Der Anaesthesist
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A uvular edema can be associated with angioedema, urticaria and anaphylaxis. Furthermore, it can be caused by medications, such as angiotensin-converting enzyme (ACE) inhibitors, non-steroidal anti-inflammatory drugs and angiotensin II receptor antagonists. ⋯ This article presents the case of a patient who underwent kidney transplantation and developed extensive edema of the uvula that occurred postoperatively after general anaesthesia. The case report describes the diagnosis and therapy of this rare disease.
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Comparative Study Observational Study
[Methohexital for analgosedation of ventilated intensive care patients : Prospective nonrandomized single center observational study on incidence of delirium.]
Delirium is defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) as a potentially reversible disturbance of consciousness and a change of cognition caused by a medical condition, drug intoxication, or medication side effect. Delirium affects up to 80 % of intensive care unit (ICU) patients and is associated with increased morbidity and mortality. One risk factor for development of delirium in ventilated intensive care unit patients is sedation. The German S3 guidelines on "Analgesie, Sedierung und Delirmanagement in der Intensivmedizin" (analgesia, sedation and delirium management in intensive care medicine) of the DGAI (German Society for Anesthesiology and Intensive Care Medicine) and the DIVI (German Interdisciplinary Association for Intensive Care and Emergency Medicine) recommend midazolam and propofol for sedation, although both drugs are associated with a high incidence of delirium. ⋯ Sedation with methohexital compared to midazolam or propofol reduced the incidence of delirium by more than 50 % in ventilated ICU patients.
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Practice Guideline
[Perioperative management of patients with obstructive sleep apnea : Update on the practice guidelines of the American Society of Anesthesiologists Task Force.]
Obstructive sleep apnea (OSA) is a widespread disease which is associated with many cardiovascular diseases and can have health-related consequences for affected patients if untreated. It is known that perioperative airway complications occur more often in OSA patients during general anesthesia. ⋯ These guidelines have now been revised and updated. This article gives a summary of the recommended approach for the perioperative treatment of patients with OSA given in the 2014 guidelines.