[Awareness under remifentanil-propofol anaesthesia]. / Wachheitserlebnis unter Remifentanil- und Propofolanästhesie ohne vegetative Reaktionen für den erinnerten Zeitraum.

We report on a 49-year-old female patient suffering from recurrent carcinoma of the rectum, who underwent a palliative Hartmann operation for an anus praeter reconstruction. After a remifentanil bolus of 90 microg and a propofol bolus of 200 mg, anaesthesia was maintained with 0.25 microg/kg/min remifentanil and 4 mg/kg propofol, and after skin incision with 1.0 microg/kg/min remifentanil and 5 mg/kg/h propofol. Throughout the operation, the patient showed a stable blood pressure of 120-130/80 mmHg but 15 min after skin incision the heart rate suddenly rose to 140 beats/min, so remifentanil was increased to 1.8 microg/kg/min and propofol to 8 mg/kg/h. Over a time period of 15 min the heart rate decreased to 90 beats/min. Subsequently vegetative parameters stayed within the normal range (heart rate 90 beats/min, blood pressure 120-130/80 mmHg) so that continuous administration of remifentanil and propofol could be tapered. After completion of skin sutures, administration of remifentanil and propofol was terminated. After extubation the patient reported having heard conversations contributable to the end of the operation and the sentence: "now we're done" was clearly remembered. The patient stated that she had not been able to move any part of her body, that she had perceived the situation as extremely unpleasant and dangerous and that she had felt severe pain. At the postoperative rounds the patient refused any psychological and psychiatric help.

[Mechanical aspects of bone stability by an in vivo testing method (author's transl)]. / Mechanische in vivo-Prüfung der Knochenstabilität.

This is a report of a new method for in vivo determination of the Young modulus of human os radii. The failure of the apparatus is +/- 1.86 per cent. The accuracy of the measuring procedure on healthy subjects bases on a variation coefficient of nearly 10 per cent. 124 forearms of healthy persons had been studied in relation to age, sex and to the right and the left os radii. There was a statistically significant higher elastic property of the bones of adolescent versus elder men (over 60 years), but no significant differences between male and female. Right and left os radii had nearly the same amounts for the Young modulus.