Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2012
[Anaesthesia and pain therapy: perioperative management of patients with complex regional pain syndrome].
The complex regional pain syndrome (CRPS) is indeed a very complex pain situation. The treatment of CRPS is challenging. ⋯ Recommendations for the management of such patients will be described in the article. High degree of evidence exists for high doses of vitamin C to prevent the development of a CRPS in trauma patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2012
Case Reports[Serious complications following a marathon run: interactive case report of a dramatic course].
A marathon runner collapses after crossing the finish line and shows neurological disorders. Aftertreatment at the scene hyponatremia and cerebral edema are found at hospital admission. Thepatient is treated for "exercise-associated hyponatremia" (EAH) on the ICU for six days. ⋯ Symptoms include nausea and vomiting, desorientation, dizziness, seizures or coma. Therapyincludes fluid restriction and application of hypertonic saline. Plasma sodium concentration shouldbe checked at the scene in all collapsed athletes showing neurological symptoms to differentiatebetween exercise-associated hyponatremia and dehydration.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2012
[First aid and management of multiple trauma: in-hospital trauma care].
Injuries remain the leading cause of death in children and young adults. Management of multiple trauma patients has improved in recent years by quality initiatives (trauma network, S3 guideline "Polytrauma"). On this basis, strong links with preclinical management, structured treatment algorithms, training standards (ATLS®), clear diagnostic rules and an established risk- and quality management are the important factors of a modern emergency room trauma care. We describe the organizational components that lead to successful management of trauma in hospital.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2012
[Regional anaesthesia in obese patients: what's different?].
Basically regional anaesthesia offers a lot of advantages compared with general anaesthesia for obese patients, e.g. avoiding airway manipulation and systemic application of opioids. Although anesthesiologists are increasingly faced with obesity, regional anaesthesia poses a challenge because of missing landmarks, increased depth of nerval structures and difficulties in positioning these patients. ⋯ Ultrasound guidance may be an important aid but it is associated with specific phenomena caused by obesity. Further studies are needed to optimize regional anaesthesia techniques and dosing of local anaesthetics avoiding block failures as well to improve the patients' safety and outcome.