Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2015
Review[Anesthesia and hemodynamic management in the sitting position].
Every year thousands of patients are operated in the sitting position. The most common position is the beach chair position. Due to case reports with deleterious neurologic outcome, the safety of the beach chair position in combination with general anesthesia is discussed controversially. In this review article the possible complications according to the beach chair position are explained and practical advice is given for the daily anesthetic routine.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2015
Review[Antiemetic therapy in preclinical emergency medicine - a literature review].
Nausea and vomiting are frequent symptoms in emergency medicine and require a targeted drug intervention. Despite known disadvantages in terms of efficacy and side effects, metoclopramide is still often used in the emergency medical service to treat nausea and vomiting. Recent studies show that, especially in the therapy of opioid-triggered vomiting, metoclopramide is not significantly effective when compared to placebo. ⋯ In addition, neither of the 5-HT3-antagonists are approved for therapy of non-chemotherapy-induced vomiting or PONV. In conclusion, it may be considered to include 5-HT3-antagonists in addition to dimenhydrinate in the ambulance medical equipment. The routine use of a specific antiemetic is not recommended.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2015
Review[Regional anaesthesia in patients with lower limb injury].
Almost all surgical procedures following injury can be provided in peripheral regional anaesthesia or spinal anaesthesia - under consideration of specific contraindications. The majority of injuries at the lower limb are associated with severe pain and immobilization during the postoperative phase. Moreover, opioids are often required which are related to nausea, vomiting and impairment of vigilance. ⋯ Therefore anaesthesia is challenging in those patients. Even injuries of the long bones - like the femur and the tibia - are causing severe pain, therefore an appropriate concept for acute pain therapy is required. Moreover, for injuries with affection of bony joint-structures (i. e. knee, ankle, calcaneus) and marked soft-tissue injuries continuous regional anaesthesia techniques could provide advantages during acute pain therapy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2015
Review[Anesthesiology in interventional pneumology- endoscopic interventions: part 1].
Less invasive bronchoscopic techniques for lung-volume-reduction have almost replaced surgical resections. Tracheobronchial obstructions and - to a certain degree - even bronchial tumors can be treated bronchoscopically. However all these procedures show specific risks anesthesiologists have to consider.