University Hospital Homburg Germany Saar, Department of Anaesthesiology and Intensive Care, Homburg/ Saar, Germany

University Hospital Homburg Germany Saar, Department of Anaesthesiology and Intensive Care, Homburg/ Saar, Germany

University Hospital Homburg Germany Saar, Department of Anaesthesiology and Intensive Care, Homburg/ Saar, Germany

University Hospital Homburg Germany Saar, Department of Anaesthesiology and Intensive Care, Homburg/ Saar, Germany

s and Programme: EUROANAESTHESIA 2011: The European Anaesthesiology Congress: Airway Management

s and Programme: EUROANAESTHESIA 2011: The European Anaesthesiology Congress: Airway Management

Wrobel, M.; Bauer, Ulrich.; Kreuer, Sascha.; Bauer, Clemens.; Grundmann, Ulrich. Author Information

In this prospective, double-blind, randomized, placebo-controlled study we compared the efficacy of three IV non-opioid analgesics for postoperative pain relief after lumbar microdiscectomy. Eighty healthy patients were randomly divided into 4 treatment groups (n = 20 each) to receive either parecoxib 40 mg, paracetamol 1 g, metamizol 1 g, or placebo IV 45 min before the end of surgery. In the postanesthesia care unit (PACU) patients were treated using patient-controlled analgesia (PCA) with piritramide. In the metamizol group the pain score at arrival in the PACU was significantly lower compared with the paracetamol, parecoxib, and placebo groups. In addition, in the metamizol group significantly fewer patients required additional PCA compared with the other groups studied. However, in those patients who required additional pain therapy in the four treatment groups, there was no significant difference in time to first request for piritramide and cumulative consumption of piritramide as assessed by the PCA data in the PACU. The incidence of adverse side effects was infrequent in all groups. These results suggest that in patients undergoing lumbar microdiscectomy, metamizol is superior to parecoxib, paracetamol, and placebo for immediate postoperative pain relief with minimal side effects.

Ziel dieser Studie war der Vergleich der Sichtverhältnisse auf die Glottis, die beim Einsatz des Macintosh-Spatels während der konventionellen Laryngoskopie und während der Videolaryngoskopie erreicht werden.

BACKGROUND:We compared the ease of viewing the glottis under direct vision during conventional laryngoscopy with the quality of indirectly viewing on a monitor during laryngoscopy with a Macintosh videolaryngoscope in a multicenter study.PATIENTS AND METHODS:After ethical approval and written informed consent of 300 patients with no anticipated difficult airway, conventional laryngoscopy with a Macintosh videolaryngoscopy blade was performed and the quality of the view of the glottis was assessed and documented according to the Cormack and Lehane scoring system as modified by Yentis and Lee. Subsequently, the indirect viewing conditions on the monitor were documented without changing the position of the blade. Differences between both distributions were analyzed using the Bland-Altman Test.RESULTS:Videolaryngoscopy improved the laryngoscopy score by 1 grade in 72 cases, by 2 grades in 17 cases and by 3 grades in 2 cases. A relevant improvement (from grades III/IV to II) was found in 28 patients. Viewing conditions worsened in 3 cases by 1 grade, in 4 cases by 2 grades and in 3 cases by 3 grades. A statistical analysis of the data gave a bias of 0.31 and an SD bias of 0.77.The 95% confidence interval of the distribution ranged from -1.12 to 1.81.CONCLUSION:Videolaryngoscopy can lead to better viewing conditions but in rare cases it may result in worse viewing conditions.

Wrobel, M.; Kreuer, S.; Schlaich, N.; Thielen, T.; Larsen, R.; Wilhelm, W. Author Information

Kenntnisse des Zusammenhangs zwischen Bispektralindex (BIS, A-2000, Aspect Medical Systems, USA) und endtidaler Desflurankonzentration bei remifentanilbasierter Anästhesie liegen nicht vor. Wir untersuchten Desflurankonzentrationen unterhalb von 1 MAC („minimal alveolar concentration“), da bei Fast-track-Anästhesie mit Remifentanil höhere Desflurandosierungen nicht erforderlich sind.

Ziel der vorliegenden Untersuchung war ein Vergleich der klassischen Larynxmaske (LMA) mit dem Larynxtubus (LT) bei nichtrelaxierten Patienten.