Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2013
Review[Regional anaesthesia in children--caudal anaesthesia and trunk blocks].
In children, elective surgery is often performed in the trunk region. Regional anaesthetic techniques allow good analgesia with reduced opioid consumption, and enhance rapid discharge of the small patients. This review focuses on indication, anatomic structures, puncture techniques and potential complications of caudal anaesthesia, transversus abdominis plane block, ilioinguinal/iliohypogastric nerve block and rectus sheath block.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2013
[Flight and altitude medicine for anesthetists-part 3: emergencies on board commercial aircraft].
The demographic trend of industrialized societies is also reflected in commercial airlines' passengers: passengers are older nowadays and long-haul flights are routine mode of transport despite considerable chronic and acute medical conditions. Moreover, duration of non-stop flight routes and the number of passengers on board increase. Thus, the probability of a medical incident during a particular flight event increases, too. ⋯ Besides flight operations and technical aspects, the medical infrastructure on the ground has to be considered carefully. Regardless of the amount of experience of a physician medical emergencies on board an aircraft usually represent a particular challenge. This is mainly due to the unfamiliar surroundings, the characteristics of the cabin atmosphere, the often existing cultural and language barriers and legal liability concerns.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2013
Comparative Study[Supraglottic airways in infants and children].
The development of the LMA-Classic™ revolutionized anaesthesia practice as its wide-spread use led to the establishment of a unique form of airway management, the "supraglottic airway management", besides the existing classical airway management with the face mask or endotracheal tube. Today, 25 years later, along with the original prototype of supraglottic airways quite a few numbers of different devices exist that can be used to secure the airway "above the glottis". ⋯ Consequently, the routine use of these devices outside controlled clinical studies must be considered questionable. The following article aims at providing a critical appraisal of currently available supraglottic airway devices for neonates and infants.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2013
[Definitions, decision-making and documentation in end of life situations in the intensive care unit].
The present work provides assistance for physicians concerning decision making in clinical borderline situations in the ICU. Based on a structured checklist the two fundamental aspects of any medical decision, the medical indication and the patient's preference are queried in a systematic way. Four possible steps of withholding and/or withdrawing therapy are discussed. Finally, recommendations regarding appropriate documentation of end of life decisions are provided.