Der Anaesthesist
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A patient reported anxiety and sleeping problems 9 months after reconstruction of the anterior floor of the mouth following tumor surgery. These symptoms had been initiated by a postoperative delirium with hallucinations, which had not been detected during its occurrence. ⋯ Patients in intensive care units should be asked and informed about delirium symptoms. This might prevent long-term psychological distress.
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Randomized Controlled Trial Comparative Study
Different anesthesia methods for laparoscopic cholecystectomy.
The aim of the study was to compare the possibility of performing laparoscopic cholecystectomy using two different anesthesia procedures (spinal anesthesia versus general anesthesia). ⋯ Laparoscopic cholecystectomy with low pressure pneumoperitoneum with CO(2) can be safely performed under spinal anesthesia. Spinal anesthesia was associated with an extremely low level of postoperative pain, better recovery and lower cost than general anesthesia.
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Review
[Cardiac biomarkers in perioperative medicine : significance for noncardiac surgery patients].
Perioperative detection of cardiac biomarkers may help to identify patients at risk. Whether detection of these markers will be recommended in the preoperative setting for patients with cardiac diseases in the future has to be discussed as large prospective trials on this topic are missing. ⋯ In unstable patients coronary angiography and/or percutaneous coronary intervention (PCI) are indicated. However, in stable patients the decision for coronary angiography and/or PCI has to be made in each patient individually after interdisciplinary discussion between anesthesiologists, cardiologists and surgeons.
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This case history deals with an 85-year-old patient who underwent surgery to treat rhinoliquorrhea. The patient aspirated a lutescent fluid shortly after anesthesia was administered. ⋯ The CSF had been stained with fluorescein prior to surgery in order to help localize the CSF fistula. This case of top down aspiration is discussed and preventive measures which can be employed in order to avoid similar complications in patients with rhinoliquorrhea are presented.