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Targeted monitoring of analgesia, sedation and delirium, as well as their appropriate management in critically ill patients is a standard of care in intensive care medicine. With the undisputed advantages of goal-oriented therapy established, there was a need to develop our own guidelines on analgesia and sedation in intensive care in Germany and these were(More)
BACKGROUND Endothelium-dependent dilator responses mediated by NO and endothelium-derived hyperpolarizing factor (EDHF) are altered in arteriosclerosis and sepsis. The possibility that proinflammatory mediators that stimulate the expression of inducible NO synthase (NOS II) affect the generation of EDHF was examined in isolated arteries. METHODS AND(More)
UNLABELLED Worldwide, long-acting bupivacaine is the most popular local anesthetic for spinal anesthesia in parturients undergoing elective cesarean delivery. With advances in surgical techniques, e.g., the Misgav Ladach method, and shorter duration of surgery, the local anesthetic mepivacaine, with an intermediate duration of action, may be a reasonable(More)
Objective. To compare two single-dilator percutaneous tracheostomy techniques, Ciaglia Blue Rhino and the new PercuTwist technique. Design and setting. Randomized, observational clinical trial in patients undergoing elective percutaneous tracheostomy in the intensive care units of a university hospital. Patients. Seventy consecutive, adult patients(More)
OBJECTIVE Fiberoptic intubation for the management of the difficult airway is usually achieved with the patient under light sedation. The goal of the present study was to evaluate the combination of propofol and remifentanil for sedation during fiberoptic intubation. METHODS Plans were made to use fiberoptic intubation in 40 patients with predictably(More)
Es war das Ziel der vorliegenden Untersuchung, zwei intravenöse Sedierungstechniken mit Propofol (P) oder Methohexital (M) zur elektiven Magnetresonanztomographie (MRT) bei 120 Kindern unter 6 Jahren bezüglich Sicherheit, Nebenwirkungen, Aufwachverhalten und Verlegungszeiten zu vergleichen. Jeweils 60 unprämedizierte Kinder erhielten prospektiv,(More)
UNLABELLED Rectal acetaminophen (Ac) is often administered prophylactically at anesthesia induction for postoperative pain management in small children and is thought to have an opioid-sparing effect. We assessed in this double-blinded, prospective, randomized study early opioid requirements after three doses of Ac (10, 20, and 40 mg/kg versus placebo) in(More)
INTRODUCTION This open label, multicentre study was conducted to assess the times to offset of the pharmacodynamic effects and the safety of remifentanil in patients with varying degrees of renal impairment requiring intensive care. METHODS A total of 40 patients, who were aged 18 years or older and had normal/mildly impaired renal function (estimated(More)
Certain cytokines stimulate the expression of the inducible nitric oxide synthase (iNOS) in vascular smooth muscle cells (VSMCs) and in many other cell types. The large amounts of nitric oxide (NO) generated by iNOS in the vascular wall contribute to the unrelenting hypotension in septic shock. Because septic patients are often treated with barbiturates, we(More)
OBJECTIVE This study compared general anesthesia (GA), combined GA plus thoracic epidural anesthesia (TEA), and TEA alone in patients scheduled for off-pump coronary artery bypass grafting. DESIGN Prospective, nonrandomized clinical study SETTING University hospital. PARTICIPANTS Ninety consenting patients undergoing beating-heart coronary artery(More)