A study of airway management using the ProSeal LMA® laryngeal mask airway compared with the tracheal tube on postoperative analgesia requirements following gynaecological laparoscopic surgery

In a randomised double blind prospective study, we tested the hypothesis that postoperative pain is lower in patients who receive an ProSeal LMA™ laryngeal mask airway compared with a tracheal tube. One hundred consecutive female patients (ASA I–II, 18–75 years) undergoing laparoscopic gynaecological surgery were divided into two equal-sized groups for airway management with the ProSeal LMA or tracheal tube. Anaesthesia management was identical for both groups and included induction of anaesthesia using propofol/fentanyl, and maintenance with propofol/remifentanil, muscle relaxation with rocuronium, positive pressure ventilation, gastric tube insertion, dexamethasone/tropisetron for anti-emetic prophylaxis, and diclofenac for pain prophylaxis. All types of postoperative pain were treated using intravenous patient-controlled analgesia (PCA) morphine. Patients and postoperative staff were unaware of the airway device used. Data were collected by a single blinded observer. We found that pain scores were lower for the ProSeal LMA at 2 h and 6 h but not at 24 h. Morphine requirements were lower for the ProSeal LMA by 30.4%, 30.6% and 23.3% at 2, 6 and 24 h, respectively. Nausea was less common with the ProSeal LMA than with the tracheal tube at 2 h and 6 h but not at 24 h. There were no differences in the frequency of vomiting, sore throat, dysphonia or dysphagia. We conclude that postoperative pain is lower for the ProSeal LMA than the tracheal tube in females undergoing gynaecological laparoscopic surgery

Zur statischen und dynamischen Analyse rotierender elastischer Strukturen (Turbinenschaufeln, Verdichter) bei transienten Betriebsbedingungen

Die vorliegende Arbeit stellt die erforderlichen theoretischen Zusammenhaenge zur Berechnung von rotierenden elastischen Strukturen wie etwa Turbinen- und Verdichterschaufeln, Laufraeder, Scheiben etc. zusammen und zeigt die Entwicklung eines entsprechenden FEM-Programm-Systems. Es ermoeglicht die Berechnung der Eigenfrequenzen und Eigenformen von Einzelstrukturen und rotations-periodischen Strukturen in Abhaengigkeit von der Drehfrequenz unter Einbeziehung aller wesentlichen Effekte. Weiterhin ist es moeglich fuer einen beliebigen durch ein Polygon angenaeherten Drehzahl-Zeit-Verlauf die erzwungenen Schwingungen und daraus resultierend die Spannungsverlaeufe ueber der Zeit zu berechnen. Hierauf aufbauend koennen die Lebensdauer der Struktur abgeschaetzt und Parameterstudien durchgefuehrt werden. Zunaechst wurde die sehr umfangreiche Literatur zu dieser Problematik, eingeteilt in verschiedene Problemklassen, zusammengefasst. Anschliessend wurde die allgemeine Bewegung eines Strukturpunktes beschrieben und mit Hilfe des Prinzip der virtuellen Verschiebungen (PVV) in Formulierungen fuer drei verschiedene Elementtypen, in denen saemtliche Effekte aus Rotation enthalten sind, umgesetzt und die Loesungsstrategien fuer Einzelstrukturen und rotations-periodische Strukturen beschrieben. (orig./AKF)The present doctoral thesis compiles the necessary theoretical framework for the calculation of rotating elastic structures, such as turbine and compressor blades, rotors, disks, etc., and indicates the development of a corresponding FEM program system which permits the calculation of natural frequencies and natural modes of individual structures and rotationally periodic structures as a function of the rotary frequency and integration of all essential effects. In addition it is possible to calculate forced vibrations for arbitrary rotational speed-time profiles approximated by a polygon and, resulting from this, the stress profiles over time. Based on this, the structure's fatigue life can be estimated and parameter studies can be conducted. First, a summary is given of the very comprehensive literature relating to this problem, broken down into different problem classes. Subsequently the general movement of a structural point was described and, using the principle of virtual displacements (Lagrange-d'Alembert principle), converted into formulations for three different element types containing all effects from rotation, and the solution strategies for individual structures and rotationally periodic structures were described. (orig./AKF)SIGLEAvailable from TIB Hannover: RR 2040(1994,6) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman