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Biomedical subjects

P Stieglitz

Publications and source records attributed to P Stieglitz.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Comparison of the clinical effects of propofol and methohexital in induced abortion].

The clinical effects of propofol and methohexitone were compared in a group of 59 women undergoing abortion under general anaesthesia. At induction, the premedicated patients were given 2.5 mg . kg-1 propofol or methohexitone, followed by 1 mg . kg-1 fentanyl; if necessary, extra bolus doses of hypnotic were given. Hiccups and other movements were more frequent with methohexitone. There was no difference between the two groups as for injection pain and apnoea. The quicker recovery with propofol, with a mean of 2 min less, even when extra doses were given, could be explained by the pharmacokinetics of the drug. However, the quality of recovery in either group was satisfactory for short-length anaesthesia.

Abortion, Induced↗
PubMed1984

[Pollution of operating rooms with volatile and gas anesthetics. Methods of prevention].

Gaseous anaesthetic pollution in operating theatres has been known since as far back as 1924. Following Vaisman and Cohen's epidemiology studies, health organizations have been involved in this professional concern. Halogenated vapours and nitrous oxide anaesthetic pollution have been accused of doubling the abortion rate and of moderately increasing the number of congenital abnormalities in the offsprings of anaesthetists. The liver and nervous system are also likely targets for anaesthetic pollution. Animal or cell culture experimental studies concerning pathological consequences of exposure to nitrous oxide or halogenated vapours give conflicting results and are not conclusive. The pollution rate is measured by chromatography and spectrophotometry. 25 ppm nitrous oxide and 2 ppm halothane are the upper limits allowed for air contamination. Total intravenous anaesthesia, closed circuits, draining away expired gases can prevent such pollution, but these techniques do have drawbacks. Pollution prevention is rather simple, moderately expensive and comforting for operating room staff.

Air Pollution↗
PubMed1983

[Exposure to anesthetic gases: risk and prevention].

Several studies published during the last fifteen years seem to demonstrate that major risks, i.e. congenital malformations in the offspring and increased rate of spontaneous abortions, are associated with occupational exposure to anesthetic gases (halothane and nitrous oxide) in operating rooms. In view of the severity of the potential risk, we have: 1) analyzed risk factors in the light of epidermiologic and experimental studies; 2) determined the threshold levels of air pollution for these risk factors; 3) analyzed the situation in the Grenoble Hospital and the means of dealing with it.

Abnormalities, Drug-Induced↗
PubMed1983

[Respiratory obstruction during anesthesia in cases of mediastinal malignant lymphoma].

Three cases of asphyxia at the beginning of general anaesthesia for mediastinoscopy or biopsy of adenopathy are described in patients with malignant lymphoma. One of them died in spite of endobronchial intubation, artificial ventilation and steroids. The two others recovered when specific chemotherapy was added to the same symptomatic treatment. The risk of respiratory obstruction seems higher in non-Hodgkin than in Hodgkin lymphomas. This kind of obstruction is not relieved by an antiasthmatic therapy. Pulmonary lymphatic filtration may be hindered in case of mediastinal lymphoma, especially during anaesthetic induction, and pulmonary interstitial congestion may occur impeding gas propagation. Specific chemotherapy according to the histological type of the tumour may relieve the compression and respiratory obstruction in a few hours.

Adolescent↗
PubMed1982

[Hemodynamic and hormonal study of electronarcosis and neuroleptanalgesia. Clinical study in 17 surgical patients].

The blocking effect of electropharmaceutical anesthesia (EPA) and neuroleptanalgesia (NLA) on adrenergic and hormonal reactions to abdominal surgery were compared in 17 ASA class I to III randomized patients. This study was intended to define the indications for each of these techniques in patients with heart diseases. Each individual received the same anesthetic premedication and induction and was submitted to iterative identical measurements and biological dosages. Before and during surgery, both groups were catheterized with a Swan-Ganz and a radial catheter. Blood sampling for catecholamines, cortisol, glycemia, blood gases dosages were regularly drawn. Electrical stimulation was performed in the EPA group, and fentanyl injections were repeated in the NLA group patients only. The same doses of pancuronium and droperidol were given to every patient. A circulatory hyperkinesia and hyperadrenergia were observed during surgery in all of the subjects but, during EPA, the tachycardia, the cardiac index and the rate-pressure product were higher than during NLA. The body temperature increased towards normal in EPA, not in NLA. Adrenergic and hormonal levels were equal in both groups. The slow variations of all the important parameters demonstrate that the measured phenomenons have a long time-course what legitimates this kind of prolonged on-the-spot observation. The role of droperidol, pancuronium and fentanyl in the observed variations is discussed. The characteristic high hyperkinesia in EPA may be due partly to an inefficacious analgesia because of the fentanyl suppression after induction, partly to the preserved thermogenesis partly to a direct effect of the electrical stimulation on cerebral tissues.

Adult↗
PubMed1981

[Fentanyl-oxygen-pancuronium anaesthesia in cardiac surgery (author's transl)].

A retrospective study of the anaesthetic records in cardiac surgical patients was undertaken: massive doses of fentanyl were used according to Stanley (29). The rate of drug administration was fentanyl 150 micrograms/kg for induction and 15 to 25 micrograms/kg/hour for maintenance, pancuronium bromide 0,1 mg/kg for induction and 0,015 mg/kg/hour for maintenance. Myocardial oxygen consumption (estimated by rate-pressure-product) during induction period remains constant. The oesophago-rectal temperature gradient is smaller than with other anaesthetic techniques, showing a very good perfusion homogeneity without the need of vasodilatator drugs. The temperature after-drop in the post bypass period is also reduced (less than 1,2 degrees C). The incidence of hemodynamic and rhythmic disturbances during operations and during the first post-operative day is lowered. Delayed respiratory autonomy appears to be the major drawback of this method (group 1: 25,30 h +/- 7,30 h; 30,20 h +/- 12,25 h; group 3: 21,15 h +/- 6,25 h).

Adolescent↗