Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2015
Review[Epidural analgesia in combination with general anesthesia].
Epidural anaesthesia is a widely used and accepted technique for perioperative analgesia in different kinds of surgery. Apart from analgetic effect and due to wide positve effects on patients outcome epidural analgesia is often used with general anaesthesia. ⋯ Further, a benefit is expected in patient's mortality. This article summarizes and critically discusses the current knowledge on the effects of epidural anaesthesia on pain management, cardiopulmonary as well as gastrointestinal functions and patient's outcome.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2015
["Dual Guidance"? - parallel combination of ultrasound-guidance and nerve stimulation - Contra].
Sonography is a highly user-dependent technology. It presupposes a considerable degree of sonoanatomic and sonographic knowledge and requires good practical skills of the examiner. Sonography allows the identification of the puncture target, observes the needle feed and assesses the spread pattern of the local anesthetic in real time. ⋯ PNS in parallel to sonography serves primarily as a warning technology in the case of an invisible cannula tip. It should not be construed as a compensation technique for the lack of sonographic skills or knowledge. However, PNS may be helpful in the sense of a bridging technology as long as the user is aware of its limitations.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2015
["Dual Guidance"?- Parallel combination of ultrasound-guidance and nerve stimulation - Pro].
Combination of ultrasound and nerve stimulation technique could be useful under several conditions. Nerve stimulation canvarify the position of the nerve in case of bad preconditions during ultrasound. The knowledge of the importance of low and critical threshold currents could help to identify the needle tip. Thus the combination of ultrasound and nerve stimulation could lead to reduced unintentional intraneural injections and may result in a higher safety standard in peripheral regional anesthesia.