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W Röse

Publications and source records attributed to W Röse.

At least 19 recordsLinked to original sources
PubMed2001

The effect of anxiety and personality on the pharmacokinetics of oral midazolam.

UNLABELLED: We investigated the relationship between the pharmacokinetic variables of oral midazolam and patients' state/trait anxiety and personality. Twenty-six patients received the standard 15-mg oral dose for anxiolysis on the evening before otorhinolaryngological surgery. Blood samples were taken over a 9-h period after the administration, and the samples were analyzed for concentrations of midazolam and its two main metabolites by using a gas chromatography-mass spectrometry procedure. The pharmacokinetic variables maximum concentration, time to reach the maximum concentration, the elimination half-life, and the area under the curve were calculated from these data. When the patients were divided into groups with respect to their anxiety and personality scores, no significant differences in the pharmacokinetic variables of midazolam could be found. Only small, insignificant changes in the maximum concentrations were found with respect to nervousness and emotionality. We conclude that personality traits and anxiety levels had no effect on the pharmacokinetic variables of midazolam. IMPLICATIONS: We conclude that personality traits and anxiety levels had no effect on the pharmacokinetic variables of midazolam. Therefore, it is not necessary to obtain anxiety or personality scores to find the proper midazolam dose for the individual patient.

Administration, Oral↗
PubMed2000

Ropivacaine plasma concentrations during 120-hour epidural infusion.

The pharmacokinetics of ropivacaine were evaluated during long-term continuous epidural analgesia (CEDA) for about 120 h. The total and free plasma concentrations of ropivacaine and the alpha1-acid glycoprotein (AAG) concentration were measured in 12 patients after total knee arthroplasty. The infusion rate was adjusted according to patients' analgesic needs or side effects. The mean (SD) rate of infusion of ropivacaine (Naropin 2 mg ml(-1)) was 14.6 (3.2) mg h(-1) on the day of surgery and was increased after surgery to 15.4 (4.4) mg h(-1) on days 1-5. This was equivalent to an absolute dose of 1786 (553) mg of ropivacaine over the entire infusion period. After an initial increase, the mean free ropivacaine plasma concentration nearly plateaued and than decreased slightly after approximately 70 h. The individual peak free plasma concentration was 0.096 (0.034) microg ml(-1). The highest individual free plasma concentration was 0.16 microg ml(-1). The individual peak total plasma concentration, 4.1 (1.2) microg ml(-1), was achieved after 67.7 (16.5) h, although the AAG concentration increased throughout the observation period. Our data support the safety and efficacy of long-term ropivacaine CEDA.

Adolescent↗
PubMed2000

Development of a pulmonary phenytoin-associated hypersensitivity reaction despite concomitant dexamethasone and prednisolone administration.

OBJECTIVE: This is the report about a very early onset of phenytoin hypersensitivity reaction showing respiratory insufficiency, fever, hepatic and skin reactions in a 68-year-old male patient who was concomitantly treated with high dose dexamethasone/prednisolone because of brain edema. CASE REPORT: The patient developed a hypersensitivity reaction one week after starting a phenytoin treatment, 250 mg daily intravenously, because of a focal epileptic seizure after a transsphenoidal resection of a pituitary tumor. The drug hypersensitivity was diagnosed first clinically and was confirmed by an in vitro rechallenge using the lymphocyte transformation test three months later. Phenytoin itself did not stimulate the lymphocytes' proliferation. The test was performed successfully using human reference sera. CONCLUSIONS: The results suggest that protein-bound reactive drug metabolites which are assumed to occur in the sera may be responsible for the reaction. Corticosteroids did not prevent the reaction and even seem to mask laboratory and clinical findings. Dexamethasone might accelerate the accumulation of potential allergotoxic epoxide metabolites. Both phenytoin and dexamethasone should be withdrawn urgently in the case of suspected hypersensitivity syndrome.

Aged↗
PubMed2000

[Historical vignettes in intensive care medicine].

Intensive care medicine is the youngest anaesthesiological field. Its roots only go back to the 19th century. It was only in the middle of the 20th century that the technical, organisational and staffing conditions existed for providing concentrated care for the critically ill and injured. Poliomyelitis epidemics, especially the one in Copenhagen in 1952, contributed significantly to the establishment of the first intensive care units. In Germany, the first intensive care units were set up at the end of the fifties. Soon after, in the sixties, publications on intensive care already made up a large part of anaesthesiological literature.

Anesthesiology↗
PubMed1999

[Forty years of anesthesiology in Germany].

Four decades of anaesthesiological development are a relatively short period in the 150 years of modern methods of pain relief. But looking at the very different development of this special field--now known as anaesthesiology--we see that precisely the last 40 years have brought enormous local, national and international progress in anaesthesiology. This is true of the content as well as the speed of development, organisation and reflection in society. In all this, the development in Germany differed from that in comparable neighbouring countries due to the special political conditions that existed. Seen from 40 years of professional experience--gained in the eastern part of Germany--the development of anaesthesiology is presented in four periods: 1958-1968: A common beginning and arbitrary division. 1968-1978: Separate developments during the "Cold War". 1978-1988: Change through rapprochement--the Bahr concept also in anaesthesiology? 1988-1998: Joint development after political change in 1989.

Anesthesiology↗
PubMed1998

[Anesthesiologic retrospective view of the surgeon Hans Kehr].

Prof. Hans Kehr's contributions to the development of operative procedures for the treatment of gall bladder and bile duct diseases at the end of the 19th and the beginning of the 20th century are unquestionable. An anaesthesiological look back at Kehr demonstrates, that this vivacious surgeon drew his attentions also to the perioperative care of his patients and to the choice and administration of adequate anaesthesiological procedures. Already in 1896 in his report to the Annual German Surgical Congress he mentioned anaesthesiological aspects. In his main book publications ("Technique of gall-stone operations"; 1905 respectively "Practice of bileduct surgery"; 1913) there are special chapters on "Anaesthesia in gallstone operations resp. Anaesthesia in bile duct surgery". Some of Kehr's statements, published here, seem to be accurate even today, for example these from 1913: "Adequate anaesthesia is nearly more valuable than the best surgical technique and the most skillful assistance". "... it is clear for me, that a good anaesthetist remarkably improves the results of an operation, while a bad one deteriorates them."

Anesthesia, General↗
PubMed1997

[Professor Fritz Lotsch--a wrongfully forgotten German pioneer in anesthesia].

Like many of the contributors to the early development of anaesthesia in Germany. Prof. Fritz Lotsch (1879-1958) was a surgeon. His acknowledged clinical teachers were Habs. Magdeburg, (1904-1907) in surgery and Benda, Berlin, (1909-1911) in pathology. Lotsch worked at the famous Charité in Berlin under Hildebrand (1908-1909 and 1911-1924) and later as chief surgeon in Burg (1925-1946) and Magdeburg (1946-1952). Lotsch's main contributions to anaesthesia were the development of devices for the administration of inhalation anaesthesia. In cooperation with the Georg Haertel Company he recommended as early as 1910 a "positive pressure anaesthesia apparatus". He improved this device and demonstrated repeatedly the advantages of the Kuhn principle of endotracheal intubation. As early as 1903 Lotsch reported on clinical experience with the recently developed barbiturate "Veronal". Later he reported on advantages and disadvantages of combined anaesthesia using inhalation anaesthetics, opiates and barbiturates. In 1913 he recommended a special double cannula for intravenous infusion purposes which was only rediscovered decades later.

Anesthesia, Inhalation↗
PubMed1996

[The 16th October 1846 and its outcome].

Morton's first successful public demonstration of ether anaesthesia for a surgical operation, performed on October 16, 1846 in Boston/Massachusetts, had far-reaching consequences. The first effect was the surprisingly fast propagation of the new way of preventing pain to nearly all parts of the globe. Anaesthesia made it possible to perform operations previously considered impossible under conditions now acceptable for the patient. From the beginning, recurring side effects and complications made it necessary to collect and report these and to look for improvements or alternatives. This led to the development of local and regional pain relief procedures. Much later, the special field of anaesthesiology emerged. Today, 150 years after Morton's pioneer work, anaesthesiology comprises not only pain relief for operative procedures but also responsibilities in Emergency and Critical Care Medicine and in the treatment of patients with chronic pain. Accordingly, without the least disparagement of daily interdisciplinary cooperation, one can wholeheartedly support Mayrhofer's view that the "Century of Surgeons" has given way to the "Century of Anaesthesiologists".

Anesthesia, General↗
PubMed1995

[A 100-year-old transatlantic contribution to anesthesiologic quality control].

Aspects of quality assurance or control in anaesthesia were already discussed at the end of the last century. The reports "Zur Narkotisirungs-Statistik" given by the Berlin surgeon Gurlt between 1891 and 1895 are published examples. Answers in questionnaires and additional comments--mainly from German surgical hospital departments--were the main sources of these reports. However, every year some answers also came from foreign countries. In his fifth report Gurlt published in 1895 the full text of a contribution given by Prince from Chicago, Illinois, USA. That report--given here once again in the original form--allows an insight into the practice of anaesthesia in North America in those days. Many of these statements and recommendations are still relevant; they are now essentials of the so-called "quality assurance" or "quality control".

Anesthesia, General↗
PubMed1995

[The "narcotization statistics" of Ernst Julius Gurlt of 1895--an early contribution to quality control in anesthesia].

The fifth compilation of anaesthetization statistics "Zur Narkotisirungsstatistik", presented by the surgeon Ernst Julius Gurlt in 1895 summarizes the answers to a questionnaire of the German Surgical Society given by 78 mainly large German surgical hospital departments. It comprises 55,395 anaesthetic procedures, most of them (34,412) performed under chloroform, although this substance was still associated with many more fatal complications than ether. At the same time, unpleasant non-fatal complications in connection with the application of ether are also pointed out. Details concerning premedication, the role of the anaesthetist, postoperative care, documentation and especially complications and how to prevent and deal with them are taken from 38 reprinted reports. Gurlt's activities initiated more than 100 years ago are to be seen as pioneer work in the field of anaesthesiological quality assessment.

Anesthesia, General↗
PubMed1993

[Quality control 100 years ago. "Narcosis statistics" by Gurlt from 1893].

Even 100 years ago the problem of quality assurance in anaesthesia was investigated. In 1890 the German Society of Surgery decided to start "Multicenter Statistics on Surgical Anaesthesia." The project was headed by Ernst Gurlt, surgeon in Berlin. In 1893 he reported on the basis of 62 questionnaires on approximately 50,000 anaesthetic procedures, mostly performed with chloroform. 9 fatal chloroform cases led to a mortality rate of 1:4,275. On the other hand among 6,213 cases with ether anaesthesia there was no death. Gurlt strictly recommended the administration of ether, seconded by contemporaries such as Garré, Trendelenburg, Roux and Juillard. Gurlt's report includes as appendix detailed information on the administered anaesthetics, application techniques, premedication, fatal and non-fatal complications extracted from 18 of the analysed questionnaires. Gurlt's publication is an early document of quality assurance in Germany.

Anesthesia, General↗
PubMed1993

[Heinrich Braun (1862-1934)--a pioneer in anesthesiology in Germany].

Heinrich Braun was born on January, 1, 1862. He attended school in Dresden and was a student of Medicine at the Universities of Strassburg, Greifswald and Leipzig between 1881 and 1887. In 1887 he acquired his doctorate degree. Von Volkmann was his teacher in surgery in Halle. From 1891 to 1905 he worked in different non-university hospitals in Leipzig. In 1894 he was promoted "doctor habilitatus" under Thiersch as an extern. He lectured on general and local anaesthesia as a "Privatdozent". In 1905 he was appointed extraordinary Professor at the Medical Faculty of the University of Leipzig. 1906 he left Leipzig and became Chief Surgeon and Medical Director of the Royal Saxonian Hospital in Zwickau. In this position he worked until his retirement in 1928. He died on April, 26, 1934 in Uberlingen. Heinrich Braun's contributions to the development of anaesthesiology are numerous. They concern general as well as local and regional anaesthesia. In 1901 he designed an apparatus for mixed-gas anaesthesia and reported on experiences with combined inhalational anaesthesia with ether and chloroform. In 1903 he recommended on the basis of profound experimental investigations to add adrenalin as a vasoconstrictor to local anaesthetics. In 1905 the first edition of his manual "Local Anaesthesia--Scientific Basis and Medical Practice" appeared. Braun extended the general practice of local and regional anaesthesia significantly. Famous representatives of his school are Läwen, Peuckert, Kulenkampff, Härtel and Kappis. In Zwickau he extensively dealt with problems of hospital organisation and -construction. In 1921 the new "Krankenstift Zwickau" constructed on the basis of his plans and recommendations was inaugurated.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesiology↗
PubMed1991

[Anesthesiology and intensive therapy 25 years ago--reflections of a new specialty in medical periodicals].

In the search for scientific publications on anaesthesiology and intensive therapy in the year the medical scientific association in the GDR was founded, four periodicals from 1964 were analysed: Das Deutsche Gesundheitswesen, Zeitschrift für Arztliche Fortbildung, Zentralblatt für Gynäkologie and Zentralblatt für Chirurgie. Fifty-six articles were found, half of them written by full-time anaesthetists. These articles give an impression of aspects of pain relief, intensive care and emergency medicine under conditions 25 years ago.

Anesthesiology↗