Anesteziologie a intenzivní medicína, 2007 (vol. 18), issue 6
Advances in general anaesthesiaAnaesthesiology
J. Málek
Anest. intenziv. Med. 2007;18(6):324-327 
In 2006-2007 we celebrated the160th anniversary of the first successful administrations of general inhalational anaesthesia in various countries and the 50th anniversary of the publication of the mouth-to-mouth ventilation method by Dr. Safar.There have been no significant developments in general anaesthesia in the past two years. Perhaps the most cited single drug was sugammadex and the issue of residual neuromuscular blockade. Another interesting topic was the potential neurotoxicity of general anaesthetics. At the end of the article, a list of reviews is given.
New findings in the field of neuromuscular transmission and neuromuscular blocking agentsAnaesthesiology
I. Herold
Anest. intenziv. Med. 2007;18(6):328-331
The author summarizes recent developments in the field of neuromuscular transmision, the structure and function of the acetylcholine receptor and the introduction of new neuromusclar blocking agents in anaesthesiology and intensive care.
Regional anaesthesia in the past yearAnaesthesiology
D. Mach
Anest. intenziv. Med. 2007;18(6):332-334
This article is aimed at giving a comprehensive summary of new findings in regional anaesthesia that have been published in recent volumes (2006- 2007) of peer-reviewed medical journals, presented at European and World congresses and discussed on regional anaesthesia websites.
Lipid resuscitation: Progress in the pharmacology of local anaesthetics - a view from the perspective of the year 2007Anaesthesiology
M. Horáček
Anest. intenziv. Med. 2007;18(6):335-339
The popularity of peripheral nerve blocks is steadily increasing. Due to the high doses of local anaesthetics used in these techniques the incidence of toxic reactions could rise. In this review we discuss the current knowledge of the pathophysiology, diagnosis and treatment of the cardiotoxicity of local anaesthetics. Cardiotoxicity induced by 22 mg of bupivacaine in a patient with isovaleric acidaemia stimulated research of local anaesthetics effects on mitochondria. In animal studies a lipid emulsion reversed cardiotoxic signs and symptoms. Its beneficial effect has been confirmed by five published case reports in humans. The mechanism of action...
Neuromodulation in chronic pain managementAlgeziology
M. Hakl, P. Ševčík
Anest. intenziv. Med. 2007;18(6):340-344
Neuromodulation methods include management strategies employing the application of agents or a defined electric current directly to the nerve structures. Modern neurostimulation management is based on the concept of the gate theory of pain formulated by Melzack and Wall in 1965. The principle of spinal cord stimulation is based on an increased release of inhibitor substances (endorphins, enkephalins, dynorpfines). Segmental spinal mechanisms play an important role in the therapeutic effect. Spinal cord stimulation is suitable in the treatment of chronic neuropathic and ischaemic pain. In appropriately selected patients very good results are achievable...
Notes on perioperative haemodynamic optimizationAlgeziology
R. Kula, P. Szturz, V. Chýlek, P. Sklienka
Anest. intenziv. Med. 2007;18(6):345-350
Perioperative haemodynamic optimization strategies, effectiveness, controversy and technical aspects have been a hot topic in anaesthesiology and intensive care medicine for some decades. In this brief review we aim to present a short retrospective summary of the development of this interesting issue and to address the main controversial matters and methodical problems of perioperative haemodynamic optimization. We are aware of our inability to address the whole extensive issue in this paper.We merely hope to raise awareness of the importance of perioperative haemodynamic optimization in daily practice.
Emergency Preservation and Resuscitation: A new chance for traumatic cardiac arrest victimsIntensive Care Medicine
T. Drábek
Anest. intenziv. Med. 2007;18(6):351-356
The outcomes from resuscitation of cardiac arrest victims remain suboptimal. Conventional resuscitation approach to trauma-related exsanguination cardiac arrest carries especially dismal prognosis. A majority of the patients die at the scene. However, some of the injuries could be surgically repairable. Emergency Preservation and Resuscitation (EPR) is a novel resuscitation method using large-volume ice-cold aortic flush to induce hypothermia, a key mechanism decreasing metabolic demands.This buys time for the transport, damage-control surgery and delayed resuscitation using cardiopulmonary bypass.The depth of hypothermia correlates well with the...
Cardiocerebral resuscitation: For laymen without ventilation?Intensive Care Medicine
A. Truhlář, V. Černý
Anest. intenziv. Med. 2007;18(6):357-363
The authors present a review of the current literature on basic life support without mouth-to-mouth ventilation (cardiocerebral resuscitation). The historic rationale for the integration of mouth-to-mouth breathing into cardiopulmonary resuscitation and its controversial role in relation to the pathophysiology of the most frequent circulatory arrests of cardiac origin are discussed. Conclusions of experimental studies, clinical trials and the recent recommendations of resuscitation societies are summarized.