Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2011
[Anaesthesia and breast-feeding: should breast-feeding be discouraged?].
Until a few years ago an interruption of breast-feeding for 12 or even 24 hours was recommended for breast-feeding mothers after anaesthesia, this is no longer valid. If it is the mother's wish, if she is sufficiently awake and physically able, there is no reason not to start breast-feeding a mature and healthy baby immediately after recovery from a general or regional anaesthesia. Even breast-feeding after a Caesarean delivery with administration of the common anaesthetics in the usual (single) doses is no longer considered to be a problem since the amount of the substance taken up from colostrum is vanishingly small in comparison to the amount that is transferred by transplacental routes. Neither the pharmacological properties of the drugs used in association with anaesthesia nor clinical experience justify an interruption of breast-feeding.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2011
[The taking and transport of biological samples].
The results of microbiological tests are the foundation for a targetted therapy and the basis for monitoring infections. The quality of each and every laboratory finding depends not only on an error-free analytical process. ⋯ These include the correct timepoint for sample taking, the packaging and the rapid transport of the material to be investigated. Errors in the pre-analytical processing are the most frequent reasons for inappropriate findings.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2011
[Hemostasis management based on ROTEM(®): contra].
Diagnostic point of care testing based on thrombelastometry with the aim to fully understand the overall changes in global haemostasis during the perioperative phase is today performed in several operating theatres. Therapeutic measures are based on these laboratory results. Within the scope of a pro and contra outline of the journal this paper comment, why point of care diagnostic solely based on laboratory testing using the ROTEM is not recommendable. On the other hand the author values the thrombelastometry as a supplementary supportive method used directly by haemostasis specialists or in a tight cooperation with such skilled specialists.
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Acute pain therapy in children can be achieved by numerous modalities: non-medicamentous supportive measures, regional and local anesthesia, systemic opioids, non-opioids and co-analgesics. The multimodal approach for prevention and therapy of acute pain in children helps minimizing side effects. A well-organized pediatric pain service based on transparent standard operating procedures seems to be essential for the successful treatment of pain in children.