Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2012
[Patient's participation during the pre-anesthesia visit --"if you have no more questions ..."].
Preanesthesia visits are highly complex communicative events with legally demanded participation of the patients. The contribution describes the logical communicative course of this communication type as well as the communicative tasks of the participants. It is shown that physicians in fact offer opportunities for patients' questions but combine them with initiatives for the completion of the interaction; formulations of such offerings are also discouraging patients' questions. Initiative questions of patients during the conversation otherwise indicate where patients are in need for questions.
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Among clinical benefits like reduction in blood loss, faster postoperative recovery of gastrointestinal and lung function, lower rate of perioperative complications and less postoperative pain level, cost reduction by shortening of hospital stay plays a pivotal role for high incidence of laparoscopic surgery. Elevated intraabdominal pressure due to creation of pneumoperitoneum induces various pathophysiologic changes. Most of these changes are clinical inapparent in case of appropriate anesthesiologic management. This paper aims to sensibilize the anaesthesiologist for pathophysiologic changes, particularly with regard to hemodynamic and pulmonary complications, differential diagnosis and therapies.