[Holistic promotion in the process of nursing care in a home nursing situation--an empirical case study]. / Ganzheitlich-fördernde Prozesspflege in der ambulanten Pflegesituation--eine empirische Einzelfallstudie.

This article presents results of an empirical test of the conceptual model of "holistic promotion in the process of nursing care" (Krohwinkel, 1991, 1992, 1993a, b, 1994) in a home care situation within an empirical case study. The results show that by an integrated assessment of the client's problems/needs and the systematic integration of his abilities and those of his primary related person, as well as the application of promoting methods of nursing in the nursing process, independence and well-being can be reached in "Activities and Existential Experiences of Living" (AEDL's). This independence/well-being leads also to a relief of the primary related person, his wife, and therefore contributes to the security of the home care situation.

[Outpatient dental surgery under anesthesiological monitoring. Investigation with 1022 patients at risk]. / Ambulante zahnärztliche chirurgische Eingriffe unter anasthesiologischer Monitorüberwachung. Untersuchung an 1022 Risikopatienten.

The aim of the study was to explore retrospectively the risks of ambulatory treatment under local anaesthesia during dental operations of elderly patients. Anaesthetic care was divided into control and therapeutical measures. Among the previous disorders the hypertension and its sequelae proved to be the main risk factors. The need of anaesthetic intervention doubled, when the time of operation exceeded 30 min. Due to good interdisciplinary cooperation, 99.3% of the operations took their proper course.

[Effect of isoflurane on intracranial pressure]. / Die Wirkung von Isofluran auf den intrakraniellen Druck.

The influence exercised by isoflurane on intracranial pressure is studied in a total of 22 patients subjected to neurosurgery. Of these, 12 patients had brain tumours, 4 hydrocephalus occlusus (preoperative measurement of the intracranial pressure) and 6 severe craniocerebral trauma (continuous monitoring of intracranial pressure). In the patients suffering from cerebral tumours the intracranial pressure remained generally unchanged under isoflurane or dropped only slightly in accordance with the drop in median arterial pressure. This drop in median arterial pressure was considerable (-20% to -30%). In patients with hydrocephalus occlusus a biphasic course of the intracranial pressure was frequently observed. After a transient rise the pressure dropped again to the starting level. Isoflurane, on the other hand, led to marked increases in intracranial pressure in 5 patients with craniocerebral trauma (+4 to 22 mmHg). If the median arterial pressure also dropped at the same time, critical ranges were occasionally calculated for the cerebral perfusion pressure. The influence of nitrous oxide in respect of the performance of isoflurane in connection with intracranial pressure is discussed. It appears possible that in contrast to halothane isoflurane does not further increase the intracranial pressure if used in low doses and in the presence of nitrous oxide. However, the results presented here point to the need to exercise caution when using isoflurane in patients with markedly limited intracranial compliance.