Rapid onset of amiodarone induced pulmonary toxicity after lung lobe resection - A case report and review of recent literature.

Amiodarone-induced pulmonary toxicity (APT) is a severe side effect that can lead to lung fibrosis or fatal respiratory failure. Usually APT occurs during long term therapy after administration of prolonged loading doses or high cumulative doses. We present the case of a 58 year old woman who underwent thoracic surgery with lobe resection.

Peripheral nerve blocks on the upper extremity: Technique of landmark-based and ultrasound-guided approaches.

The German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin, DGAI) established an expert panel to develop preliminary recommendations for the application of peripheral nerve blocks on the upper extremity. The present recommendations state in different variations how ultrasound and/or electrical nerve stimulation guided nerve blocks should be performed. The description of each procedure is rather a recommendation than a guideline.

[Unexpected drop in hemoglobin value and acute renal failure after a routine laparoscopic cholecystectomy--an interactive case report].

An unexpected drop in hemoglobin value requiring immediate transfusion and an acute renal failure were noticed after a routine laparoscopic cholecystectomy because of symptomatic cholecystolithiasis in an 81-year-old woman on the second postoperative day. The management of these complications including the important differential diagnosis of anemia in combination with an acute renal failure are discussed in this case report.

[Spread of hyperbaric local anesthetics in a spinal canal model. The influence of Trendelenburg position and spinal configuration].

Background: The influence of Trendelenburg positions and variations in spinal canal configuration on the spread of hyperbaric spinal anesthetics was examined in two models of the subarachnoid space.

Methods: Both models included simulations of the spinal cord, filum terminale and cerebrospinal fluid. Model I had a straight shape, thus omitting replications of lumbar lordosis and thoracic kyphosis.

[Intraoperative coronary artery spasm with cardiac arrest: cardiologic acute intervention].

Ventricular fibrillation occurred intraoperatively during a laparoscopy-assisted resection of the rectum in a 63-year-old patient. A coronary artery spasm was identified as the cause. It was possible to rectify the coronary artery spasm and restore a stable circulatory situation with an intracoronary injection of nitroglycerine.

[Intended and actual paths of epidural needles. Investigations with a test tissue model].

Peridural anaesthesia needles (PDA) do not only differ in calibre or gauge but also vary in the design of the needle tip, which shows a special configuration to place a catheter in the epidural space. A laboratory model was performed to determine the influence of different types of virgin epidural needles concerning their path through tissue. In an additional test run we analysed the influence of a previous use on the path through tissue.

Efficacy of sufentanil addition to ropivacaine epidural anaesthesia for Caesarean section.

Background: This prospective double-blind trial evaluated the effect of sufentanil addition to epidural ropivacaine for elective Caesarean section.

Methods: Sixty healthy parturients were randomly assigned to receive an initial dose of 90 mg of plain ropivacaine, or 90 mg of ropivacaine plus 10 or 20 microg of sufentanil (n = 20 each). Before surgery, if necessary, additional epidural ropivacaine was injected.

Epidural ropivacaine 1% with and without sufentanil addition for Caesarean section.

Background: So far only ropivacaine concentrations of 0.5 and 0.75% have been used for Caesarean section.

Spinal anesthesia performance conditions and side effects are comparable between the newly designed Ballpen and the Sprotte needle: results of a prospective comparative randomized multicenter study.

Unlabelled: In this study, we examined the characteristics of a newly designed spinal needle (Ballpen [B]) with a pencil-like tip formed by a stylet that is withdrawn after penetration of the dura. The main goal was to examine whether the use of the B needle could reduce performance time by improved puncture conditions in comparison with the Sprotte (S) needle. Seven-hundred patients at 4 hospitals received single-dose spinal anesthesia with a 25-gauge B or S needle and 0.

[Influence of positioning on the quality of unilateral spinal anesthesia].

Objective: Unilateral spinal anaesthesia ("hemi-spinal") is theoretically associated with the advantages of fewer cardiovascular effects and longer duration of action while offering high density motor block of the extremity affected.

Methods: In a prospective, randomised study 60 patients received 2 mls of 4 % hyperbaric mepivacaine intrathecally. Group I (n = 30) was returned into the supine position after 5 minutes in the lateral position, Group II (n = 30) was kept in the lateral position for 15 minutes.

[NPPE - a rare anaesthetic complication].

We report a rare anaesthetic complication: NPPE (negative pressure pulmonary edema). A 20-year-old otherwise healthy man developed pulmonary edema in the early postoperative phase after uneventful general anaesthesia. The release of the edema was acute obstruction of the upper airways due to postoperative drowsiness.

[Local anesthetics from ester to isomer].

The use of chemical substances to prevent or treat local pain had its origin in South America. It was known that central nervous system stimulation occurred among the natives of Peru who chewed the leaves of an indigenous plant (Erythroxylon coca). Circumoral numbness was believed to have occurred as a by-product of this custom.

[Clinical significance and effects of foreign body embolism during the use of central venous catheters].

An embolism caused by catheters or puncture devices is generally a rare complication during the use of central venous catheters. Possible reasons are either mistakes on the part of the user (e.g.

Ropivacaine epidural anesthesia and analgesia versus general anesthesia and intravenous patient-controlled analgesia with morphine in the perioperative management of hip replacement. Ropivacaine Hip Replacement Multicenter Study Group.

Unlabelled: The aim of our study was to compare epidural anesthesia and analgesia (EDA) with ropivacaine versus general anesthesia followed by IV patient-controlled analgesia with morphine (GA/PCA) after hip replacement regarding pain, side effects, and discharge from the postanesthesia care unit. After ethics committee approval, randomization, and informed consent, 90 patients were enrolled. In Group EDA, epidural anesthesia (ropivacaine 10 mg/mL, 15-25 mL) was followed by an epidural infusion (2 mg/mL, 4-6 mL/h for 24 h, plus top-up doses of 6-10 mL for 48 h).

[Mechanical autologous transfusion in orthopedic surgery in children. Is the use of mechanical autologous transfusion possible even in pediatric orthopedic surgical procedures?].

The use of autotransfusion devices is an established method of reducing the need for homologous transfusions in surgery [3, 11, 13], but technical factors still contraindicate the washing and concentration of blood volumes smaller than 300 ml. Therefore, haemoconcentration of small volumes of salvaged blood, as usually found in paediatric surgery, is considered to be a complicated and questionable practice [5]. Whereas these amounts of blood loss are easily tolerated by adults, they may necessitate homologous transfusions in paediatric surgery.

Development of resistance by Enterobacter cloacae during therapy of pulmonary infections in intensive care patients.

The emergence of resistance during therapy and the efficacy of different antibiotic therapy regimens were studied in 38 intensive care patients suffering from pulmonary infections caused by Enterobacter cloacae. Every three days a fresh isolate was obtained from each patient and tested in vitro for susceptibility to 16 antibiotics by determination of the minimal inhibitory concentrations. During therapy with cefotaxime and tobramycin the E.