Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2001
[Epileptic seizures from etomidate? The human Kv1.1 potassium channel in humans].
It is a matter of dispute whether etomidate exhibits an epileptogenic action. It is also disputed whether frequently observed myocloni induced by etomidate are related to seizure-like activity in the EEG. The clinical effects of anaesthetic agents reflect their molecular action. A possible epileptogenic action of etomidate should, therefore, result from action on a molecular target that has yet to be identified. Suppression of Kv1.1 channels may be associated with epilepsy in men. Inhibition of Kv1.1 channels by etomidate at clinically relevant concentrations would, thus, argue in favour of an epileptogenic action of etomidate. ⋯ The small effect of etomidate on human Kv1.1 channels at these concentrations questions an epileptogenic action of etomidate caused by inhibition of Kv1.1 channels.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2001
Comment Letter[Comments on "Severity in the prognosis following head-brain trauma." Krier C., Kienzle F. Anäesthesiol Intensivmed Notfallmed Schmerzther 2000;35:63-66 and "Outcome factors in severe head-brain trauma." Thomas A et al. Anästhesiol Intensivmed Notfallmed Schmerzther 2000;35:91-8].
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2001
Review[Pain relief for vaginal delivery--an overview].
The multimodal aspects of labour pain, it's origin and effects, as well as the possibilities of it's treatment will be described from the obstetrician's point of view. This will include a comparison of methods in current common use during delivery including psychosomatic methods, physical methods, acupuncture, homeopathy, use of water, drug therapy as well as the use of local and regional anaesthesia. For particular discussion is the use of epidural catheter in delivery, with respect to availability, optimal timing and obtaining informed consent and it's documentation, as well as teamwork and clear interdisciplinary decisions concerning frequency and parameters of monitoring for epidural catheter anaesthesia following the motto: "how much is necessary, how little is possible?"
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2001
[10 years experience with extracorporeal membrane oxygenation].
Extracorporeal membrane oxygenation (ECMO) is a supportive therapy used for severe acute respiratory distress syndrome (ARDS). We present outcome, clinical parameters, and complications in a cohort of 245 ARDS patients of whom 62 were treated with ECMO. ⋯ ECMO is a therapeutic option for patients with severe ARDS, likely to increase survival. However, a randomized controlled study proving its benefit is still awaited. Until the development of a causal or otherwise superior therapy ECMO should be used in selected patients.