heart rate (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Endotracheal↗
PubMed1986

Functional evaluation of cerebral palsy using the ICIDH.

In the past children with cerebral palsy have been assessed by evaluation of the most important functions found to be disturbed in this condition. Such evaluation provides a database for planning long-term rehabilitation. The approach has been transformed by introduction of the ICIDH. From a practical point of view it is useful to concentrate evaluation on only the typical and important disabilities associated with cerebral palsy. It is recommended that, where the severity scale is not applicable to particular disabilities, appropriate means of scaling the severity of involvement should be developed.

Activities of Daily Living↗
PubMed1984

Reno-cerebral oxalosis induced by xylitol.

A 20-year-old man suffering from Crohn's disease developed coma and generalized seizures following ileocecal resection. During postoperative parenteral feeding he received xylitol in an unusually high concentration. CT examinations a few days before death showed intense hypodensity and swelling of brainstem and basal ganglia and increasing triventricular dilatation. Autopsy revealed, mainly in the brainstem and cerebellum, a destruction of intracerebral, intracerebellar and leptomeningeal vessel walls by birefringent crystals (probably calcium oxalate), an early inflammatory reaction and severe brain edema with final tonsillar herniation. The same crystalloid deposits were found in the kidneys.

Adult↗
PubMed1983

[An automated procedure for the determination of the malignancy of tumorous tissue changes].

The accuracy of the "Histomat", an apparatus for automated histophotometric determination of malignant or benign tissues, was used on samples from 235 breast tumours (94 malignant and 141 benign tumours). Analysis of the measured data, using the schema developed by the manufacturer (Hytec), showed that in tumours of the breast this type of histophotometric analysis cannot distinguish between benign and malignant tissue changes. Its diagnostic use is therefore not justified.

Automation↗
PubMed1983

[Sonographic diagnosis of Budd-Chiari syndrome].

In a 28-year-old female patient a diagnosis of Budd-Chiari syndrome was established post partum on the basis of characteristic ultrasonographic findings. The results permit establishment of the syndrome in the early phase of the disease. Early diagnosis of hepatic vein occlusion is particularly important because directed therapeutic regimes may lead to revascularisation of hepatic veins and may thus prevent liver cell necrosis and subsequent hepatic failure.

Adult↗