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[The Braun apparatus for mixed ether-chloroform anesthesia. A contribution to the early history of combination anesthesia].

The Braun ether-chloroform vaporiser was very frequently used during the first fifty years of the 20th century, mainly in the German speaking region. This primacy was principally involved by the simple management, the universal possibilities of application and the "expedient" combination of ether and chloroform: this term means the differential employment of these two substances for conducting individual anaesthesia. Heinrich Braun had published his method after extensive experimental studies, here briefly referred to; further reasons for the considerable success of the apparatus are discussed.

Anesthesia, Inhalation↗

[Electrostimulation anesthesia in comparison with enflurane-nitrous-oxide anesthesia during gynecologic operations. 1. Clinical experiences].

Concerning twenty-two gynaecological abdomen laparotomies, electrostimulation anaesthesia was opposed to inhalation anaesthesia with nitrous oxide-enflurane. Electrostimulation anaesthesia (ESA) was compared to a nitrous oxide-enflurane technique among two groups of eleven patients each scheduled for gynecological abdominal surgery. The present part of this communication concerns the description of the anesthetic techniques, reactions of the cardiocirculatory system, consumption of muscular relaxants and of analgetics supplementation intraoperatively and during recovery. While heart rate remained fairly normal in both groups, mean arterial pressure in the ESA group increased by 20% of the preanesthetic level as compared to a 10% increase in the enflurane group. It is felt that electrostimulation anaesthesia can be effectively employed even in abdominal surgery. However in cardiac risk patients this technique should not be considered.

Adult↗

[Electrostimulation anesthesia in comparison with enflurane-nitrous-oxide inhalation anesthesia during gynecologic operations. 2. Hormonal reactions in the pre-, intra- and postoperative course].

This study describes the secretion of cortisol, growth hormone, prolactin and catecholamines before, under, and following gynaecological surgery in electrostimulation anaesthesia combined with nitrous oxide (ESA). The hormonal stress reactions of ESA were compared to inhalation anaesthesia with enflurane-nitrous oxide ( EFL ). Twenty-two patients undergoing laparotomy were allocated evenly to one of these procedures. In both groups serum levels for cortisol, growth hormone, and prolactin increased during surgery. Growth hormone showed a considerably higher increase during ESA at the end of the operation, whereas prolactin was higher at all periods of surgery during EFL . Cortisol, however, was identical for both groups. Renal excretion rates of adrenaline and noradrenaline were not significantly different. During surgery more metanephrine and normetanephrine were excreted in the urine under ESA than under EFL . There is no advantage with ESA intra- or postoperatively as compared to other routine procedures of anaesthesia for abdominal gynaecological surgery with regard to the so-called stress hormones or sympathetic activity.

Anesthesia, Inhalation↗

[A technic of analgesic anesthesia as brief anesthesia].

An original technique of analgesic anaesthesia, with the characteristics of brief and out-clinic anaesthesia, has been experimented in a group of patients undergoing light surgery (eye surgery). The technique employs an association of an analgesic--Fentanil--a low dose hypnotic and marked hyperventilation. Recovery characteristics have been assessed by studying neuromuscular and psychoaptitudinal recovery times (Romberg negativisation). The results show that this technique may be worthily included among the best techniques of brief anaesthesia.

Ambulatory Surgical Procedures↗