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K H Weis

Publications and source records attributed to K H Weis.

At least 37 records · Page 2Linked to original sources

[Spontaneous motility of the human taenia coli under morphine, thiopental and dehydrobenzperidol].

Intestinal dysfunction is well known after narcotic analgesics and anaesthetics. The site and extent of this action is not really known in man. We investigated the direct effect of morphine, thiopentone and droperidol on human taenia libera in vitro. The spontaneous motility of strips of fresh resected human taenia libera induced by a suitable preload was observed by isometric measurement of developed tension. Cumulative doses of morphine 1 X 10(-8) - 3.89 X 10(-6) g/ml, thiopentone 2.5 X 10(-6) - 9.75 X 10(-5) g/ml or droperidol 2.5 X 10(-8) - 9.72 X 10(-6) g/ml were added to the bath solution. The following parameters were analysed: amplitude, frequency and performance (Montevideo Units MU) of the spontaneous contractions and also the basal tone between contractions. Morphine showed no effects. Thiopentone reduced basal tone to 45.5% of the initial value and frequency to zero. The amplitude of contractions and the MU decreased with thiopentone more than 22.5 X 10(-6) g/ml. All effects are reversible. Droperidol has no significant effects with the exception of a light increase of frequency in high doses. The well known in vivo effect of morphine is therefore not induced by direct action on the smooth muscle of human intestine. Thiopentone in high dose can reduced intestinal motility by direct action on the smooth muscle. Droperidol in the dose used is probably without clinical relevance.

Colon↗

[Oxycom 50 D].

Explore the source record for details and available documents.

Anesthesia, Inhalation↗

[Pulmonary fibrosis following ARDS. Case report of successful intensive therapy (author's transl)].

The course of the illness of a 56 year old female patient is reported, who is still surviving one and a half years after developing advanced, presumably progressive, so called "shock-lung syndrome". Following two episodes of hemorrhagic shock due to intestinal hemorrhage and post-operative secondary hemorrhage, interstitial lung edema developed, which was resistant to therapy. During the following weeks this was followed by bronchopneumonia with symptoms of sepsis persisting over several weeks. Between the third and seventh week of artificial ventilation X-ray of the lungs showed significant progressive changes of the interstitial tissues. This correlated with a progressive deterioration in gas exchange for O2 and CO2, which reached its peak in the seventh week with a paO2 of 71 mm Hg at a FIO2 = 1 and a paCO2 of 68 mm Hg at a minute volume of 15,51. The compliance of lung and thorax was severely reduced at 19 m1/cm H2O. At this apparently unfavourable time the patient was weaned off the respirator, and subsequently, over a period of three weeks, from oxygen insufflation. After eleven weeks of therapy, transfer to the medical ward was possible, with discharge from the hospital following three weeks later. The lung function tests at the time of discharge revealed a high grade reduction of all lung volumes and capacities without a significant obstructive component. The findings have shown a definite improvement during the following one and a half years. In retrospect the polypragmatic intensive therapy measures do not allow valid generalised therapeutic guidelines to be derived. We conclude, however, from this single observation, that therapeutic nihilism is not justified even in a progressive shock-lung syndrome which appears clinically and radiologically to be at an "irreversible" end stage.

Anesthesia↗

[Recovery from anesthesia with enflurane and neuroleptanesthesia. Quantitative assessment with the aid of psychopathometric tests].

Methodological differences between techniques used to examine recovery from anesthesia prevent direct comparison of results. Also psychological tests are not validated for certain anaesthesiological considerations. The two tests presented here combine ease of use for a bedside test with the advantage that the results are expressed as absolute values of cerebral depression. Based on Wieck's concept of symptomatic or functional psychosis they were developed to document the course of neuropsychiatric illness. Their application following anaesthesia seems to be justified as anaesthesia may be regarded as being a deliberately induced functional psychosis characterized by extremely compressed dynamics. The target of a first pilot study were 60 patients following neuroleptanalgesia with and without antagonization with naloxone, or enflurane anaesthesia, respectively. Psychopathometric evaluation yielded an obvious post-operational decline in the SKT-scores which clearly remained below the pre-operative values even after three hours. All the patients revealed a severe transient syndrome after thirty minutes, a moderate syndrome after one and two hours and a mild syndrome after three hours. The only exception were patients antagonized with naloxone who initially showed an improvement but who afterwards did not behave any better. Neither duration of anaesthesia nor total dose of drugs administered showed any significant correlation to the extent of postoperative cerebral depression. Being uninfluenced by moderating variables such as age and IQ, the psychopathometric tests presented here seem to provide a sensitive and reliable method for quantification of recovery from anaesthesia.

Adolescent↗

[Halothane and spontaneous motility of human taenia libera in vitro (author's transl)].

Isolated human taenia libera shows spontaneous motility in the organ bath. The active basal tone, force development and frequency of spontaneous contractions and total power parameter "Montevideo Units" were first analysed under control conditions. Halothane lowered the active basal tone, frequency and the total power of the muscle strip in a dose-dependent manner. The amplitude and force of contraction of human taenia libera first began to increase under halothane, attaining its maximum at 1.0 vol.%. Halothane concentrations above 1.5 vol.% at first caused a depression and finally abolished spontaneous motility. The changes in the spontaneous motility pattern brought about by halothane were completely reversible. Possible causes for the halothane effect were considered as to the possible relevance to the in vivo situation.

Gastrointestinal Motility↗

[The clinical usefulness of Tramadol-infusion anaesthesia (author's transl)].

Tramadol-HCl was used clinically in the form of a continuous infusion as the analgesic component of a balanced anaesthetic technique. In over 90% of the anaesthetics a further injection of barbiturate and/or supplementary muscle relaxant was necessary because the patients did not tolerate the operative procedure. Although a higher dosage of Tramadol reduces significantly the supplementary barbiturate dosage per kilogram bodyweight per minute which is required, it has no effect on the incidence of reflex movements, nor does it prevent the marked intraoperative rise of diastolic blood pressure. The balanced anaesthetic with Tramadol-HCl is characterized by prompt awakening, total amnesia, good post-operative analgesia and minimal side effects (occasional nausea). In particular, there was no case in which there was noticeable respiratory depression. As insufficient analgesia and hypnosis is provided by Tramadol-HCl, making the administration of muscle relaxants and barbiturates obligatory, there is no significant advance in our technique of using Tramadol-HCl, despite the advantages which have been outlined.

Adult↗

[Hydroxy-ethyl-starch as plasma substitute in transurethral prostatectomy with the "cold-punch" method (author's transl)].

Each of 24 patients undergoing transurethral prostatectomy under spinal anaesthesia received 1000 ml HES and, depending from the clinical situation, some patients received blood-transfusion. Afterwards two groups were formed: group A (11 patients), who received HES only, and group B (13 Patients) with additional blood-transfusions. The following parameters were monitored simultaneously: blood pressure, heart rate, stroke index, cardiac output, active blood volume, hemoglobin and hematocrit in whole blood as well as in the irrigatin fluid of the bladder. They showed HES to be a useful plasma substitute for older patients. It is well tolerated and has a slow stabilising effect on circulation, which was effective for several hours. Furthermore, HES-infusion reduced the average need of bloodtransfusion by 500 ml.

Aged↗

[Heart rate of anaesthesiologists under physical and psychological professional stress (author's transl)].

The heart rate of anaesthesiologists under defined physical and psychological stress as well as during normal anaesthetic practice was studied. An acceleration of heart rate during induction and management of anaesthesia did not occur except in the presence of complicating circumstances. A phone call or a beeper alarm led to a rather ergotropic heart rate reaction (increase of 21%), especially when sleep was interrupted (increase of 75%). Locomotion for a professional reason, whether urgent or not, enhanced the heart rate up to 121/min. A simultaneous subjective feeling of psychological stress had no additional effect. The heart rate during the treatment of life-threatening situations remained at 109/min and often exceeded that of exhaustive running. The mean heart rate during the normal narcotic programe (90/min) was not uncommon and comparable with that of other surgical disciplines. However an increasing tolerance was seen with growing experience. Physical and psychological stress during the anaesthesiologist's work could be differentiated by means of heart rate except in some single observations. In the presence of both stressing factors the heart rate seems to be determined by the motor effort required.

Adult↗

[On the use of concentrated haptoglobin in the treatment of a haemolytic transfusion accident of the ABO-system (author's transl)].

The clinical course and the treatment of a case of severe haemolytic ABO-incompatibility are described. In addition to the routine therapy 3 times 2000 units of haptoglobinconcentrate were given since it is known according to the literature to metabolize free haemoglobin. The clinical result seems to confirm the beneficial effect. The course remained free of complications and the hospital stay was not prolonged. Further clinical experience is needed to confirm the effectiveness of the treatment with haptoglobin in cases with severe haemolysis.

ABO Blood-Group System↗