Perioperative management of mentally handicappedArticles

J. Rupreht, E. C. M. Bouvyberends

Anest. intenziv. Med. 1998;9(6):218-220

Modern medicine has improved beyond measure survival of physically or mentally handicapped children. Mental handicap often becomes obvious long after birth and severely retarded persons later end up in centres for special care. They usually do not look after their health and are usually nor reasonable when medical treatment is needed. In this they are similar to very young children who benefit from special paediatric hospital environment and medical staff trained especially to meet all their needs. No such provisions are generally available for mentally handicapped although their mental development has stopped at a very childish age and their retarded...

Malignant hyperthermia - an actual overviewArticles

E. Kurča, B. Sániová, M. Drobný, P. Kučera

Anest. intenziv. Med. 1998;9(6):221-225

Malignant hyperthermia (MH) is a hereditar disorder of skeletal muscle characterised by a paroxysmal hypermetabolic state of muscle fibers. MH is triggered by some drugs usually during general anesthesia. MH may lead to death if no accurate therapy is applied immediately. An overview of MH epidemiology, pathogenesis, clinics, therapy and genetics is presented with attention to counselling and situation in Slovakia.

First experience with the use of COPA during anesthesia - a comparison with laryngeal mask airwayArticles

P. Michálek, L. Doleček, O. Cihlářová

Anest. intenziv. Med. 1998;9(6):226-230

The paper presents first experience with securing the airway patency during anesthesia with the use of cuffed oropharyngeal airway (COPA). We sought to determine the indications criteria, selection of optimal size for particular patients and optimal induction technique for COPA insertion. Complications associated with insertion of COPA, during anesthesia and after the procedure are reviewed. All monitored parameters are compared to parameters of the group of patients who were anesthetized with the use of laryngeal mask airway in the corresponding time period.

Premedication with depot form of clonidineArticles

D. Hylas, J. Zahrádka

Anest. intenziv. Med. 1998;9(6):231-233

In a prospective study we evaluated 252 patients premedicated with oral flunitrazepam vs combination of oral flunitrazepam and clonidine. We compared the incidence of postoperative shivering, basic hemodynamic parameters during anesthesia (incl. response to tracheal intubation and preoperative parameters), the effect on halothane and opioid consumption. The study also reflects routine feasibility of this pharmaceutical form of clonidine. With the addition of oral clonidine to standard oral premedication with flunitrazepam there can be achieved significant decrease of the frequency of postoperative shivering which would significantly increase oxygen...

Perioperative risk in patients with obstructive sleep apneaArticles

E. Szabóová, Z. Tomori, J. Gonsorčík, O. Rácz

Anest. intenziv. Med. 1998;9(6):234-237

Sleep apnea syndrome, especially its obstructive form, is serious medical and social-economic problem. Its importance is documented on various adverse effects on distant organs. Cardiovascular complications of obstructive sleep apnea (OSA) are relatively frequent. They represent the major cause of morbidity and mortality in patients with OSA. Patients presenting for anesthesia with OSA are considered to be of high-risk. The most threatening perioperative complications are of cardiovascular origin, namely post-obstructive pulmonary edema. The most important risk factors are AI>70, SaO2

Ondansetron in the prevention of postoperative nausea and vomitingArticles

P. Kothaj, M. Novotný, M. Onderčanin, J. Příborský, J. Vlček, F. Vyhnánek

Anest. intenziv. Med. 1998;9(6):238-240

Ondansetron in the prevention of postoperative nausea and vomiting (PONV) in patients with general anaesthesia undergoing elective abdominal surgery was evaluated in randomised, double blind, placebo controlled, multicenter, parallel group study. Based on the results, we can conclude that ondansetron in dose 4 mg i.v. is effective in the prevention of postoperative hausea and vomiting. Number of emetic episodes was in ondansetron group statistically significantly lower and no nausea was observed in larger number of patients. No significant increase of adverse events was observed in ondansetron group vs. placebo.

Central sleep apnea syndrome - a case reportArticles

J. Polívková, K. Šonka, Z. Ehler, J. Cheníček

Anest. intenziv. Med. 1998;9(6):241-242

The paper presents a short review of ventilatory disorders during sleep. The authors try to elucidate the cause, symptoms and treatment available for separate types of disorders - obstructive, central and mixed. In a detail, there is presented a case report of central sleep apnea from the onset of first symptoms, complications and following course with an attempt of a patient to return to normal life.

Intracranial hypertension - pathophysiologyArticles

M. Filaun

Anest. intenziv. Med. 1998;9(6):243-249

pathologic conditions. Three basic parts of intracranial volume with is autoregulation are described. The role of cerebrospinal fluid, its production and resorption, the role of blood volume and cerebral blood flow with autoregulation and the role of brain mass with types of brain oedema is described. Specific aspects in children are mentioned in the last part of this paper.

Intracranial hypertension - treatmentArticles

M. Filaun

Anest. intenziv. Med. 1998;9(6):250-253

The paper reviews basic aspects of treatment of intracranial hypertension with contemporary view on treatment. Basic principles of treatment are: control of temperature, positioning of head, control of seizures, sedation, neuromuscular blockade, CSF removal, osmotic therapy, hyperventilation, barbiturates, hypotermia and surgical decompresion. Contraindicated therapeutic agents are mentioned. Specific approach of therapy in infant and children is mentioned in last part of this paper.

Our technique of retrograde cannulation of internal iugular veins in head-brain injuriesArticles

M. Kolkus, M. Berešík, M. Pauliny, J. Jacková

Anest. intenziv. Med. 1998;9(6):254-256

Continuous monitoring of SjO2 and lactate concentration in iugular venous blood is used to screen for brain ischemia. This method deserves retrograde introduction of fiberoptic cannula to bulbus superior of internal iugular vein. Constant and well palpable points create anatomic landmarks for the introduction approach. Using this technique, introduction of the cannula can be performed easily, because the distance between puncture sites of the skin and vein is short, the head does not to be turned to one side with tilt in the neck. This is extremely important and advantageous especially in patients who suffered head-brain injury.

Prognostic value of pEtCO2 monitoring during CPR in out-of-hospital settingArticles

J. Knor, M. Pokorná

Anest. intenziv. Med. 1998;9(6):257-260

The aim of the study was to determine the value of intermittent capnometry during cardiopulmocerebral resuscitation in the prehospital care setting. It is proven that partial tension of carbon dioxide at the end of expiration (pEtCO2) directly corresponds to the effectivity of indirect cardiac massage and perfusion of pulmonary vasculature. The authors tried to determine the prognostic value of this parameter with respect to the short-term and long-term survival, respectively.

DiskuseArticles

Anest. intenziv. Med. 1998;9(6):261

RecenzeArticles

Anest. intenziv. Med. 1998;9(6):262