Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1995
Historical Article[Indications for anesthesia?].
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1995
Review[Current status of ambulatory pediatric anesthesia].
Anaesthesia in paediatric outpatients represents a multi-facetted challenge for the anaesthesiologist. Certain steps have to be taken to allow preoperative examination of the patient on an outpatient basis. Preoperative screening should identify patients whom it is preferable to treat as inpatients. ⋯ Prophylactic administration of antiemetic agents must be considered for special operations. Patients should also be discharged according to standardised guidelines. In this way, the risks involved in anaesthesia and surgery should not be higher for outpatients than they are for inpatients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1995
Case Reports[Amniotic fluid embolism--a case report with positive outcome].
While inducing delivery, shock occurred in a 23-year old primipara (41 weeks and 5 days of gestation). She showed symptoms of cyanosis, unconsciousness and asystoly. During cardiopulmonary resuscitation an emergency Caesarean section was performed. ⋯ Hysterectomy had to be performed, because the substitution of packed red blood cells, whole blood, fresh frozen plasma and other blood derivatives could not stop bleeding. Although the prognosis seemed to be very poor, mother and child survived without any physical damage or neurological deficit until now. Because of the clinical pattern we diagnosed an AFE syndrome (amniotic fluid embolism).
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Treatment of postoperative shivering with nalbuphine].
Postoperative shivering is common and has potentially adverse side effects in high-risk patients. Meperidine, which binds to both mu- and kappa-opioid receptors, is reported to be more effective in treating shivering than morphine or fentanyl. Recent data indicate that much of meperidine's special antishivering effect may be mediated by its kappa-opioid receptor activity. Nalbuphine, an opioid agonist/antagonist also has a potent affinity for kappa-receptors. The aim of this study was to evaluate the antishivering effect of nalbuphine in comparison to meperidine. ⋯ The data indicated that nalbuphine suppressed postoperative shivering as effectively and timely as meperidine in equianalgesic doses. The observation is consistent with the hypothesis that stimulation of kappa-opioid receptors is a likely explanation for much of meperidine's antishivering action.