Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2007
Review[Postresuscitation care: therapeutic concepts and prognostication].
After cardiac arrest, mortality in the postresuscitation period is still up to 70%. Therefore, optimal intensive care of these patients is of great importance. ⋯ Particular focus is given to mild therapeutic hypothermia. This is currently the only therapeutic concept for which randomized clinical trials have shown improved survival and neurological outcome after cardiac arrest.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2007
Review[Paediatric anaesthesia for neurosurgical procedures].
Paediatric neurosurgical procedures request special considerations for the anaesthetic management. Due to patients age and diagnostic findings certain therapeutic procedures are performed under anaesthetic care. Main reasons for craniotomy are hydrocephalus, intracranial tumors and craniofacial synostosis. ⋯ Operative access will be performed for selected cases additionally to embolization, but is associated with risk of massive bleeding. Severe traumatic craniocerebral injury leads to compromised cerebral blood flow and hypoxic ischemia. The article imparts funded knowledge of surgical as well as anaesthetic rationale and techniques in neuropaediatric therapies.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · May 2007
Review[Walking epidurals: mobilisation during neuraxial labour analgesia].
Neuraxial anaesthesia offers the most effective form of obstetric pain relief and is superior to other methods of analgesia, and it does not increase the risk of caesarean section. In daily practice, various techniques are used including the options of patient-controlled epidural analgesia (PCEA) and combined spinal epidural analgesia (CSEA). Risk information is one of the prerequisites for 'informed consent'. Omitting the epidural test dose and using low-dose local anaesthetics with lipophilic opioids enhances early mobilisation.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · May 2007
Review[Combined spinal-epidural anaesthesia for pain relief in obstetric patients].
Besides epidural analgesia combined spinal-epidural anaesthesia (CSE) is one of the favourite techniques of regional anaesthesia for pain relief in obstetric patients. CSE combines the advantage of spinal anaesthesia, e.g. rapid onset and reliable effect, with the advantage of continuous epidural anaesthesia, e.g. titration of analgesics and prolongation. While subarachnoid injection of solely opioids provides fast pain relief for nearly 2 hrs in the first stage of labour with an opportunity of ambulation for the parturient ("walking epidural"), the subarachnoid injection of a combination of low doses of opoids and local anaesthetics provides profound analgesia with minor motor blocking side effects for 1-2 hrs in the second stage of labour.