Der Anaesthesist
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Review Comparative Study
[Indications for central versus peripheral regional anesthesia].
Serious neurological complications caused by spinal hematoma or abscess following central neuraxial block have been reported more often during the last years. In contrast, severe complications are extremely rare associated with peripheral nerve blocks. Concerned about the safety of spinal and epidural anesthesia, we encourage the use of peripheral regional techniques for procedures on the lower extremity and especially for postoperative regional analgesia. ⋯ Any increase in motor block following neuraxial blockade should raise the suspicion of a spinal compression (e.g. hematoma or abscess). Other symptoms are back pain, radicular pain or paresthesia and incontinence. Disastrous neurological injuries can only be prevented by immediate diagnosis (MR, CT or myelography) and therapy (surgical decompression).
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Clinical Trial
[Primary cesarean section. Use of phenylephrine during anesthesia in a patient with hypertrophic obstructive cardiomyopathy].
We report on anaesthesia management for elective Caesarean section in a parturient woman with hypertrophic obstructive cardiomyopathy (HOCM). Special considerations for anaesthesia are associated with this condition. Women with HOCM need a closed diagnostic and therapeutic follow-up during pregnancy. ⋯ Adequate hemodynamic monitoring is essential. Phenylephrine is a pure alpha-adrenergic vasoconstrictor without inotropic effects. It is suitable for therapy of blood pressure drops induced by peripheral vasodilation.
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Meta Analysis
[The menstruation cycle in the postoperative phase. Its effect of the incidence of nausea and vomiting].
Several studies suggest that the menstrual cycle has an impact on postoperative nausea and vomiting (PONV). However, many studies report inconsistent results. Thus, in this systematic review the results of all available studies are compared and statistically synthesised. ⋯ Studies investigating the influence of the menstrual cycle on the incidence of PONV show inconsistent results. Summarising the data of these studies suggests that the phase of the menstrual cycle has no impact on the occurrence of PONV.