Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Nausea and vomiting after anaesthesia for children - Big problems for little patients].
Postoperative nausea and vomiting are undesirable and unpleasant side effects after surgery and anaesthesia associated with delayed oral intake and postoperative recovery, and impaired parental satisfaction. Since current modalities against PONV are cheap, highly effective, and almost free from relevant side-effects - providing contraindications are appropriately considered -, recommendations tend to move away from risk-score guided administration of antiemetic towards a more liberal administration policy or even favour routine administration to children undergoing general anaesthesia for surgery combined with total-intrevanous anaesthesia using propfol and reduction of perioperative opioid administration.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Case Reports[Residual relaxant block due to pseudocholinesterase deficiency - First manifestation in an elderly patient].
Pseudocholinesterase or butyrylcholinesterase (BChE) inactivates the relaxant drugs mivacurium and suxamethonium. A deficiency in plasma activity of this enzyme may result in prolonged muscular paralysis and subsequently the need for an extended duration of mechanical ventilation. We report the case of a 65-year-old patient who was diagnosed with butyrylcholinesterase deficiency for the first time during elective surgery. Neuromuscular monitoring constitutes a central diagnostic asset in ensuring patient safety.
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The national German hand hygiene campaign is implementing the WHO patient safety initiative "Clean Care is Safer Care". After 6 years over 1400 health care institutions are participating in the campaign on a voluntary basis. The implementation of the multimodal intervention concept including improvement of alcohol based hand rub availability, the introduction of 2 surveillance methods and of the WHO "My 5 Moments of Hand Hygiene Model" in those health care facilities, participating for several years, increased median hand hygiene compliance by 11% and alcohol based hand rub availability by 61%.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Indications, risk factors, specialities and after-care of surgical treatment for cardiac and thoracic vascular diseases].
Despite a known high risk and complexity in the operative therapy of cardio-thoracic patients, cardiac surgery is medical routine activity today. The German Society of Cardiothoracic Surgery regularly analyses the more than 100.000 cases a year in Germany. Fixing procedural statics, it gives us the knowledge of individual risk factors and success rates for surgical therapy of our patients. Following we want to shortly summarize indications, risk factors, specialities and after-care of surgical treatment for cardiac and thoracic vascular diseases in adults.