Der Anaesthesist
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Postoperative cognitive dysfunction is a severe and life-threatening complication after an operation. The mobilisation of the patient is difficult and, therefore, the stay of the patient in the hospital is extended and the resulting immobilisation is associated with further complications (e.g. decubitus, pneumonia, or thrombosis). ⋯ Preexisting diseases, like diabetes mellitus, heart failure, depression or alcohol excess are high risk factors as well as the use of anticholinergic drugs. A specific therapy for this cognitive dysfunction is unknown and, therefore, preventive measures should be used in patients with a preexisting high risk.
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Despite the development of new devices and strategies to manage and secure the difficult airway, morbidity and mortality in anaesthesia due to airway problems such as difficult intubation or unrecognised failed intubation remain high. The problem seems to lie in the transfer of skills and strategies to daily clinical practice. ⋯ This article outlines new training concepts in airway management with the help of simulation and simulators. We describe technical prerequisites and provide information on the implementation of difficult airway scenarios.