Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2006
[Regional anesthesia-- approaches to the brachial plexus].
Peripheral regional blocks are not only appropriate for intraoperative anaesthesia. More and more they become popular for postoperative analgesia after painful operations of the extremities. ⋯ The continuous technique of the block of the suprascapular nerve is very helpful in patients with chronic pain in the shoulder, if no surgery is performed. The authors are very interested in a praxis relevant description of the techniques including numerous "tips and tricks".
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2006
[Stimulating catheters for regional anesthesia: considerations in routine clinical use].
The use of peripheral catheter techniques for regional anaesthesia and analgesia is quite common today. Although electrical nerve stimulation facilitates the correct placement of the insertion cannula, nobody knows where exactly the tip of the advanced catheter will be located after insertion. ⋯ These new catheter systems require--in comparison to the conventional--a modified insertion technique. This article illustrates how to use these catheters in clinical practice and provides information about investigations to success rate and failure.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2006
[Ultrasound-guided peripheral nerve blockade].
Without miniaturization resulting in affordable hand-held ultrasound systems, ultrasound-guided regional anaesthesia would not be practicable. Nowadays facilitation of nerve blockade by means of ultrasound is achievable even in remote locations. Non-traumatic technique, visualisation of nerves, surrounding structures and the ability to assess the spread of the injected local anaesthetic combined with a high and predictable success rate are the major advantages when ultrasound is used in regional anaesthetic practise. ⋯ Ultrasound can be used to facilitate blockade of the upper and lower extremity. The advantages and limitations of the technique when applied to the classical approaches for blockade of the brachial plexus and the femoral and ischiadic nerve are discussed. Ultrasound-guided regional anaesthesia is a valuable tool to improve safety, success rate and patient comfort in daily anaesthetic practise.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2006
[Regional anaesthesia and analgesia for total knee replacement].
Postoperative analgesia for total knee replacement with a continuous nerve catheter is more effective than any other form of systemic analgesia. For complete analgesia a combined technique of a femoral with a proximal sciatic nerve block is recommended. An easy and reliable way to achieve this is a femoral or a fascia iliaca compartment block together with a subgluteal sciatic nerve block.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2006
Practice Guideline[Guideline: "Treatment of acute perioperative and posttraumatic pain". Updating from the S2- to the S3-level: a preliminary report].
The German guidelines for the treatment of acute perioperative and posttraumatic pain from 1999 have been revised during the last three years and will be published at the end of 2006 as a guideline on S3-level. 20 medical societies evaluate with the instruments of the centre of evidence based medicine of Oxford (CEBM) the available randomised controlled trials, systematic reviews and existing guidelines and consent in final Delphi rounds the detailed recommendations (grades A - C). Comprehensive information of the patients (pain level, therapeutic possibilities), measurement and documentation of pain, interdisciplinary management of therapy and complete consideration of all operative, pain therapeutic, medicinal, psychologic, physiotherapeutical and physical procedures are central aims of the actual guideline.