Der Anaesthesist
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Lidocaine is commonly used for regional anesthesia and nerve blocks. However, recent clinical studies demonstrated that intravenous perioperative administration of lidocaine can lead to better postoperative analgesia, reduced opioid consumption and improved intestinal motility. It can therefore be used as an alternative when epidural analgesia is contraindicated, not possible or not feasible. ⋯ The lidocaine infusion is stopped in the recovery room 30 min before discharge or in the ICU at the latest after 24 h. Lidocaine is not used on normal wards. This overview summarizes the current evidence for the intravenous administration of lidocaine for patients undergoing different types of surgery and gives practical advice for its use.
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Acute type A dissection is among the most dangerous of vascular diseases and is associated with a high lethality. Surgery for type A dissection is a complex procedure which is accompanied by relevant blood losses and severe deterioration of the coagulation system. ⋯ Furthermore, reestablishment of sufficient hemostasis can be challenging and requires thorough understanding of the relevant aspects affecting normal hemostasis during surgical repair of aortic dissection. In this article relevant pathophysiological aspects and basic principles of anesthesiological management of type A dissection are described.
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The goal of the present study was to evaluate the publication rate of abstracts presented during the German Anesthesia Congress (Deutscher Anästhesiecongress, DAC) and the meeting of the European Society of Anesthesiologists (ESA) in the years 2000 and 2005 in Medline listed journals (http://www.ncbi.nlm.nih.gov/pubmed). In addition, the respective impact factors of the journals in which the articles were published were evaluated (http://www.isiknowledge.com). ⋯ In the year 2005 more abstracts of the DAC were published in Medline listed papers than in 2000. When comparing the number of abstracts published in Medline listed journals, more abstracts of the DAC were published compared to abstracts of the ESA. The increase in papers written in English after abstract presentation on the DAC is mostly due to the wider readership which can be reached with manuscripts in the English language. Besides a larger readership, English journals often also have a higher ranked impact factor. This analysis does not claim to be a complete registration of all published abstracts due to the limitation on Medline listed journals and publications in other journals were not rated. Medline was selected because of the widespread and international use of this database.
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Randomized Controlled Trial Multicenter Study
[Implementation of new standards in anaesthesia. Exemplified by the ad hoc introduction of desflurane in 10 German hospitals].
According to numerous pharmacoeconomic studies new anaesthesia techniques can improve recovery times and thus can have a positive economic impact on patient turnover. However, artificial study protocols do not always match real world situations and thus the practical impact of such studies remains unclear. ⋯ The implementation of a new drug (here: desflurane to substitute sevoflurane) can improve speed of recovery immediately after termination of anaesthesia even after a very short period of introducing the new technique but has no positive long term effects. Thus, the results of this trial performed under a real world scenario (health service research) without tight standardization by an artificial study protocol supports the results originating from randomized controlled clinical trials.
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Review Case Reports
[Burn-out in anesthesia and intensive care medicine. Part 1. Clarification and critical evaluation of the term].
Both acute critical life events and circumstances continuously perceived as strenuous may lead to psychomental and somatic symptoms. The term burn-out as an expression for chronic occupational stress has become a popular catchword over the last years. Employees in many occupations feel especially prone to burn-out due to a work environment perceived as increasingly intense and commercialized. ⋯ Even though the classic concept of burn-out and the Maslach Burnout Inventory have been used for many years, a critical appraisal shows that burn-out has not yet been recognized as a diagnostic entity. Presumably there are other concepts and psychometric instruments more capable of collecting epidemiologic data regarding chronic work-related stress. With enhanced data, perhaps, measures based on principles of public health can be created and evaluated for the prevention and treatment of this condition.