Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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The incidence of overweight and obesity in children and adolescents who need an anesthesia is increasing. These children have a higher risk for perioperative complications. The review discusses definition and causes of obesity in children, gives information about relevant pathophysiological changes, and focuses anesthesiological management and complications.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2009
Review[Anaesthesia management of the obese patient].
Obesity is a global epidemic, and approximately 20 % of the German population are obese. Therefore anaesthesiologists will be increasingly involved in the care of obese and morbidly obese patients in the near future. ⋯ Comorbidities such as diabetes, hypertension, coronary heart disease and sleep apnea considerably increase the risk of obese patients. A thorough preoperative evaluation of comorbidities, an anaesthesia induction and intraoperative ventilation tailored to the pathophysiological sequelae of obesity and a sound knowledge of pharmokocinetics are necessary to ensure optimal care for obese patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2009
Review[Videolaryngoscopy for endotracheal intubation - new developments in difficult airway management].
Difficulties in tracheal intubation are the major causes of anaesthesia related morbidity and mortality. Novel videolaryngoscopes facilitate endotracheal intubation by indirect visualisation of glottic structures through optical systems. In this review, differences and the advantages and disadvantages of videolaryngoscopes are discussed.
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Thoracic paravertebral block for postoperative pain control has been introduced more than a century ago. It is currently gaining increasing popularity. ⋯ When compared to epidural analgesia for postthoracotomy pain control, thoracic paravertebral analgesia provides comparable analgesic efficacy, but less side-effects. Regarding concomitant use of anticoagulants and antiplatelet drugs, paravertebral blockade is considered a central nerve block.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2009
Review[Regional anaesthesia for carotid endarterectomy].
Cervical plexus blocks have been established as safe and feasible procedures for carotid endarterectomy. Comparable perioperative complication rates have been reported for plexus techniques and general anaesthesia. The results of the GALA trial support the theory that the indication for insertion of intraluminal shunts was significantly reduced by regional procedures (14 % vs. 43 %) in consequence of the more reliable diagnosis of neurological complications. However, it has not been identified yet which technique (superficial, deep or a combination) offers the highest effectiveness.