Journal of clinical anesthesia
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As of 1991, intensive care medicine in Germany is not an independent medical specialty but a part of other main medical specialities such as anesthesiology, internal medicine, surgery, and pediatrics. Accordingly, there is neither formal training nor a separate board examination in intensive care medicine. ⋯ Surgical (or operative) ICUs predominantly are operated by anesthesiology departments, as anesthesiologists' expertise in respiratory and hemodynamic support qualifies them for the management of the critically ill patient in the perioperative phase. This article gives a brief review of the development of intensive care medicine in Germany, thereby providing the historical background for its present national and regional organization, facilities, and education and training programs.
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The first ether anesthetic was administered in Germany by J. F. Heyfelder (1798-1869) at the Erlangen University Hospital on January 24, 1847. ⋯ Killian and Gauss established the first journals, Der Schmerz and Narkose und Anaesthesie, in 1928. After the Second World War, the field of anesthesia in Germany rapidly regained international standards. The journal Der Anaesthesist was founded in 1952, and the German Society for Anesthesiology and Intensive Medicine was established in 1953.
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The beginnings of organized emergency care can be traced through military history dating back to the Middle Ages. In 1769, the first civilian rescue society was established to look after shipwrecked persons. Sociological and technical requirements of the late 19th century led to the formation of different rescue associations and to writing of regulations for rescue and ambulance services. ⋯ Today the rescue service functions to bring a physician, often an anesthesiologist, to the victim as quickly as possible. Modern rescue laws fix a lead time of 5 to 15 minutes for a professional rescue service to reach the scene. The medical equipment and qualifications of personnel treating life-threatening trauma and diseases have improved, and in this context, the role of the anesthesiologist is important.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effectiveness of oral clonidine as a sedative/anxiolytic and as a drug to blunt the hemodynamic responses to laryngoscopy.
To determine the effects of oral clonidine premedication on sedative, anxiolytic, and hemodynamic responses during the immediate preoperative period, laryngoscopy/intubation, and postanesthetic recovery. ⋯ Oral clonidine 0.2 mg was effective in reducing the level of behavioral and hemodynamic responses preoperatively and in blunting systolic hypertension produced by prolonged laryngoscopy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain management and respiratory depression after thoracotomy: a comparison of intramuscular piritramide and intravenous patient-controlled analgesia using fentanyl or buprenorphine.
To compare the analgesic efficacy of fentanyl, buprenorphine, and piritramide and to define the respiratory risk during conventional postoperative pain management and patient-controlled analgesia (PCA). ⋯ Opioid-induced respiratory depression occurred infrequently during postoperative pain management whether by conventional means or using PCA, even though high doses of opioid analgesics were required intermittently for adequate postoperative pain relief by either technique.