Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2012
Review[Nerve injury due to peripheral nerve blocks: Pathophysiology and aetiology].
Permanent nerve injury as a complication of peripheral regional anaesthesia is fortunately rare with an estimated incidence of 0,03%. However, transient neurological symptoms are more frequent with an occurrence of 3-8%. ⋯ Regarding pathophysiology, trauma-related inflammation should be acknowledged as an important interference during nerve recovery. Needle-nerve contacts, nerve perforation and local cytotoxicity of local anaesthetics should be reduced to a minimum by application of nerve stimulation, ultrasound and an adequate dosage of local anaesthetics with less locotoxicity.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2012
Review[Nerve injuries associated with nerve blocks: clinic and incidence].
Persistent nerve injuries in context of peripheral nerve blocks are uncommon. Previous surveys and prospectively designed studies have specified neurological dysfunctions in different ways, which may cause the variability of data about incidence; so it has to be reckoned with about 5% after 1 week, 1% after 1 month and 0,01% after 6 months. ⋯ Dysfunctions manifest as numbness, parasthesia, tingling sensation and/or amyasthenia. Fortunately long-term lesions, caused by nerve blocks are a rarity.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2012
Review[Muscle relaxants and neuromuscular monitoring - Introduction for a safe clinical application].
The use of muscle relaxants facilitates endotracheal intubation and ameliorates the conditions of surgery. But, their use should be controlled - otherwise there will be postoperative residual curarisation which can lead to patient discomfort up to severe medical complications. Therefore, an appropriate surveillance via objective neuromuscular monitoring is essential. This article gives a review of the basic principles of muscle relaxants, their clinical application and the surveillance of their effects and degradation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2012
Review[Neurologic complications after epidural analgesia].
Epidural analgesia is regarded as gold standard after major abdominal or thoracic surgery in combination with general anaesthesia. Apart from well documented positive effects of epidural analgesia on the postoperative period, evidence for the incidence of neurologic complications is less clear. ⋯ The review article gives an overview about current data on neurologic complications related to epidural analgesia and shows feasibility of prevention and early detection. Furthermore a therapeutic approach in case of a neurologic incident will be demonstrated.