Anesthesiology developments in Europe

Anesthesiology developments in Europe

Rapidly effective, short-acting intravenously administered anesthetics increasingly are being employed in European ambulatory surgery because of ease of infusion administration, simpler control of anesthesia, rapid onset and equally important, rapid recovery after completion of the surgical procedure. One of the early intravenous analgesics used was Rapifen, chemically related to fentanyl, but with lower potency. Rapifen was developed by Janssen Pharmaceutica (Beerse, Belgium) a wholly owned subsidiary of Johnson & Johnson (New Brunswick, New Jersey). Subsequently Diprivan (propafol) marketed by Zeneca Pharmaceuticals (Macclesfield, England) has been very widely adopted for use in day-surgery procedures as well as in general anesthesia applications. Propafol has been widely reported as a reliable IV anesthetic suitable both for induction and maintenance of anesthesia. The greatest advantage reported has been rapid patient recovery after anesthesia. Glaxo Wellcome has developed the first in a new class of IV anesthetics and analgesics, Ultiva (remifentanil) which has recently received FDA clearance. Ultiva is already marketed in Germany and Glaxo Wellcome expects to receive clearance shortly for most of the remaining European Union countries. Ultiva is characterized by an extremely fast onset and offset of the anesthetic action.

Opportunities in gas monitoring market

As more anesthetic gas agents are introduced to the European market, the need for additional monitoring capabilities provides market opportunities. pneuPAC (Luton, United Kingdom) has developed the Model 770 System 4 anesthetic monitor for Sevoflurane and Desflurane as well as regular monitors for Halothane, Ethrane and Isoflurane. The monitor unit also includes a paramagnetic oxygen monitor as a hypoxic prevention device. Marquette Hellige (Roissy, France) produces the SAM, or Smart Anesthesia Multi-Gas module, which identifies Halothane, Isoflurane, Enflurane and Desflurane as well as measuring inspired and expired values for C[O.sub.2], [N.sub.2]O and [O.sub.2]. Marquette Hellige also has the RAMS dedicated mass spectrometry system which will monitor for up to 10 different gases simultaneously in the operating theatre, ICU or anywhere where breath-to-breath monitoring of both inspired and expired gases is needed.

Anesthetic infusion systems

Becton Dickinson (Franklin Lakes, New Jersey) recently introduced to the European market the B-D Master TCI computer-controlled anesthetic infusion system, intended for use with Zeneca’s (London) Diprivan. The Master TCI system incorporates a pharmacokinetic model named Diprifusor, also developed by Zeneca.

Originally developed at the University of Glasgow (Glasgow, Scotland) by Professor Gavin Kenny, head of anesthesia at the HCI (Health Care International) Medical Center at Clydebank, near Glasgow, the Master TCI device automatically adjusts to a targeted concentration level in the blood, so improving patient recovery and reducing adverse side effects. The Master TCI system is produced at Becton Dickinson’s plant in Brezins, France, and is scheduled to be available in Europe by the end of 1996.

Fresenius (Bad Homburg, Germany) has developed the Injectomat TIVA (Total IntraVenous Anesthesia) programmable infusion pump system which offers differing modes of operation including initial bolus, basic infusion, maintenance bolus or any combination of modes. Other European infusion pump suppliers include B. Braun Medical Division (Melsungen, Germany), Disetronic (Burgdorf, Switzerland), Foures (Bordeaux-Gradinan, France), Intercare (Or Yehunda, Israel) and Miciel (Athens, Greece).

New anesthesia workstations

Chirana-Prema (Stara Tura, Slovakia) has designed the compact modular Anemat N8-950 apparatus produced to full ISO standards and with comprehensive gas scavenging, monitoring and alarm modules. The Omega 2000 from Siare (Crespellano, Italy) is its top-of-the-line anesthesia/resuscitation volumetric electronic ventilator system. It has now been joined by the Babytron which is a microprocessor-controlled ICU ventilator for children and neonates. Weighing only about 16 pounds, the Babytron interfaces with most gas monitoring systems. Dragerwerk (Lubeck, Germany) has used high technology and ergonomic design to provide simplicity of operation with its new Julian anesthesia workstation, which has all functions displayed on a single screen.

Table 6

European OTC Drug Expenditures, 1995

(Per-capita consumption in U.S. $)

Vitamins/ Cough/Cold/ Pain Gastro-

Country Minerals Allergy Relief intestinal

Belgium 6.35 15.38 8.83 9.82

France 7.39 11.65 8.10 10.25

Germany 8.39 9.10 5.87 7.62

Italy 4.21 3.92 2.36 5.50

Netherlands 2.25 3.66 2.25 2.68

Spain 2.06 1.78 3.36 2.31

Switzerland 5.29 13.58 9.82 7.12

U.K. 3.86 4.00 5.03 3.73

Source: The BBI Newsletter

COPYRIGHT 1996 A Thomson Healthcare Company

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