Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1994
Case Reports[Capnothorax and subcutaneous emphysema in attempted laparoscopic suture of duodenal ulcer].
A 72-year old lady suffering from coronary heart disease was admitted with acute abdominal pain. Laparoscopy was performed and revealed perforation of a duodenal ulcer. The surgeon decided to suture the perforation via laparoscope. ⋯ The further hospital stay was uneventful. The possible causes for the increasing hypercapnia are discussed. We suggest close monitoring of patients during laparoscopy including capnometry and the anaesthesist should be aware of rare complications.
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Carotid endarterectomy has become a standard surgical procedure in the therapy of cerebrovascular insufficiency. An important consideration in this form of therapy is to maintain a low perioperative morbidity and mortality. In planning the procedure the two most frequent complications deserve special consideration. ⋯ Another continuous technique is transcranial Doppler sonography; this, however, does not monitor brain function and its role in carotid surgery is still under investigation. Carotid stump pressure or cerebral blood flow measurements provide intermittent data and should therefore only be used as an adjunct. The goal to find an approach that minimizes the risk for the individual patient can only be attained by close cooperation between anaesthesiologists and surgeons.