[Intraoperative suppression of spasticity using intrathecal baclofen]. / Intraoperative Unterdrückung von Spastik mit intrathekalem Baclofen.

Even in patients with complete loss of sensation and paraplegia after cervical spinal trauma, abdominal operations usually require general or spinal anesthesia due to spasms and increased muscle tone. Both anesthetic types have serious drawbacks under these circumstances, e.g. hyperkalemia induced by relaxation or the impossibility of adequate monitoring of the level of spinal blockade. After an onset time of 1-2 h the intrathecal injection of approx. 100 micrograms baclofen, a spinally acting GABAB-agonist, led to complete and long-lasting suppression of surgically induced spasticity. This could be demonstrated by neurological examination (spasticity scores: Ashworth score, spasm score, clonus score) during 5 neurosurgical operations in 3 patients with paraplegia. Except for slight sedation, the patients had no discomfort during operation. Intrathecal baclofen was also effective against autonomic hyperreflexia, i.e. vegetative dysregulation such as bradycardia or hypertension, provoked by catheterization or bladder surgery.

[Palliative disconnection of the kidney by transcatheter arterial embolization (author's transl)]. / Paliative Funktionsausschaltung der Niere durch arterielle Katheterembolisation.

To eliminate urine production of one Kidney transcatheter embolization of the renal artery was performed in 11 patients with mallignant tumors in the area of the pelvis; in addition to the abave procedure in 9 patients a urinary; diversion by transrenal catheter and a ureteric ligation of the opposite side was also carried out. The therapy is of palliative character and signifies the smallest intervention possible to most treat effectively involuntary urination caused by urine fistulas, painful pollakisuria caused by shrinking bladders, and to treat painful hydronephrosis caused by tumors and the like.