Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2010
Review[The potential of the analgetic placebo effect - s3-guideline recommendation on the clinical use for acute and perioperative pain management].
The effectiveness of the analgetic placebo effect has been confirmed by several meta-analyses: not only can substances without active agents (placebos) achieve (hypo-) analgetic effectiveness, but also the effectiveness of active analgetics can be increased by added placebo effects. For this reason the new AWMF-S3 guidelines (DIVS 2009, www.awmf.org ) on the "treatment of acute and perioperative pain" recommend the clinical use of placebo effects and the avoidance of nocebo effects. The point is not to use placebos as a substitute for analgetics, but rather to add placebo effects on to those of analgetics.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2010
Review[Pain management after ambulatory surgery in Germany].
An increasing percentage of surgical procedures are performed in an ambulatory setting. However, a fairly high number of patients experience moderate to severe postoperative pain and pain is a common reason for unanticipated hospital admission. An adequate postoperative pain therapy in the ambulatory setting is therefore essential not only for ethical reasons or improvements in recovery but also for economic reasons but - in Germany - still remains inadequate. ⋯ Benefits from regional anesthesia and analgesia techniques are well known after sugery. Experiences from other countries demonstrate improved analgesia, less side effects (e.g. sedation, insomnia) and increased patients satisfaction associated with continuous peripheral nerve blocks at home. In Germany, these techniques are not frequently used but need to be considered in the future to optimize postoperative pain management after ambulatory surgery.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2010
Review[Aneurysmal subarachnoid hemorrhage - therapy and complications].
The management of patients with aneurysmal subarachnoid hemorrhage (SAH) requires a fundamental knowledge of the disease, its therapeutic options and possible complications. The preoperative goal is to prevent rebleeding by controlling blood pressure and treating pain and anxiety as well as stabilizing cardiopulmonary functions. ⋯ The postoperative goal aims at securing cardiopulmonary functions as well as recognizing and treating cerebral (cerebral vasospasm, hydrocephalus, epilepsy) and systemic complications (electrolyte disorder, cardiac dysfunction). This article provides an overview about the pre-, peri- and postoperative management of patients with SAH.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2010
Review[Pharmacotherapy in cancer pain management].
Cancer-related pain affects approximately about 30 to 80 % of all patients, according to primary and metastatic sides and stage of disease. Cancer pain management depends on the underlying pathophysiological mechanisms. ⋯ Advantages and side effects of the different nonopioids, anticonvulsants, and antidepressants are discussed. The recommendations are limited for the adult outpatient treatment.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2010
Case Reports[Case Report: young woman with reduced state of consciousness - rescue team stumble across curious cause].
Causes for reduced states of consciousness are diverse; it is often impossible to directly reveal the underlying agents. The following case report describes a young healthy patient who showed a temporary unconsciousness that first appeared seemingly without reason. Accidentally we hit a very uncommon cause for the prevailing carbon monoxide intoxication and were able to prevent further impairment of health status of both patient and environment.