Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2014
Review[Diclofenac up2date - Part 2: The use in specific groups of patients].
The non-opioid analgesic diclofenac is used worldwide for musculoskeletal and perioperative pain therapy. Despite its frequent use and easy access as an "over the counter" drug, gastrointestinal, cardiovascular, and renal adverse drug effects have to be considered. Availability of diverse formulations (e.g. tablets, suppository, gel-formulations) with different indications, dosage recommendations and contraindications may easily lead to confusion, thus accounting for inadequate use on the one hand or withholding of an effective analgesic. This review may provide physicians in perioperative medicine, intensive care and pain therapy with important and suitable information about the pharmacology and appropriate use of this drug.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2014
Review[Pitfalls of anesthesiologic management in operative or interventional securing of aneurysm].
Despite significant advances in operative, interventional and perioperative management aneurysmal subarachnoid hemorrhage is still associated with high rates of 30-day mortality in 35% and severe impairments in neurologic functional outcomes in up to 50% of the survivors. Apart from severity of initial brain injury prognosis depends on the extent of secondary brain injury triggered by re-rupture, vasospasm, hydrocephalus and/ or further operative, interventional or intensive-care associated complications. Due to the complexity of disease the paper exclusively deals with pitfalls of anesthesiologic management in operative and non-operative aneurysm repair.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2014
Case Reports[Case Report - A dangerous intoxication after ingestion of alkyl nitrite ("Poppers")].
This case report describes the inadvertent poisoning of a young man with "poppers" after having ingested an unknown amout of the drug. "Poppers" (alkyl nitrite) were made famous in the 1960s as a party drug, and during certain sexual practices, and are still in use today. The drug's inhalation leads to a short-lived rush, vasodilation and relaxtion of smooth muscles. An accidental ingestion can lead to a significant build-up of methemoglobin with dire consequences. The therapy consists of the intravenous administration of methylene blue.