Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2007
Review[Walking epidurals: mobilisation during neuraxial labour analgesia].
Neuraxial anaesthesia offers the most effective form of obstetric pain relief and is superior to other methods of analgesia, and it does not increase the risk of caesarean section. In daily practice, various techniques are used including the options of patient-controlled epidural analgesia (PCEA) and combined spinal epidural analgesia (CSEA). Risk information is one of the prerequisites for 'informed consent'. Omitting the epidural test dose and using low-dose local anaesthetics with lipophilic opioids enhances early mobilisation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2007
Review[Combined spinal-epidural anaesthesia for pain relief in obstetric patients].
Besides epidural analgesia combined spinal-epidural anaesthesia (CSE) is one of the favourite techniques of regional anaesthesia for pain relief in obstetric patients. CSE combines the advantage of spinal anaesthesia, e.g. rapid onset and reliable effect, with the advantage of continuous epidural anaesthesia, e.g. titration of analgesics and prolongation. While subarachnoid injection of solely opioids provides fast pain relief for nearly 2 hrs in the first stage of labour with an opportunity of ambulation for the parturient ("walking epidural"), the subarachnoid injection of a combination of low doses of opoids and local anaesthetics provides profound analgesia with minor motor blocking side effects for 1-2 hrs in the second stage of labour.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2007
Review[Anesthesia and restrictive and obstructive pulmonary diseases].
Restrictive and obstructive pulmonary diseases are major risk factors of perioperative morbidity and mortality. The incidence of pulmonary complications may be in the range of 3 and 40% (3), depending on the underlying disease and the type of surgery. In this review the specific pathophysiology, preoperative evaluation and suitable anesthesia procedures are discussed for patients with restrictive and obstructive pulmonary diseases.