Der Anaesthesist
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This 1998 survey was carried out on the use of the sitting position for neurosurgical procedures in the posterior fossa and operations of the craniospinal and cervical spine region by the dorsal approach. In addition, anesthetic management of the sitting position and the compliance with recommendations of the Neuroanesthesia Study Group of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) published in 1995 were investigated and compared to results of a 1995 survey. ⋯ The survey demonstrates that the use of the sitting position in German neurosurgery is still high when compared to other Western countries, but a tendency for decline over last 3 years can be observed from our data. In addition, our data appears to indicate a positive effect of the Study Group's recommendations on anesthetic management of the sitting position in neurosurgery.
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Residual neuromuscular block is a major risk factor behind critical events in the immediate postoperative period. Residual weakness due to muscle relaxants is seen in more than thirds of postoperative patients with ventilatory failure and hypoxia. Residual neuromuscular block should therefore be regarded as a serious adverse event in the same way as we regard ventilatory depression due to opioids and anaesthetic agents. This presentation aim to clarify our present knowledge and shortcomings in the field of residual neuromuscular blockade.