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In clinical anaesthesiology the inhalation anaesthetics halothane (fluothane), enflurane and - in recent times - forane got a renaissance in clinical application. The reasons are not only the ad vantages of volatile anaesthetics, but also the fact that the investi gations of pharmacodynamics and pharmacokinetics of Lv. narcot ics showed negative aspects. It was the aim of the organizers of the symposium to give a survey of the present state of knowledge on inhalation anaesthetics, which is as up-to-date, critical as well as detailed as possible. Furthermore it was the intention to evaluate the recent advances made in the field of basic research. The first section of the symposium in particular enters into the question of the toxicity of volatile anaesthetics as well as their mechanisms of action. In a second main part the influences on cardiovascular system and on microcirculation are discussed. Apart from the extensive discussion of the advances in knowledge in the field of cardiovascular pathophysiology, the focal point of the contribut ions is made up of those with anaesthesia in coronary heart disease and cardiac insufficieny as well as the contribution on interactions of inhalation anaesthetics with cardiovascular drugs. In the third and fourth section the influences of volatile anaesthetics on cerebral, hepatic, renal and pulmonary function are dealt with as well as questions concerning the clinical application. Particular attention is given to the important problems of indicat ion in patients belonging to the extreme age groups.
List of contents
Basics of Biotransformation.- Hepatic Oxygenation and Fluoride Release During Halothane Anaesthesia.- Current Status of Hepatotoxicity of the Halogenated Inhalation Anaesthetics.- Present Status of Chronic Exposure to Trace Concentrations of Volatile Anaesthetics.- Aspects of Possible Health Hazards from Traces of Waste Anaesthetic Vapours and Gases.- The Kinetics of the Uptake and Elimination of Halothane and Enflurane.- Molecular Basis for Unitary Theories of Inhalation Anaesthesia.- Clinical Implications of the Pharmacodynamics of Inhalation Anaesthetics.- Advances in Cardiovascular Pathophysiology.- Anaesthesia in Coronary Heart Disease.- The Anaesthetic Management of Coronary and Cardiac Surgery.- Influence of Inhalation Anaesthetics on the Autonomic Nervous System.- Interactions of Cardiovascular Drugs with Inhalational Anaesthetics.- Microcirculatory Effects of Halothane and Enflurane.- Distribution of EEG Frequency Bands as Revealed by Factor Analysis During Anaesthesia with Halothane and Enflurane.- The Effects of Inhalational Anaesthetics on the Brain.- The Effects of Inhalation Anaesthetics on Intracranial Pressure.- The Effects of Inhalation Anaesthetic Agents on Liver Blood Flow and Hepatic Oxygen Consumption.- Total Effect of Repeated Anaesthetics on Liver Function.- The Effect of Inhalation Anaesthetics on Pulmonary Ventilation and Perfusion.- Effects of Inhalation Anaesthetics on Renal Function.- The Effect of Inhalational Anaesthetics on Skeletal and Smooth Muscle.- Inhalational Anaesthesia and Endocrine Disease.- Concept in Patients with Hypertension and Coronary Heart Disease - Clinical and Experimental Aspects.- Inhalation Anaesthetics as Hypotensive Agents: Controversial Aspects.- Inhalation Anaesthesia in Paediatrics.- Inhalation Anaesthesia inGeriatric Patients.- Balanced Anaesthesia as an Alternative Concept.
