Release of S(+) enantiomers in breath samples after anaesthesia with isoflurane racemate.

BACKGROUND AND OBJECTIVE: Isoflurane is a chiral volatile anaesthetic, routinely administered as racemate. It has a low metabolic rate and is mostly eliminated via respiration. In blood samples, S(+) enantiomers are found in greater proportion in the days immediately after administration of isoflurane racemate whereas the ratio in breath samples is unknown. METHODS: Breath and blood samples were drawn immediately after recovery and daily up to 19 days after operation from patients undergoing anaesthesia with isoflurane racemate. The percentage of isoflurane enantiomer was determined by gas chromatography mass spectrometry in blood and thermodesorption gas chromatography mass spectrometry in breath samples. RESULTS: In breath samples, there were significant differences in S(+) enantiomers at all time points compared to the racemate. During the early postoperative phase, the percentage of S(+) enantiomers were significantly enhanced whereas 5 days after surgery predominantly R(-) enantiomers (50.41%) were detected in the breath samples. Also in blood samples a statistical significant accumulation of the S(+) enantiomer was noted between days 1 and 5 compared to isoflurane racemate blood control. S(+) enantiomers were significantly higher in blood compared to breath samples and was most evident on the third day after surgery (51.43%). CONCLUSIONS: During the first days after application of isoflurane racemate, the percentage of S(+) enantiomers are higher in breath and blood samples of patients. We suggest that resorption and/or redistribution of enantiomers are responsible for the different kinetics of isoflurane enantiomers.

[Therapy of meralgia paresthetica with acupuncture. Two case reports]. / Möglichkeit der Behandlung der Meralgia paraesthetica mit Akupunktur. Zwei Fallbeispiele.

The authors demonstrate a way to treat meralgia paresthetica ("jeans disease") with acupuncture. Two patients with therapy-resistant chronic pain and paresthesia of the lateral thigh became free of symptoms quickly and remained under acupuncture therapy. Gynecological, vertebral and urological factors must be excluded before any kind of symptomatic therapy is begun. The advantages and disadvantages of acupuncture are discussed.

[Midfacial and mandibular fractures during the growth period]. / Mittelgesichts- und Unterkieferfrakturen im Wachstumsalter.

This study investigated the occurrence of primary and secondary complications following conservative versus surgical intervention in the treatment of midface and lower jaw fractures. Follow-up studies were undertaken on 81 patients who had been admitted to the above clinic with such fractures during their adolescence. It was found that more complications developed after surgical intervention.