Anaesthesiologie und Reanimation
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Anaesthesiol Reanim · Jan 2003
Review[Smoking and preoperative fasting--are there evidence-based guidelines?].
Over the last years several clinical studies have modified the guidelines for preoperative fasting to reduce the risk of pulmonary aspiration. In most western countries the following guidelines are accepted: for clear liquids 2 hours, breast feeding 4 hours, small meals and breast milk substitutes 6 hours, heavy meals 8 hours. Since preoperative smoking is acknowledged as a risk factor, it should be ceased in most clinics 6 hours before induction of anaesthesia, as well. ⋯ To reduce the risk of perioperative pulmonary complications, cessation of smoking is necessary 8 weeks before operation. Stopping smoking only a few days before operation and anaesthesia even tends to increase the risk of pulmonary complications. Regarding cardiac complications, cessation of smoking 12 hours before anaesthesia is sufficient to reduce the incidence of cardiac ischaemia.
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Anaesthesiol Reanim · Jan 2003
Review[Management of pediatric airway--anatomy, physiology and new developments in clinical practice].
Due to the special features of paediatric anatomy and physiology, the expected and unexpected difficult paediatric airway is one of the major challenges to every anaesthesiologist, paediatrician and emergency physician. During the last years, some new devices have been made available to improve airway management in children and infants, and several studies have advanced our understanding of the risks and benefits of our clinical practice. ⋯ Recent studies have also demonstrated specific problems with the LMA in infants, as well as possible advantages of a new prototype LMA for children, similar to the ProSeal. Furthermore, the following review presents data about the use of the Cuffed Oropharyngeal Airway (COPA) and the Laryngeal Tube (LT) in paediatric patients.
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A tracheal tear requires fast and proper treatment. A 55-year-old man working in a sewage pipe slipped and hit his neck on the edge of a concrete ring. The patient showed the following symptoms: cervical bruising, neck emphysema and increasing dyspnea. ⋯ Due to an injury to both laryngeal nerves, the patient suffered from dysphagea, whispered speech and dyspnea on minimal exertion as long-term side-effects. A lateralization of the vocal cord was made eight months later. Because of the quick assessment of the situation and proper treatment of the patient at the site of the accident, the patient was able to survive the injury.
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Anaesthesiol Reanim · Jan 2003
Case Reports[Time costs cardiac muscle tissue--prehospital therapy of acute myocardial infarct--a case report].
Symptoms of an acute myocardial infarction are a common reason for calling the emergency physician. Pre-hospital mortality caused by cardiac infarction is constantly high. The main potential for decreasing infarction mortality lies in the pre-hospital period. ⋯ A particular focus is the management of pre-hospital thrombolysis, the preconditions, realization and risks of which are described. In this context, the experience and competence of the emergency physician is prerequisite for the exact diagnosis and therapy. Furthermore, the importance of a smooth transition from pre-hospital therapy to intensive care is emphasized.
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Anaesthesiol Reanim · Jan 2003
Historical Article[Relations of German anesthesiology to east European societies of anesthesiology].
On the occasion of the 50th anniversary of the foundation of the "German Society of Anaesthesiology" (DGA)--later called "German Society of Anaesthesiology and Intensive Care Medicine" (DGAI)--which was founded on 10 April 1953, and in memory of the foundation of the "Section of Anaesthesiology", which was founded in East-Berlin ten years later on 25 October 1963 and later called "Society of Anaesthesiology and Intensive Therapy of the GDR" (GAIT), the development of relations between German anaesthetists and anaesthesiological societies in East Europe are described. The limited economic base of the medical-technical and pharmaceutical industries, a chronic lack of hard currencies and economic and political restrictions on travel activities by East German and East European anaesthetists to West European countries resulted in improved contacts between East German and East European anaesthesiological societies. This, in turn, led to the holding of "International Anaesthesiological Congresses" of the so-called socialist countries and "Bilateral Symposia of the Anaesthesiological Societies of Czechoslovakia and the GDR" and also bilateral meetings of nurses of anaesthesiology and intensive therapy from both countries. ⋯ The German members of this association, in particular its Secretary-General, Prof. Dr. Reinhard Purschke/Dortmund, organize postgraduate courses including theoretical lectures and practical work not only in Russia but also in Armenia and Usbekistan.