Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2024
Review[Update: Neuromuscular Blockade during General Anesthesia].
The correct use of muscle relaxants and neuromuscular monitoring during anesthesia has been subject of controversial discussions for decades. Particularly important in clinical practice are identification and management of residual neuromuscular blockages and avoidance of associated complications. Despite the differences in the molecular mechanisms of action between depolarizing and non-depolarizing muscle relaxants the blockade of the postsynaptic nicotinic acetylcholine receptor remains a common ending pathway. ⋯ However, even the single use of muscle relaxants increases the likelihood of postoperative pulmonary complications. These complications associated with the use of muscle relaxants, such as residual neuromuscular blockade, must be anticipated. The application of guideline-based approaches, including continuous neuromuscular monitoring and the application of muscle relaxant reversal agents, may significantly reduce the rate of adverse events associated with the use of muscle relaxants.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2024
[A Local Gender Equality Plan - A Modern Human Resources Development Tool].
The implementation of equal opportunities is a challenge for the staff of an anaesthesia department. At the Department of Anaesthesiology and Intensive Care Medicine at Hannover Medical School, a local Gender Equality plan has been implemented to create a secure and transparent framework for reconciling scientific and clinical careers with family responsibilities. ⋯ At the same time, it is important to offer an attractive workplace in view of the increasing shortage of qualified staff. In order to provide equal opportunities for all employees and to increase satisfaction, it is necessary for employers to address the issues of equality and work-life balance, to identify challenges and to create structures for improvement.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2024
[Neuromuscular Blockade in Geriatric Patients].
The administration of neuromuscular blocking agents has been used in anesthesia for decades and continues to play an important role in modern anesthesia. Special patient populations, such as very young or very old patients, require adapted use. The following article discusses the specifics of neuromuscular blocking agents administration in geriatric patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2024
Review[Neurosurgical Management of Traumatic Brain Injury].
The neurosurgical management of traumatic brain injury (TBI) plays a critical role in ensuring acute survival and mitigating secondary brain damage, which significantly impacts patients' quality of life. TBI is defined as an external force impacting the skull, leading to brain injuries and subsequent functional impairments. It is a leading cause of mortality and morbidity, particularly among young individuals. ⋯ Treatment aims not only to secure immediate survival but also to reduce secondary injuries, with ICP management being crucial. Neurosurgical interventions are guided by cranial pathologies, with options including ICP monitoring, burr hole trepanation, craniotomy. In severe TBI cases with refractory ICP elevation, decompressive craniectomy may be performed as a last resort, significantly reducing mortality but often resulting in high morbidity and vegetative states, necessitating careful consideration of indications.