Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2004
[Cricothyroidotomy training on cadavers - experiences in the education of medical students, anaesthetists, and emergency physicians].
Should the technique of surgical cricothyroidotomy be practiced on cadavers and should it be a compulsory part of the teaching curriculum? Is it wise to use a speculum for the insertion of the endotracheal tube? What is the optimum size of the tube? ⋯ In our opinion it is highly recommended that the technique of cricothyroidotomy should be practiced on cadavers and that the course should become a compulsory part in a future educational curriculum. In addition the incision of the ligamentum conicum using dilators or a speculum is not to be recommended from the point of view of this study. The tracheal tube used in this study (reinforced wire tube, ID 6.0) was best suited for surgical cricothyroidotomy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2004
[On the use of ultrasound to assist central vein cannulation in Germany: a surgery of 817 departments of anesthesia].
A survey on the current practice in using portable ultrasound machines to assist central vein cannulation was performed by sending a questionnaire to 817 departments of anaesthesiology and intensive care medicine in Germany. Also, incomplete questionnaires were included in the analysis. ⋯ In Germany, placement of central venous catheters is usually based on anatomical landmarks. Every anaesthetist and intensive care physician should be able to place central venous catheters without an ultrasound device. Still there is not a doubt that ultrasound assistance is useful for beginners, in children, and when blind cannulation fails. Also in patients in whom catheterisation is likely to be difficult (e. g. patients, with previous central venous catheters, with abnormal anatomy etc.) Due to our data a promotion of ultrasound assistance seems urgently required.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2004
Case Reports[Intoxication with methadone and benzodiazepines in a morbidly obese patient in the social environment of a heroin addict receiving methadone maintenance therapy].
Methadone is a well-established maintenance drug for the therapy of opioid addicts. Reduction of mortality, social stabilization and reintegration are basic goals of this therapeutic concept. In the ideal case, total opioid abstinence can be achieved. ⋯ We report an intoxication with methadone of the husband of a heroin-addict patient. In this morbidly obese patient, a simultaneous ingestion of benzodiazepines was suspected. This case report describes the diagnostic and therapeutical options of an opioid intoxication in a patient with severe obesity with special emphasis on the airway management strategy in an out-of-hospital situation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2004
Randomized Controlled Trial Clinical Trial[Propofol-LCT versus propofol-MCT/LCT with or without lidocaine - a comparison on pain on injection].
A disadvantage of Propofol (commercial preparation containing long-chain triglycerides; Propofol-LCT) is pain on injection, which is reported by 54 - 100 % of the patients. Many different approaches have been used in an attempt to decrease the pain on injection of propofol. The currently most efficacious treatment is lidocaine given intravenously with a tourniquet prior to Propofol injection. In previous studies, larger concentrations of free propofol in the aqueous phase of an emulsion were associated with more pain on injection. A new formulation of propofol (a mixture of long-chain and medium-chain triglycerides in the carrier emulsion; Propofol-MCT/LCT) reduces the incidence of pain on bolus injection. This study was designed to investigate, whether the use of Propofol-MCT/LCT alleviates pain on injection to a similar degree as pretreatment with lidocaine. ⋯ The results suggest that pain on injection is reduced equivalent using either Propofol-MCT/LCT alone or Propofol-LCT with pre-treatment of lidocaine. Pre-treatment with lidocaine before Propofol-MCT/LCT seems to have an additional effect.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2004
[Microbiological isolates associated with nosocomial infections in intensive care units: data of 274 intensive care units participating in the German Nosocomial Infections Surveillance System (KISS)].
To describe the frequency and distribution of microbiological isolates in association with nosocomial infections (NI) in intensive care units (ICUs) in Germany. ⋯ The KISS data give an overview of the most important pathogens associated with nosocomial infections on ICUs in Germany.