Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2011
Review[Perioperative metabolism control of diabetic and non-diabetic patients].
Overview on the perioperative metabolism of diabetic patients. The text provides important information for the clinician and summarises the evidence in the international literature. Important studies, background of the diabetic perioperative metabolism, patient screening, existing oral diabetes therapies and insulin regimes, differences between regional and general anesthesia, and important laboratory parameters are discussed. Oral antidiabetics used in Germany, different classes of insulins and possible regimes for the intraoperative management of insulin therapies and important aspects of the postoperative management are presented.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2011
Review[Pathophysiology of impaired insulin sensitivity in the perioperative period].
Hyperglycemia and insulin resistance are frequently observed during critical illness. The underlying pathophysiology is not yet fully understood, although hyperglycemia predicts post-surgical morbidity and mortality. ⋯ Multiple causative factors and intracellular signalling pathways have been identified driving the development of systemic perioperative insulin resistance. This review will focus on mechanisms involving the classical insulin signalling cascade.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2011
Review[Tipps and Tricks - Anesthesiologic management in total knee replacement].
Total knee replacement improves mobility and quality of life in gonarthrosis. In 2004 more than 60.000 total knee arthroplasties were performed in Germany. ⋯ For the 1990(th) years femoral nerve blocks have become more popular leads back to lower risk of complications and equal quality of analgesia compared to neuroaxial blockades. The prevention of "tourniquet pain" as well as treatment of hemodynamic and respiratory failure in the context of pulmonary embolic events and tourniquet deflation is part of anesthesiologic challenge.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2011
Historical Article[Is there any correlation between the increase of knowledge and specialisation in medicine? Looking back on anaesthesia].
Since the middle of the 19th century medical knowledge was increasing enormously. According to this differentiation medical specialisation was necessary and began at the Deutschen Ärztetag 1924. The recommendation for a specialist for anaesthesia was fulfilled with the introduction of the Facharzt für Anästhesie. The increasing knowledge stands in correlation to the specialization, but not with the slow installation of Anaesthesia as an independent speciality.