Search PubMed⌕ Search

Biomedical subjects

V Hempel

Publications and source records attributed to V Hempel.

At least 19 recordsLinked to original sources
PubMed1999

[Is spinal anesthesia for operations in the prone or jackknife position suitable?].

There is still controversy on the usefulness of spinal anesthesia for operations performed in the prone or jackknife position. There is about the risk of inadvertent increase of the sensomotory blockade with the patient in the prone position and the difficulty of managing consecutive cardiorespiratory complications or inducing general anesthesia in case of failures. This article reviews the current literature in terms of safety and effectiveness of spinal anesthesia for such operations. For lower-limb or perianal operations with limited extension and blood loss, performed in the prone position, spinal anesthesia seems to be a safe, effective and economic technique in patients without severe a cardiac history. Substantial knowledge about the onset time, fixation time, duration of sensomotory block and baricity of the applied local anesthetic is crucial in this setting. Obese patients are at risk for sudden extension of the block when turned into the prone position. Additional narcotics and sedatives should be avoided and continuous monitoring of hemodynamic and respiratory parameters, of the level of the blockade and vigilance of the patient is mandatory.

Anesthesia, Spinal↗
PubMed1994

[60 years thiopental].

In 1994, thiopentone has been in clinical use as an induction agent for 60 years. For this reason, a literature review is given dealing with its chemical properties and pharmacokinetics with special regard to plasma protein binding, recommended speed of injection, diaplacentar transfer to the foetus in Caesarean section and the transfer to breast milk. The pharmacodynamics of thiopentone are reviewed with emphasis on the effects on the CNS, the cardiovascular system, the respiratory system, renal function, liver and the effect in porphyria. Its side effects such as local reactions and release of histamine are also reviewed. The clinical importance of thiopentone in anaesthesia induction and the present state of cerebral protection are discussed, as well as the results of controlled trials comparing thiopentone to other induction drugs. Thiopentone has the main disadvantage of a slow elimination resulting in minor CNS depression, which seems of very limited clinical importance. In most respects thiopentone seems to be comparable to its younger competitors.

Anesthesia, General↗
PubMed1993

[The laryngeal mask with > 1900 general anesthesias--report of experiences].

Since November 1990 until January 1993, the laryngeal mask airway was employed for 1925 general anaesthesias, i.e. 19.6% of all general anaesthesias in our hospital. On the basis of the protocols the age distribution of the patients, the practice of anaesthesia (premedication with oral benzodiazepines, induction with thiopental, anaesthesia sustained with enflurane/nitrous oxide/oxygen) and the complications are reported. The complications not directly related to the laryngeal mask were: hypotension (5.92%), dysrhythmias (3.17%) and hypertensive states (1.71%). Other complications directly related to the laryngeal mask (bronchospasm, laryngospasm, difficult insertion of the mask, intraoperative vomiting) were less than 1.3% each. One aspiration was recorded, but could not be attributed to the laryngeal mask. Complications with major influence on the postoperative course and hospital stay were not seen.

Adolescent↗
PubMed1993

[The stellate ganglion blockade].

Stellate ganglion block is a selective sympathetic blockade affecting one side of the head and neck, and the upper extremity and upper part of the thorax on the same side. It is an important method of treating impaired vascular circulation, sympathetic reflex dystrophy, causalgia and herpes zoster in the area other indications, e.g. acute hearing loss and retinal arterial spasms, are still disputed. The anatomy of the cervical sympathetic chain, the technique used to achieve the block (paratracheal access) and tests of the effectiveness of stellate ganglion blockade are described. The side-effects and complications of the method and other means of sympathetic blockade are discussed. Patients need to be informed of the possible complications and the alternatives available before being asked to give informed consent.

Autonomic Nerve Block↗
PubMed1992

[The modified Magill forceps].

The Magill forceps are used for nasotracheal intubation, endotracheal suctioning, passing gastric tubes, placement of tampons in the nasopharynx and extraction of foreign material from the pharynx. There are several disadvantages of the standard Magill forceps; however: the danger of cuff perforation, the necessity of readjusting the forceps when placing a tube or catheter, and the risk of injury to the mucous membrane. For these reasons the standard Magill forceps have been modified: the jaws of the forceps have been changed to give curved atraumatic parts without any serrations or sharp edges. RESULTS. The resulting benefits are as follows: Reduced risk of injuring the mucous membrane and perforating the cuff. Tubes and catheter are safely guided between the semiround jaws, making it unnecessary to open the forceps repeatedly to advance the tube. Tampons being placed in the throat no longer get caught between the serrations, and even small foreign objects can easily be extracted from the pharynx.

Anesthesiology↗
PubMed1991

[Prognostic parameters in peptic ulcer disease].

Tendency of peptic ulcer to frequent recurrence and spontaneous healing as to life-threatening complications are apart of the natural history of ulcer disease. In a retrospective study of 7 years, we examined 27 simple factors for their prognostic value by 218 patients suffering from ulcer disease which were diagnosed by fibroscopy. The interpretation with help multi analysis, the variant and discriminant analysis showed by patients with stomach ulcer that, the prognosis of the combination between renunciation of nicotine the begin of the disease until 30th years of the people, more than three foods daily, stomach cancer in the family, blood group A and left finger position would be suitable. The prognosis was better for patients with duodenal ulcer who have nicotine abstinence, childlessness negative history of the family with view to ulcer disease, blood group 0, positive Rh-factor and the working time.

Analysis of Variance↗