[Intrathecal morphine administration in pain therapy following extensive gynecologic operations. Clinical study]. / Intrathekale Morphinapplikation zur Schmerztherapie nach ausgedehnten gynäkologischen Operationen. Klinische Studie.

Experiences with intrathecal morphine analgesia in 36 patients undergoing Wertheim-Held hysterectomy are reported. Postoperative painrelief, bloodgas-parameters (pO2, pCO2, pH, SBE, SAT), analgetica demand, side-effects are compared with 23 patients of a control group. 95% of patients with intrathecal morphine analgesia were postoperatively without pain for at least 24 hours. The postoperative demand of analgetic drugs could be reduced to less than 50% in the first 48 postoperative hours. Besides not significant decreasing of the pH-value no changing of the bloodgases was observed. The incidence of nausea, vomiting and headache were not increased. Considering the not in all cases avoidable development of a respiration insufficiency even after a little dosis of morphine this method seems to be a suitable treatment of postoperative pain which enables the early mobilisation of the patients.

[Practice-relevant aspects on questions of general preoperative diagnosis and therapy]. / Praxisrelevante Aspekte zu Fragen allgemeiner präoperativer Diagnostik und Therapie.

Problems of preoperative preparation of patients with risk are pointed out. The anesthesiologist will be confronted more and more with high risk patients. It is difficult to make a risk prognosis. Therefore preoperative standardized examination programmes of heart, lungs, kidneys, water and electrolyte balance, blood and general metabolism are required, which is dealt with in this paper. The results achieved in anaesthesia consultation are described. Special attention has to be paid to diabetic obese patients, old people as well as people suffering from cardiovascular diseases. Preoperative therapy with digitalis glycosides, antihypertensive drugs and beta-receptor blocking agents is discussed. By means of specific preoperative measures the increased risk in this group of patients can be considerably reduced.

[Experience obtained from use of Faustan (diazepam)-ketamine combination in anaesthesia for minor gynaecological surgery (author's transl)]. / Erfahrung mit der Faustan/Ketamin-Kombinationsnarkose bei kleinen gynäkologischen Eingriffen.

Reference is made to the advantages implied in the combinational use of Faustan and ketamine for anaesthesia, but disadvantages are mentioned, as well. No complications with danger to life were recorded from an evaluation of 1,000 narcoses over a period between September 1st, 1977, and July 31st, 1978. Combined use of the above agents may be justified on account of low rate of complications, optimum surgical conditions, and smoother operation.