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
[EnglischerTitel: Epidural anesthesia - complications and side effects].
Thoracic epidural anesthesia remains the gold standard of intra- and postoperative analgesia for a multitude of surgical procedures as a reliable and relatively safe procedure with a low rate of complications as long as contraindications are respected. However, if complications do occur they often result in catastrophic sequelae for the patient. ⋯ Procedural complications often result in additionally required procedures and treatments, hence increasing morbidity of the affected patient. The aim of this review is to provide the reader with a current overview of the available literature with regards to classical and procedural complications.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2015
Review[Adjuvants in modern anesthesia - magnesium].
Magnesium plays a key role in many cellular functions and there is growing interest in its role in perioperative medicine. While experimental studies provided promising results for several disease states, clinical trials mainly gave conflicting results. This review article summarizes current knowledge on the homeostasis of magnesium as well as on its proposed indications and recommendations in the clinical setting.