Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2011
[Pain therapy in pediatric oncology: pain experience, drugs and pharmacokinetics].
Paediatric cancer patients often experience fear and pain from the disease but also in connection with the necessary diagnostic and therapeutic procedures. The treatment of pain is a priority for all patients, especially for critically ill children because of their vulnerability and limited understanding. The experience of pain is always subjective and depends on the age, the pain experience and the environment. ⋯ In neuropathic pain or phantom pain coanalgetics should be used to effectively treat pain in young patients. Different analgesic treatment approaches of the appropriate indications and adverse effects are presented. A particular challenge for the pediatrician is the sufficient and adequate pain therapy in palliative care.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
Review[Anesthesiological management of the drug-abusing parturient: relevance of maternal substance abuse for obstetric anesthesia].
Most of the female consumers of legal and illegal substances are of childbearing age. Occasional use, use disorder and addiction commonly devolve into each other. A lot of young women quit consuming when planning a family or at the latest with the knowledge of pregnancy. The ongoing substance abuse during pregnancy requires a coordinated interdisciplinary collaboration for a sufficient care of these highly complex and individual cases.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
Review[Perioperative antimicrobial prophylaxis].
Perioperative antimicrobial prophylaxis (AMP) is an important but not the only procedure to prevent surgical site infections. The effectiveness of AMP to prevent surgical site infections has been proven in numerous studies during the last decades and is part of national and international guidelines. ⋯ This article provides an overview on recommended antibiotics for AMP and their activity against the expected bacterial pathogens in elective surgery. Furthermore, the current spectrum of microorganisms most frequently isolated from surgical site infections and alternative antibiotic strategies are discussed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2011
Review[Transfusion medicine: does treatment of anemia reduce costs to the national health system?].
Preoprative Anaemia is an independent risk factor in perioperative medicine. Furthermore, preoperative anaemia is associated with higher treatment costs and remains the main risk factor for the transfusion of packed red blood cells. ⋯ Treatment of anemia as one pillar of patient blood management bears the potential to reduce costs to the national health system by prevention of complications and transfusion-associated morbidity. The economic impact of the treatment of preoperative anaemia versus the treatment with blood products requires prospective evaluation.
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Surgical site infections are the second or third most common type of nosocomial infections in Germany. For hospitals an annual incidence of 130000-160000 cases is estimated. Microbiological findings basically depend on type of surgery and wound location. ⋯ Subsequently the wound can be closed by secondary intention or lead to open wound healing. An accompanying therapy with antibiotics is recommendable in case of advanced local or systemic infection. To document wounds is an essential part of treating wounds.