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Biomedical subjects

L Grabow

Publications and source records attributed to L Grabow.

At least 19 recordsLinked to original sources
PubMed1994

Controlled study of the analgetic effectivity of acupuncture.

Two methods were used to test the analgesic effectivity of acupuncture: 1. as a method of postoperative pain therapy several analgesic medications were compared with acupuncture; 2. extracorporeal shockwave lithotripsy (ESWL) was used as a clinical algesimeter to test the analgesic effect of analgesic medications and acupuncture to a controlled pain stimulus. In both groups the analgesic effectivity was placebo controlled. Both methods showed equally that the analgesic effect of acupuncture is similar to that of the placebo group. Thus acupuncture is not a generally useful form for the treatment of acute pain. On the other hand the results show that there is always a minority in the examined population, who is completely satisfied with acupuncture as sole treatment of pain. So the secret of acupuncture probably lies in the selection of patients sensitive to acupuncture. A further result of possible importance could be that it was evident that under controlled conditions postoperative wound pain may serve as a measure of pain analogue to ESWL as an algesimeter.

Acupuncture Therapy↗
PubMed1991

[Effect of the depth of anesthesia on the postoperative course].

An assessment of the influence of several variables during the perioperative period revealed a cause-determining correlation between the explanatory variables age, body size, weight, duration of operation, loss of blood, and pain level and the physiologic variables adrenaline, total protein, blood glucose level, transferrin, cholinesterase and immunoglobulin G that could be statistically be proven. An evaluation of the influence of the depth of anesthesia on this cause-determining correlation demonstrated significant advantages for a deep level of anesthesia. The depth of anesthesia should be seen as an influential factor during the perioperative period. Anesthesia should therefore not be regarded simply as analgesia and loss of consciousness; rather, one should stress the psychophysiological attenuation and its negative influence on the sensorimotor functions that are accompanied by changes in physiology. The central organ of regulation controls the physiological levels of the organism, and changes in brain function result in changes in physiology. During the perioperative period, rapid and programmed functional mechanisms that are controlled by more primitive parts of the brain and thus are not influenced by individual inappropriate decisions of the "higher" brain centers are needed for the patient's convalescence. This would explain the advantage of a deep level of anesthesia. The usual grading of stages of anesthesia according to Güdel provides little help in this respect; therefore, an assessment of the depth of anesthesia using EEGs and evoked potentials should be combined with an evaluation of physiological variables at several other levels of the organism such that further information can be obtained on the conditions existing at the onset of the postoperative course.

Adolescent↗
PubMed1990

[Comparison of several variables of metabolic, immunologic and endocrine function with personality factors in perioperative stress].

To look for relations between stress and personality a comparison of neuroendocrine, metabolical, immunological variables with personality factors according to Eysenck was performed. There are unsharp relations between physiological variation and personality scores, which give reference to interconnections between stress, perioperative course and complications; not in the simple minded understanding that stress causes trouble, but the dependence of perioperative difficulties on that, how an individual percepts its inner and outer surface and reacts on events on them. The anticipation of aversive signals alone is not sufficient for triggering the stress reaction, it needs additionally the corporeal perception, which signals the brain, that the threatening event really occurred. In perioperative time the stress reaction solves round about the 5th day postoperatively.

Adolescent↗
PubMed1990

[Preoperative anxiety--anxiety about the operation, anxiety about anesthesia, anxiety about pain?].

Questioning for the content of presurgical anxiety a situative examination of different contents of anxiety was performed combined with a correlational analysis of problem relevant personality traits (Freiburger Personality Inventory, FPI; Eigenschaftswörterliste, EWL). Preoperatively the anxiety in young patients is higher than it is in old ones, women anticipating thoracotomy name the highest anxiety scores. Generally the anxiety before important surgery is higher than before operations, which are calculated as being not so impressive; women show higher anxiety than men. Postoperatively anxiety does not decrease, but remains nearly unchanged, but very high scoring anxiety preoperatively turns back to low scoring postoperatively. From the contents of anxiety that of mutilations by surgery ranges firstly in major surgery, followed by anxiety of unreversible lost of consciousness by anesthesia, in "minor surgery" this ratio is turned back, here anxiety of complicated anesthesia ranges firstly. With growing age anxiety of mutilation by surgery becomes apparent. The informations about anxiety are related to content of anxiety, rarely to other variables, which were examined together with. The information is correlated to the personality traits, esp. to extraversion-introversion and emotional lability/stability, both are similarly correlated with pain, but not to postoperative complications. The idea that preoperative anxiety may reactively induce postoperative complications cannot be supported by the results.

Adult↗
PubMed1986

[Equivalence of oral and intramuscular premedication. III. Effect of premedication on anesthesia and postoperative pain].

600 patients were given 6 different premedications in randomised design to study their effect on the course of anaesthesia and on postoperative pain. Premedication acts indirectly on anaesthesia, depending on the influence of the drug on anxiety and on the somatic correlates of anxiety. The greater the sedative-anxiolytic effect of the premedication, the easier it is to induce anaesthesia, and the more superficial the anaesthesia, resulting in earlier and stronger onset of postoperative pain. On the other hand, the more anxious the patient is, the more he consumes anaesthetic drugs, whereas anaesthesia remains superficial with the same consequences in respect of postoperative pain. In view of postoperative pain, fast and early awakening from anaesthesia must not be aimed at, particularly after operations which definitely result in postoperative pain (long-term operations in those regions of the body that cannot be immobilised).

Administration, Oral↗
PubMed1986

[Equivalence of oral and intramuscular premedication. I. Oral versus intramuscular premedication].

In a randomised study, 6 different premedications (oral flunitrazepam, oral pentobarbital, oral NaCl solution; intramuscular pethidine, intramuscular droperidol/fentanyl, and intramuscular NaCl solution) were administered to 600 patients, to determine the equal efficacy of oral and intramuscular application. The results show a significantly better mode of action of oral premedication.

Administration, Oral↗
PubMed1986

[Equivalence of oral and intramuscular premedication. II. Effect of various conventional premedication drugs].

In a randomised study, 6 different premedications (oral flunitrazepam, oral pentobarbital, oral physiological NaCl solution, intramuscular pethidine, intramuscular droperidol/fentanyl, intramuscular physiological NaCl solution) were administered to 600 patients to determine the equal efficacy of the premedicative drugs in oral or parenteral administration. Patients gave the best rating to the oral application of flunitrazepam. The differences in the assessment of application and effect of the drugs are contrasted by the statement that most patients do not feel any direct influence on their preoperative anxiety by premedication. However, it is easier for them to cope with anxiety because premedication pacifies the patients, whereas each of the dependent variables, such as apprehension, is influenced differently. Oral premedication again proves superior to parenteral premedication.

Administration, Oral↗
PubMed1982

[Cooperation of psychology and anesthesiology in intensive care medicine].

Intensive care cannot consist only of monitoring and compensatory measures in organ system failure, but likewise must comprise psychological treatment of the patient. In this field psychology and anaesthesiology share a unique opportunity to get insight into neurobiological relations of human behaviour. If psychological investigation of the intensive care patient is understood as a behavioural analysis related to biological function, then anaesthesiology may contribute substantially to this evaluation. Moreover important information on prolonged but subtle influences of anaesthetics on central nervous system function, may be gained and expand our as yet poor knowledge in this field.

Adaptation, Psychological↗
PubMed1982

[Pain treatment by sub or epidural opiate administration].

Morphine and opiate analogues for pain relief were applied epidurally or intrathecally. Synthetic opioids, eg. pethidine, pentazocine or piritramide proved unsuitable with both modes of administration. Only morphine in doses as low as 2 mg reliably produced analgesia lasting from 16-24 hours. Intrathecal application of morphine is of limited value because of the substance's possible transport to medullary regulating centres and therefore is not recommended in awake patients. Conversely this very side effect may advantageously be employed in patients on ventilator treatment as a method for analgesia and sedation. Lumbar epidural administration of single doses of morphine 2 mg at present is the most effective treatment both for pain following thoracotomy, laparotomy, surgery on the vertebral column, gynecological and urological procedures and pain due to trauma to the chest wall or pelvis, provided supervision in an intensive care ward guards against possible side effects. Epidural or intrathecal opiate is not suitable for the treatment of chronic or functional pain.

Anesthesia, Epidural↗
PubMed1982

[Intraoperative epidural opiate analgesia for pain treatment after spine surgery (author's transl)].

The intraoperative epidural opiate application seems to solve the problem of postoperative pain treatment after surgery of the vertebral column. For this purpose 2 mg of morphine in 1,0 ml NaCl-solution are placed epidurally in the root region, just prior to wound closure. 35 patients were treated in this manner and all of them, that means 100%, needed no analgetic in the first 16--24 hours after the operation. The patients feel remarkably better and nursing is facilitated. Intensive supervision however is essential during this time to prevent the risk of ascending diffusion of the morphine to the medullary regulating centers.

Anesthesia, Epidural↗
PubMed1981

[Recent development in high frequency electrohypalgesia (author's transl)].

After experiences of 1000 operative interventions undertaken during the use of a high frequency generator for production of electrohypalgesia, a technically revised generator was constructed. With that the electrohypalgesia owns a sure apparative basis. The method is suited for high risk patients.

Electronarcosis↗
PubMed1981

[Neurometric analysis of brain function under general anaesthesia (author's transl)].

Neurometric analysis is a multi factorial investigation of brain functions by means of physiological and psychological methods. This kind of procedure was developed because measurement of brain blood flow, brain electrical activity and brain metabolism are not able to describe consciousness and pain. The combination of physiological and psychological tests enlarges the possibilities for anesthesiological research, the main result is that consciousness and pain are not separated brain functional processes. Pain is a perceptual behaviour which is subordinated to consciousness.

Arousal↗
PubMed1980

[Carbohydrate metabolism and personal assessment under the influence of general anaesthesia (author's transl)].

The examination of pO2, pCO2, lactate, pyruvate and glucose-concentration of arterial and brain venous blood shows significant differences only at 2. and 6. hours after operation between the 3 methods of general anesthesia, halothane-anaesthesia, neuroleptanalgesia and electrophypalgesia. The differences are related particularly to neuroleptanalgesia, which method directs the metabolic activity of the brain tissue to a more anaerobic state. Differences due to the age or to the personal factors of the patients were not seen.

Adult↗
PubMed1980

[General anaesthesia and vigilance with respect to personal assessment (author's transl)].

The examination of vigilance by using a test independent to age, intelligence and culture shows significant differences between HAL, NAL and EHA. Striking in this connection are aged persons anaesthetized by HAL and NLA, whose vigilance is at 2. and 6. hours after operation much more restricted than with EHA. So former examinations are provided. With respect to vigilance a revized indication for the use of general anesthesia can be given.

Adult↗
PubMed1980

[Changes of brain electric activity under general anaesthesia (author's transl)].

The comparison of the influence of HAL, NLA and EHA on the electrical activity of the brain by help of a vigilo-somnogram shows equal directed curves. That is to say that the effect of general anesthesia is to be seen in a inhibition of the central nervous system, from which in the first line the orienting reticular system and pain processing centres of the limbic system are concerned. It has to be emphasized that the sleep-EEG and the EEG of general anaesthesia have a certain similarity but no identity; so the sleep state of the EEG should not be transferred to the anaesthesia states.

Adult↗