Der Anaesthesist
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Various vigilance systems have been established in medicine during the last two decades. The aims are the identification of critical incidents and to implement appropriate countermeasures thus decreasing the likelihood of accidents and increasing patient and user safety. The types of systems are very divergent: they are either restricted to individual departments, hospitals, specialist or occupational groups or function nationwide. ⋯ Not all users are aware that an obligation for reporting exists. A proposal is made to simplify the reporting process in order to enhance user willingness for reporting. Additionally, it is suggested that a link should be incorporated into all existing critical incident reporting systems which can forward the user to the specific reporting website.
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Intra-articular local anesthetics are often used for prevention of pain after arthroscopic knee surgery. However, the effect of local anesthetics other than bupivacaine on articular cartilage and synovium has not been studied. Also, complications associated with the injection of intra-articular bupivacaine have appeared in the literature. The aim of this study was to evaluate the effects of levobupivacaine on the articular cartilage and the synovium in rats. ⋯ Although more studies are needed before final recommendations can be made, by evaluating the results obtained from this study, the clinical use of intra-articular levobupivacaine can be recommended for arthroscopic knee surgery.
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There is no nationwide evaluation of the quality of anaesthesia in Germany. Thus, the aim of this study was to perform analyses using administrative routine data relating to this topic. ⋯ Administrative data seem to be an appropriated basis for measurement of quality of outcome in anaesthesiology. Further investigations should be performed to include the diagnosis present on admission. Moreover, there is a need for comparing routine data to the standardized data set, known as the "core data set anaesthesia".