Anesteziologie a intenzivní medicína, 2000 (vol. 11), issue 6
Neuromuscular Block MonitoringArticles
M. Svítek
Anest. intenziv. Med. 2000;11(6):235-244
This review presents the experience with neuromuscular block monitoring get over the last decades. Basic principles of neuromuscular block arereviewed together with peripheral nerve stimulation techniques. There are outlined distinct methods of neuromuscular monitoring with different typesof its record. The characteristic of ideal nerve stimulator for clinical practice are outlined. In the final part of the chapter there is discussedneuromuscular monitoring in anaesthesiology.
Neuromuscular Block Monitoring during Anaesthesia - Current Status in the Czech RepublicArticles
M. Adamus, O. Marek
Anest. intenziv. Med. 2000;11(6):245-250
This survey was conducted among Czech anaesthetists to evaluate neuromuscular blockade monitoring during anaesthesia. Despite the benefit ofneuromuscular monitoring, its utilisation in clinical practice is rather an exception than the routine. There is a noteworthy lack of monitoring facilitiesin Czech Republic (75 % of anaesthetic departments having no device for neuromuscular blockade monitoring).
Propofol for Prolonged Anaesthesia in Children of 1-3 Years of AgeArticles
T. Vymazal, V. Mixa
Anest. intenziv. Med. 2000;11(6):251-254
We try to determine if propofol infusion for prolonged anaesthesia (many hours) is safe even for children from 1 to 3 years of age. Thirty childrenof the studied age were enrolled in the study. We found out that the administration of propofol is devoid of any complications, provided adherence todefined doses and dose regimen. Cardiovascular system of children is not affected. The quality of recovery and recovery time as well as earlypostoperative period are not affected. We can conclude that propofol, in the hands of an experienced anaesthesiologist, represents a safe anaestheticagent even for our smallest patients.
General Anaesthesia with Laryngeal Mask AirwayArticles
M. Pavlík, T. Bartošík, R. Hřib, P. Nohel, J. Žák
Anest. intenziv. Med. 2000;11(6):255-258
Laryngeal mask airway represents a simple, effective and safe way to secure the airway during general anaesthesia. In the hands of an experiencedanaesthesiologist, its insertion is safe even in different positions of a patient. LMA can be used for both spontaneous and positive pressure ventilation.The complication rate with LMA compared to standard tracheal intubation is not higher, and t he complications appear to be less critical.
Bupivacaine versus Bupivacaine-fentanyl in Brachial Plexus Block for Postoperative AnalgesiaArticles
I. Przewłocki, M. Májek, V. Przewłocka
Anest. intenziv. Med. 2000;11(6):259-261
Analgetic effect of plain bupivacaine 0.2% vs. bupivacaine-fentanyl was assessed in brachial plexus block. In the first group, thirty millilitres ofbupivacaine 0.2% with fentanyl 3 mg/ml were administered via the catheter every 8 hours; the other group received bupivacaine 0.2% in the sameregimen. Analgesia was assessed according to visual analogue pain score (VAPS) during 72-hour postoperative period. Significantly better analgesiawas achieved in bupivacaine-fentanyl group starting postoperative hour 9, in spite of higher supplemental doses of analgetics in the non-fentanyl group.From the results we can draw a conclusion that fentanyl addition to...
Repeated Recruitment Manoeuvers during Mechanical Ventilation in ARDS PatientsArticles
P. Dostál, V. Černý, R. Pařízková
Anest. intenziv. Med. 2000;11(6):262-266
Recruitment manoeuvre is considered to be an important part of current state-of-the-art ventilatory strategy in ARDS patients. We evaluated theeffect of repeated recruitment manoeuvres during mechanical ventilation of ARDS patients in a retrospective study. We enrolled 25 patients meetingARDS criteria. 12 patients were assigned to repeated recruitment manoeuvre (ROM), 13 patients were ventilated with recruitment manoeuvre only foroptimalization of ventilatory mode (control group). Pulmonary functions were assessed using the ratio of partial tension of O2 in arterialblood/inspiratory fraction of O2 - oxygenation index and PEEP level (on admission and...
The Effect of Continuous Veno-venous Hemofiltration on T lymphocytes and Monocytes Activation in Critically Ill Patients in SepsisArticles
J. Příhodová, M. Holub, J. Hanzlíková, M. Matějovič, V. Šrámek, I. Novák
Anest. intenziv. Med. 2000;11(6):267-270
Elimination methods can improve the prognosis of critically ill patients in sepsis. With respect to that, higher activation of monocytes duringplasmapheresis could possibly play a role (increase of HLA-DR+ monocytes in peripheral blood). We observed a decrease of T lymphocyte activationin 19 patients after 24 hours of continuous veno-venous hemofiltration - CVVH (p < 0,01). On the third day of CVVH this activation returned to thelevels before initiating of the elimination method. Trend of monocyte activation followed the same course; however, it did not reach statisticalsignificance. The observed changes in the activation direct an attention to...
The Effect of Prophylactic Fluconazole Administration on Fungal Infection in Critically Ill PatientsArticles
R. Pařízková, V. Černý, P. Dostál, A. Truhlář
Anest. intenziv. Med. 2000;11(6):271-275
Fungi present an important group of pathogens causing nosocomial infection in critically ill patients. Preventive administration of anti-fungal agentsis considered to be one of the possible preventive measures to decrease the incidence of fungal infections in critically ill patients. In our study weevaluated the effect of prophylactic administration of low dose fluconazole on the fungal colonization and infection in patients without neutropenia.Fluconazole was administered in the dose of 100 mg intravenously once daily during the whole stay in the intensive care unit (group F, n = 18), thecontrol group was not give fluconazole (group C, n = 20), There...
Monitoring of Sedation with BIS Index and Comparison with Ramsey and Cook Sedation Scores in ICUArticles
R. Šplechtna, L. Pokorný, E. Hušková, D. Nalos
Anest. intenziv. Med. 2000;11(6):278-279
Authors present in this study results and experiences with monitoring of sedation with BIS index and comparison with Ramsay and Cook sedationscores in ICU. The group of 20 patients hospitalized in our ICU (October 1998 - September 1999). Including criteria - GCS 15 and the need of continualsedation or analgosedation. The values of BIS index were recorded to protocol at any time of change in the level of sedation. At the same time thislevel of sedation was evaluated by two physicians by use of Ramsay and Cook scores. Our results and experiences with continual monitoring show thatto rely only on BIS index or to titrate drugs according to these values...
First Resuscitation Ward in Our RepublicArticles
J. Počta, E. Racenberg, M. Smilek, K. Zítko
Anest. intenziv. Med. 2000;11(6):279-280
The authors refer on the launching and developing of the first resuscitation ward in the Czech Republic, possibly the first one in the central Europeat all. The importance of the hospital "Na Františku" in the context of the Czech medicine is stressed. The paper presents the history of the ward, thedrawbacks of the development, discontinuation of the service, along with the portrait of the patient population. It has been clear since the beginningthat there is a need for creating a facility for protracted intensive care patients, beyond immediate and acute resuscitation care.
The Principles of Communication between an Anaesthesiologist and Patient with RelativesArticles
J. Málek, J. Šimek
Anest. intenziv. Med. 2000;11(6):279-282
The paper based on both literature and personal experience presents basic communication skills every anaesthesiologist should be capable of inroutine practice. Preanaesthetic visits are of special importance. There are described psychological techniques for preoperative preparation of bothadult and pediatric patient prior to anaesthesia, as well as the communication skills concerning telling bad news.