Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Carotid endarterectomy has become a standard surgical procedure in the therapy of cerebrovascular insufficiency. An important consideration in this form of therapy is to maintain a low perioperative morbidity and mortality. In planning the procedure the two most frequent complications deserve special consideration. ⋯ Another continuous technique is transcranial Doppler sonography; this, however, does not monitor brain function and its role in carotid surgery is still under investigation. Carotid stump pressure or cerebral blood flow measurements provide intermittent data and should therefore only be used as an adjunct. The goal to find an approach that minimizes the risk for the individual patient can only be attained by close cooperation between anaesthesiologists and surgeons.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1994
Case Reports[Cesarean section with subsequent craniotomy in the area of the posterior cranial fossa].
We report on a 31-year old pregnant patient with von-Hippel-Lindau syndrome who presented to the emergency room with symptoms of increased intracranial pressure. She was found in premature labour with a normal foetus of 29 weeks' gestational age in breech presentation. We discuss an anaesthetic and neurosurgical management during emergent craniotomy and Caesarean section. ⋯ Neonatal depression is likely with this technique and requires resuscitative measures. The indications for rapid sequence induction in pregnant patients with raised intracranial pressure at risk for aspiration are discussed. Different options for monitoring during this procedure are described.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1994
Randomized Controlled Trial Clinical Trial[Comparison of 5% human albumin and 6% 200/0.5 HES as exclusive colloid components in large surgical interventions].
It was the purpose of the following study to compare effects of 6% hydroxyethyl starch 200/0.5 (HES) and albumin 5% (HA5) on haemostasis, haemodynamics, oncotic function and plasmatic homoeostasis. ⋯ Regarding total blood output/intake, haemodynamic functions, haematological parameters, coagulation, oncotic function, and plasmatic homoeostasis, HES is a safe colloid if contra-indications are taken into account, capable of replacing albumin 5% entirely as a colloid component of treatment of even large blood losses intraoperatively above the recommended dose of 20 ml/kg BW/d.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1994
Comparative Study Historical Article[A historical vignette. Ether versus chloroform].