Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2012
Review[Nerve injuries associated with nerve blocks: clinic and incidence].
Persistent nerve injuries in context of peripheral nerve blocks are uncommon. Previous surveys and prospectively designed studies have specified neurological dysfunctions in different ways, which may cause the variability of data about incidence; so it has to be reckoned with about 5% after 1 week, 1% after 1 month and 0,01% after 6 months. ⋯ Dysfunctions manifest as numbness, parasthesia, tingling sensation and/or amyasthenia. Fortunately long-term lesions, caused by nerve blocks are a rarity.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2012
Review[Neurologic complications after epidural analgesia].
Epidural analgesia is regarded as gold standard after major abdominal or thoracic surgery in combination with general anaesthesia. Apart from well documented positive effects of epidural analgesia on the postoperative period, evidence for the incidence of neurologic complications is less clear. ⋯ The review article gives an overview about current data on neurologic complications related to epidural analgesia and shows feasibility of prevention and early detection. Furthermore a therapeutic approach in case of a neurologic incident will be demonstrated.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2012
[Rare medical incidents: Actual consensus statement for the removal of neuraxial catheter fragments].
The rupture of a catheter near the spine is rare. There are no evidence-based guidelines for diagnosis and therapy. Opinions derived from German anesthesiologists, neurosurgeons, orthopaedics and trauma surgeons are: Infants should have immediate surgery. ⋯ Surgery should be performed in prone position and under general anesthesia. Starting at the entry wound, the surgical access should be microsurgical and preferably by a neurosurgeon. If the entry is not detectable, a midline incision is suggested.