[Restructuring of inpatient emergency treatment : What will change?]
Abstract The resolution on the restructuring of inpatient emergency treatment was passed by the Federal Joint Committee (G-BA) on 19 April 2018 based on the Hospital Structure Act and became binding with the publication in the Bundesanzeiger on 18 May 2018. The resolution describes the future structural and qualitative prerequisites for participation of hospitals in the provision of emergency treatment in three levels: basic emergency treatment, extended emergency treatment and comprehensive emergency treatment. Furthermore, a level of nonparticipation is also planned. In addition, there are special modules, e.g. ...
Source: Der Anaesthesist - April 24, 2019 Category: Anesthesiology Authors: Brokmann JC, Pin M, Bernhard M, Walcher F, Gries A Tags: Anaesthesist Source Type: research

Comparison of lateral and supine positions for tracheal extubation in children : A  randomized clinical trial.
CONCLUSION: In pediatric patients deep extubation in the lateral position improved SpO2 and reduced the incidence of stridor and laryngospasm in the early emergence period when compared to extubation in the supine position. PMID: 30993350 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 15, 2019 Category: Anesthesiology Authors: Jung H, Kim HJ, Lee YC, Kim HJ Tags: Anaesthesist Source Type: research

[Erratum to: Simulation training as part of clinical riskmanagement : A  health economic view].
[Erratum to: Simulation training as part of clinical riskmanagement : A health economic view]. Anaesthesist. 2019 Apr 12;: Authors: Speer T, Mühlbradt T, Fastner C, Schöffski O, Schröder S PMID: 30980182 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 11, 2019 Category: Anesthesiology Authors: Speer T, Mühlbradt T, Fastner C, Schöffski O, Schröder S Tags: Anaesthesist Source Type: research

[Erratum to: Certain and controversial components of "rapid sequence induction"].
[Erratum to: Certain and controversial components of "rapid sequence induction"]. Anaesthesist. 2019 Apr 12;: Authors: Mencke T, Zitzmann A, Reuter DA PMID: 30980183 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 11, 2019 Category: Anesthesiology Authors: Mencke T, Zitzmann A, Reuter DA Tags: Anaesthesist Source Type: research

[Erratum to: Catheterization of the subclavian vein and the risk of pneumothorax : Mechanical ventilation increases the risk of pneumothorax during infraclavicular subclavian vein catheterization: a  prospective randomized trial].
[Erratum to: Catheterization of the subclavian vein and the risk of pneumothorax : Mechanical ventilation increases the risk of pneumothorax during infraclavicular subclavian vein catheterization: a prospective randomized trial]. Anaesthesist. 2019 Apr 12;: Authors: Palmaers T, Frank P, Eismann H, Sieg L, Leffler A, Schmitt H, Scholler A PMID: 30980184 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 11, 2019 Category: Anesthesiology Authors: Palmaers T, Frank P, Eismann H, Sieg L, Leffler A, Schmitt H, Scholler A Tags: Anaesthesist Source Type: research

[Analysis of the personnel development in anesthesiology over the last two decades with special attention to gender aspects].
JC Abstract Skills shortage of nursing staff and physicians is a "hot topic" in health politics. For the future recruitment of medical staff in anesthesiology, an analysis of the staff development during the last decades considering gender aspects seems to be important. Therefore, the authors conducted a comparative analysis of data from the "Statistisches Bundesamt" (Fachserie 12 Reihe 7.3.1 and Fachserie 12 Reihe 6.1.1.) from 1994 until 2015. The analysis compared the development of anesthesiological staff (physicians) with the overall development of medical staff (physicians)...
Source: Der Anaesthesist - April 11, 2019 Category: Anesthesiology Authors: van den Bussche H, Scherer M, Zöllner C, Kubitz JC Tags: Anaesthesist Source Type: research

[Renal replacement therapy in acute kidney injury : From the indications to cessation].
CONCLUSION: Risk identification and prevention of AKI are essential. In the absence of absolute indications, initiation and accomplishment of RRT should be patient-adapted and carried out in the clinical context. Newly developed biomarkers could be helpful in the future for a better estimation of the prognosis and for a more precise definition of therapeutic strategies of RRT. PMID: 30980186 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 11, 2019 Category: Anesthesiology Authors: Küllmar M, Zarbock A Tags: Anaesthesist Source Type: research

[Deployment of the in-hospital emergency team in a  tertiary care university hospital : Data analysis for the time period 2013-2016 in North-Rhine/Westphalia].
CONCLUSION: Analysis of data revealed that the number of MET calls, total operating time and average deployment time increased from 2013 to 2016. The primary reason for MET activations was collapse or syncope and every 17th deployment was for cardiopulmonary resuscitation. The incidence of in-hospital cardiac arrests decreased during the study period. PMID: 30969357 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 9, 2019 Category: Anesthesiology Authors: Schmitz J, Kerkhoff S, Sander D, Schulz G, Warnecke T, Hinkelbein J Tags: Anaesthesist Source Type: research

[Publications by university Departments of Anaesthesiology from Germany, Austria and Switzerland in 2011-2015 : Scientific publications by university hospitals in D ‑A-CH].
CONCLUSION: Strategies to foster academic work in anaesthesiology in Germany, Austria and Switzerland are required. PMID: 30941445 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2019 Category: Anesthesiology Authors: Miller C, Ausserer J, Putzer G, Hamm P, Herff H, Wenzel V, Paal P Tags: Anaesthesist Source Type: research

Cardiopulmonary resuscitation: when guidelines provide no answers.
This article reports on a 71-year-old man who suffered an OHCA. Persisting gasping and recurrent ventricular fibrillation made the prehospital management difficult and imposed challenges on the whole team. The guidelines provided no answers to this specific situation. Wittingly, the emergency physician decided to abandon the standard approach. Based on this case, this article discusses the pathophysiological considerations and an approach deviating from the standard approach, which could have led to a positive patient outcome without casting doubt on the current resuscitation guidelines. PMID: 30937467 [PubM...
Source: Der Anaesthesist - March 31, 2019 Category: Anesthesiology Authors: Ventzke MM, Kemming GI Tags: Anaesthesist Source Type: research

[2018 update ESC/ESH guidelines on management of arterial hypertension : What is important for anesthesiologists?]
This article highlights the most important innovations in the ESC/ESH guidelines 2018 on management of arterial hypertension. PMID: 30937468 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 31, 2019 Category: Anesthesiology Authors: Löser B, Öner A Tags: Anaesthesist Source Type: research

[Surviving Sepsis Campaign update 2018: the 1  h bundle : Background to the new recommendations].
This article presents the background and discusses criticisms of the new recommendations. PMID: 30918985 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 26, 2019 Category: Anesthesiology Authors: Briegel J, Möhnle P Tags: Anaesthesist Source Type: research

[Antihypotensive drugs in cesarean sections : Treatment of arterial hypotension with ephedrine, phenylephrine and Akrinor ® (cafedrine/theodrenaline) during cesarean sections with spinal anesthesia].
CONCLUSION: The differences of the individual vasoactive substances seemed to be much smaller than one would expect based on the results of randomized clinical trials. The incidence and extent of bradycardia and neonatal acidosis were much lower than previously reported. The determined differences seemed to have no major clinical relevance. Although the A group required less bolus administrations and seemed to be the most potent substance, the results imply that the assessment of the effects of vasoactive substances should not be carried out without consideration of the accompanying measures. PMID: 30918986 [PubMed - ...
Source: Der Anaesthesist - March 26, 2019 Category: Anesthesiology Authors: Chappell D, Helf A, Gayer J, Eberhart L, Kranke P Tags: Anaesthesist Source Type: research

[Non-cardiac surgery in adults with congenital heart defects : Most important parameters in anesthesia management].
CONCLUSION: Decisive for the perioperative outcome of patients with CHD are the identification of high-risk patients, understanding of the individual situation with respect to the underlying pathophysiology and the intraoperative maintenance of cardiac output. PMID: 30911773 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 24, 2019 Category: Anesthesiology Authors: Massoth C, Zarbock A, Wenk M Tags: Anaesthesist Source Type: research

[Degree of implementation of structured answering of emergency calls in German emergency dispatch centers and effects of the introduction in daily practice].
CONCLUSION: Structured emergency call-taking has not yet been comprehensively implemented in German emergency dispatch centers. Wherever it is used consistently, important quality parameters are improved. Further investigations should aim to identify crucial factors for its implementation and to analyze additional quality parameters. PMID: 30899970 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 20, 2019 Category: Anesthesiology Authors: Luiz T, Marung H, Pollach G, Hackstein A Tags: Anaesthesist Source Type: research

[ESC guidelines 2018 on myocardial revascularization : What must anesthesiologists know?]
This article summarizes the most important changes of the ESC/EACTS guidelines on myocardial revascularization. PMID: 30899971 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 20, 2019 Category: Anesthesiology Authors: Löser B, Öner A Tags: Anaesthesist Source Type: research

[Catheterization of the subclavian vein and the risk of pneumothorax : Mechanical ventilation increases the risk of pneumothorax during infraclavicular landmark-guided subclavian vein puncture: a  prospective randomized study].
CONCLUSION: In this study landmark-guided infraclavicular SCV catheterization was associated with a significantly higher rate of pneumothorax when venipuncture was performed during mechanical ventilation and not in apnea. If a short phase of apnea is justifiable in the patient, mechanical ventilation should be discontinued during the venipuncture procedure. PMID: 30899972 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 20, 2019 Category: Anesthesiology Authors: Palmaers T, Frank P, Eismann H, Lion S, Leffler A, Schmitt H, Scholler A Tags: Anaesthesist Source Type: research

[Does hospital volume correlate with surgical process time? : Retrospective analysis of the five most common procedures for visceral surgery, trauma and orthopedic surgery and gynecology/obstetrics from the benchmarking program of the Berufsverband Deutscher An ästhesisten (BDA), Berufsverband Deutscher Chirurgen (BDC) and Verband für OP-Management (VOPM)].
CONCLUSION: The case volume only appeared to have a direct but limited influence on incision to suture times in laparoscopic and arthroscopic procedures. Overall, the hospital performance volume appeared to be of subordinate importance in terms of OR-economics. PMID: 30895350 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 19, 2019 Category: Anesthesiology Authors: Karaca O, Bauer M, Taube C, Auhuber T, Schuster M Tags: Anaesthesist Source Type: research

[Preclinical emergency anesthesia : A  current state analysis from 2015-2017].
CONCLUSION: The study of the current state of preclinical emergency anesthesia in Germany showed a deficient implementation of the pharmacological recommendations for action except for trauma patients. Reasons for divergence could arise due to different availability of rescue equipment, training concepts or discipline of emergency physicians. Suitable education and training could improve the quality of prehospital anesthesia in Germany. PMID: 30887074 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 17, 2019 Category: Anesthesiology Authors: Luckscheiter A, Lohs T, Fischer M, Zink W Tags: Anaesthesist Source Type: research

[Perioperative acute kidney injury].
CONCLUSION: For timely diagnosis and prevention of AKI the recommendations for action of the KDIGO guidelines should be implemented. High-risk patients should be detected early in the perioperative period in order to be able to initiate preemptive strategies in a timely manner. PMID: 30834951 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 4, 2019 Category: Anesthesiology Authors: Küllmar M, Meersch M Tags: Anaesthesist Source Type: research

[Neurobiology of opioid dependence].
Abstract Opioid dependence is a chronic mental disease with multifactorial etiology. The neurobiological theory of addiction focuses on the manipulation of the dopaminergic reward system as a basic property of substances with addictive potential including opioids. With regular opioid intake, the manipulation of the reward system results in a cognitive bias towards drug-related stimuli. In addition, opioids inhibit the locus caeruleus, resulting in symptoms of sympathetic rebound during opioid detoxification. The pharmacokinetics of opioids also influence the risk of addiction. These biological facto...
Source: Der Anaesthesist - February 28, 2019 Category: Anesthesiology Authors: Scherbaum N, Bonnet U Tags: Anaesthesist Source Type: research

[CPR after traumatic event: Don`t get under pressure!]
Abstract PMID: 30840109 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 28, 2019 Category: Anesthesiology Authors: Kulla M Tags: Anaesthesist Source Type: research

[Declaration of financial and non-financial interests in CME courses of Springer Medizin : Implementation of the regulation on the "Code on Continuing Medical Education" of the Medical Chamber North Rhine].
[Declaration of financial and non-financial interests in CME courses of Springer Medizin : Implementation of the regulation on the "Code on Continuing Medical Education" of the Medical Chamber North Rhine]. Anaesthesist. 2019 Mar;68(3):177-178 Authors: Herrmann P, Griebenow R Abstract PMID: 30840110 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 28, 2019 Category: Anesthesiology Authors: Herrmann P, Griebenow R Tags: Anaesthesist Source Type: research

Ventilator autotriggering : An underestimated phenomenon in the determination of brain death.
CONCLUSION: The phenomenon of VAT is inconsistently addressed in the national guidelines and recommendations for the determination of brain death and should, therefore, be included in future harmonized brain death codes. Detection and correction of VAT should be implemented as early as possible by a structured procedure. Additional training and information on this phenomenon should be made available to the entire intensive care unit staff. PMID: 30810759 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 27, 2019 Category: Anesthesiology Authors: Schwarz G, Errath M, Arguelles Delgado P, Schöpfer A, Cavic T Tags: Anaesthesist Source Type: research

[Treatment of carbon monoxide poisoning in Germany : A retrospective single center analysis].
CONCLUSION: Commonly known sources (fire, charcoal grills) aside, many poisonings by smoking a hookah were observed. This study highlights the importance of considering CO poisoning as a differential diagnosis when encountering patients, especially of younger age, with non-specific neurological symptoms, as well as the importance of early initiation of treatment. A direct correlation between CO-Hb values (whether measured noninvasively or by invasive BGA) and the initial symptoms could not be demonstrated. In total, substantial time expired between the diagnosis and start of treatment of patients transported to a...
Source: Der Anaesthesist - February 21, 2019 Category: Anesthesiology Authors: Eichhorn L, Kieback M, Michaelis D, Kemmerer M, Jüttner B, Tetzlaff K Tags: Anaesthesist Source Type: research

[Current treatment concepts for trauma-related cardiac arrest : Focal points, differences and similarities].
t J Abstract Trauma-related deaths are not only a relevant medical problem but also a socioeconomic one. The care of a polytraumatized patient is one of the less commonly occurring missions in the rescue and emergency medical services. The aim of this article is to compare the similarities and differences between different course concepts and guidelines in the treatment of trauma-related cardiac arrests (TCA) and to filter out the main focus of each concept. Because of the various approaches in the treatment of polytraumatized patients, there are decisive differences between trauma-related cardiac a...
Source: Der Anaesthesist - February 18, 2019 Category: Anesthesiology Authors: Jakisch B, Gräsner JT, Seewald S, Renzing N, Wnent J Tags: Anaesthesist Source Type: research

[Simulation training as part of clinical risk management : A  health economic view].
This article shows possible health economic considerations in the discussion about financing CRM-based simulation training. Cost-benefit and cost-effectiveness analyses are difficult to perform. They require an individual planning. Regardless of this, simulation training enables participants to experience (simulation) and reflect their own actions in critical situations (debriefing). With the help of specially trained CRM instructors, deviations from expected behavior can be detected. This non-conformity can be used as a starting point for the establishment and further development of patient safety by a structura...
Source: Der Anaesthesist - February 7, 2019 Category: Anesthesiology Authors: Speer T, Mühlbradt T, Fastner C, Schöffski O, Schröder S Tags: Anaesthesist Source Type: research

[Surgical treatment of proximal femoral fractures in high-risk geriatric patients under peripheral regional anesthesia : A  clinical case series].
[Surgical treatment of proximal femoral fractures in high-risk geriatric patients under peripheral regional anesthesia : A clinical case series]. Anaesthesist. 2019 Feb 05;: Authors: Seidel R, Barbakow E Abstract The authors describe in a clinical case series (n = 7) of older (age 78-95 years) high-risk patients the successful surgical treatment of proximal femoral fractures in a peripheral regional anesthesia technique. After positioning on the non-fractured side, a double injection technique (dual guidance concept: sonography plus nerve stimulation) was chosen. The ...
Source: Der Anaesthesist - February 5, 2019 Category: Anesthesiology Authors: Seidel R, Barbakow E Tags: Anaesthesist Source Type: research

[Complex regional pain syndrome (CRPS) : An update].
Abstract The acute phase of complex regional pain syndrome (CRPS) is pathophysiologically characterized by an activation of the immune system and its associated inflammatory response. During the course of CRPS, central nervous symptoms like mechanical hyperalgesia, loss of sensation, and body perception disorders develop. Psychological factors such as pain-related anxiety and traumatic events might have a negative effect on the treatment outcome. While the visible inflammatory symptoms improve, the pain often persists. A stage adapted, targeted treatment could improve the prognosis. Effective multidiscip...
Source: Der Anaesthesist - February 4, 2019 Category: Anesthesiology Authors: Dimova V, Birklein F Tags: Anaesthesist Source Type: research

[Cell salvage : Scientific evidence, clinical practice and legal framework].
Abstract Cell salvage is an efficient method to reduce the transfusion of homologous banked blood, as documented by several meta-analyses detected in a systematic literature search. Cell salvage is widely used in orthopedics, trauma surgery, cardiovascular and abdominal transplantation surgery. The retransfusion of unwashed shed blood from wounds or drainage is not permitted according to German regulations. Following irradiation of wound blood, salvaged blood can also be used in tumor surgery. Cell salvage makes a valuable contribution to providing sufficient compatible blood for transfusions in cases of mass...
Source: Der Anaesthesist - January 29, 2019 Category: Anesthesiology Authors: Seyfried T, Hansen E Tags: Anaesthesist Source Type: research

[Life-threatening subcutaneous emphysema after minor blow to the neck].
x C Abstract After a minor blow to the neck from the handlebars of a bike, a 5-year-old boy developed a massive subcutaneous emphysema with respiratory distress. Orotracheal intubation was performed. A computed tomography (CT) scan of the neck and thorax showed a pneumomediastinum and a bilateral pneumothorax. No injury to the large airways was identified. The patient was stabilized by insertion of chest tubes and controlled ventilation. The endoscopic examination of the trachea revealed a tear of the pars membranacea, which was successfully treated conservatively. The specific features of...
Source: Der Anaesthesist - January 25, 2019 Category: Anesthesiology Authors: Neuhäuser C, Kroll T, Wolf G, Uhlich H, Tomczyk L, Schwarzer M, Rohde M, Spors H, Naehrlich L, Mazhari N, Litzlbauer D, Jux C Tags: Anaesthesist Source Type: research

[Perioperative use of metamizole and other nonopioid analgesics in children : Results of a survey].
CONCLUSION: The survey confirmed that metamizole is frequently used in children in the perioperative setting. Intravenous metamizole is the preferred nonopioid analgesic administered intraoperatively for pain prophylaxis. Clinical symptoms of agranulocytosis should be monitored and patients should be better informed about metamizole-related side effects. PMID: 30680415 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 24, 2019 Category: Anesthesiology Authors: Witschi L, Reist L, Stammschulte T, Erlenwein J, Becke K, Stamer U Tags: Anaesthesist Source Type: research

How to manage terminal dehydration.
In conclusion, if CAH is applied as a part of ELC the hydration status needs to be individually appraised and all therapeutic measures constantly need to be adapted to the findings of diligent monitoring procedures. PMID: 30666341 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 21, 2019 Category: Anesthesiology Authors: Suchner U, Reudelsterz C, Gog C Tags: Anaesthesist Source Type: research

[Resuscitation room management for trauma patients].
This article describes the core tasks of the resuscitation room team as well as concepts and strategies of initial treatment of severely injured and polytrauma patients. PMID: 30649571 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 16, 2019 Category: Anesthesiology Authors: Thelen S, Michael M, Ashmawy H, Knoefel WT, Picker O, Windolf J, Bernhard M Tags: Anaesthesist Source Type: research

[Pain inhibition by opioids-new concepts].
CONCLUSION: The epidemic of opioid misuse has shown that there is a lack of fundamental knowledge about the characteristics and management of chronic pain, that conflicts of interest and validity of models must be more intensively considered in the context of drug development and that novel analgesics with less addictive potential are urgently needed. Currently, the most promising perspectives appear to be augmenting endogenous opioid actions and the selective activation of peripheral opioid receptors. PMID: 30645691 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 15, 2019 Category: Anesthesiology Authors: Stein C Tags: Anaesthesist Source Type: research

[Background and current use of adjuvants for regional anesthesia : From research to evidence-based patient treatment].
This article focuses on the historic background and the current state of the use of these adjuvants for regional anaesthesia. Adding epinephrine, clonidine or dexmedetomidine, but only as a single dose, results in a faster onset, longer duration of action and increased intensity of neuronal blockade of regional anaesthesia. The benefits of adding sodium bicarbonate, on the other hand, are relatively minor and, therefore, clinically negligible. Although increasing evidence in the literature suggests an improvement and prolongation of the analgesic effect after axonal administration of opioids, which can also be gi...
Source: Der Anaesthesist - January 15, 2019 Category: Anesthesiology Authors: Schäfer M, Mousa SA, Shaqura M, Tafelski S Tags: Anaesthesist Source Type: research

[Rapid sequence induction and intubation-the timing principle].
Abstract PMID: 30645693 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 15, 2019 Category: Anesthesiology Authors: Andel H, Markstaller K Tags: Anaesthesist Source Type: research

Radiographic evaluation as a  diagnostic tool in visualizing gastric fluid.
Radiographic evaluation as a diagnostic tool in visualizing gastric fluid. Anaesthesist. 2019 Jan 15;: Authors: Loop T, Kotter E, Hinkelbein J Abstract PMID: 30645694 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 15, 2019 Category: Anesthesiology Authors: Loop T, Kotter E, Hinkelbein J Tags: Anaesthesist Source Type: research

[Consideration of the timing principle for rapid sequence induction is unnecessary].
Abstract PMID: 30627736 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 9, 2019 Category: Anesthesiology Authors: Loop T, Hinkelbein J Tags: Anaesthesist Source Type: research

Efficacy of midazolam addition to local anesthetic in peribulbar block : Randomized controlled trial.
This study included 90 adult patients aged 40-70 years undergoing cataract surgery. Each patient was appointed to one of three groups. Group C received a single injection of a peribulbar block using a combination of lidocaine 2% and hyaluronidase 15 IU/ml, group M1 received a combination of lidocaine 2%, hyaluronidase 15 IU/ml plus midazolam 50 µg/ml and group M2 received lidocaine 2%, hyaluronidase 15 IU/ml plus midazolam 100 µg/ml. RESULTS: The quality of the peribulbar block showed significant improvement among groups by one-way ANOVA (p = 0.002). The mea...
Source: Der Anaesthesist - January 9, 2019 Category: Anesthesiology Authors: Ibrahim M, Gomaa E Tags: Anaesthesist Source Type: research

Comparison of cervical spine motion during intubation with a C ‑MAC D‑Blade® and an LMA Fastrach®.
CONCLUSION: Intubation with both a C‑MAC D‑Blade and a Fastrach LMA resulted in cervical motion but within safe ranges. Intubation with a C-mac D blade might be preferred because the Fastrach LMA may result in more failed intubation attempts in patients with cervical spine disorders. PMID: 30627738 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 9, 2019 Category: Anesthesiology Authors: Özkan D, Altınsoy S, Sayın M, Dolgun H, Ergil J, Dönmez A Tags: Anaesthesist Source Type: research

Recent preoperative imaging reveals aspiration risks.
Abstract PMID: 30617404 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 7, 2019 Category: Anesthesiology Authors: Renschler JS, Kaye AD, Riopelle JM, Diaz JH, Moran TC Tags: Anaesthesist Source Type: research

[Sonographic diagnostics in operative intensive care medicine : Pericardial hematoma after cardiac surgery].
CA Abstract These two case reports describe the use of transthoracic echocardiography in cardiac surgery patients during postoperative intensive care, when a pericardial hematoma developed. A focused echocardiographic examination was performed, which in both cases led to the correct diagnosis and revealed the cause for hemodynamic instability. Following additional computed tomography (CT) scans, cardiac surgery was performed on one patient, while in the other, bedside sonography was used for controlled pleural puncture and drainage of the pericardial hematoma. The case reports demonstrate that intrathoracic ...
Source: Der Anaesthesist - December 20, 2018 Category: Anesthesiology Authors: Heinen R, Schmitt C, Schwuchow J, Dörge H, Greim CA Tags: Anaesthesist Source Type: research

[Comparison of sublingual and intravenous administration of lorazepam in psychiatric emergencies in emergency medical services].
CONCLUSION: Sublingual administration of lorazepam is effective for treating acute agitation in emergency medical services. PMID: 30523365 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 6, 2018 Category: Anesthesiology Authors: Schwerthöffer D, Pajonk FG Tags: Anaesthesist Source Type: research

[Training in clinical acute and emergency medicine  - Supraspeciality in Germany : A concept for nationwide implementation!]
This article describes the history and development of ZWB clinical acute and emergency medicine in Germany and outlines future perspectives. PMID: 30511109 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 3, 2018 Category: Anesthesiology Authors: Gries A, Seekamp A, Wrede C, Dodt C Tags: Anaesthesist Source Type: research

[S2k guidelines of the PEG on calculated parenteral initial treatment of bacterial diseases in adults : Focussed summary and supplementary information on antibiotic treatment of critically ill patients].
abein B Abstract In January 2018 the recent revision of the S2k guidelines on calculated parenteral initial treatment of bacterial diseases in adults-update 2018 (Editor: Paul Ehrlich Society for Chemotherapy, PEG) was realized. It is a helpful tool for the complex infectious disease setting in an intensive care unit. The present summary of the guidelines focuses on the topics of anti-infective agents, including new substances, pharmacokinetics and pharmacodynamics as well as on microbiology, resistance development and recommendations for calculated drug therapy in septic patients. As in past revisions the re...
Source: Der Anaesthesist - December 3, 2018 Category: Anesthesiology Authors: Brinkmann A, Röhr AC, Frey OR, Krüger WA, Brenner T, Richter DC, Bodmann KF, Kresken M, Grabein B Tags: Anaesthesist Source Type: research

[Erratum to: Performance of prehospital emergency anesthesia and airway management].
Abstract PMID: 30488145 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 28, 2018 Category: Anesthesiology Authors: Warnecke T, Dobbermann M, Becker TK, Bernhard M, Hinkelbein J Tags: Anaesthesist Source Type: research

[Erratum to: Delirium in intensive care patients. A  multiprofessional challenge].
[Erratum to: Delirium in intensive care patients. A multiprofessional challenge]. Anaesthesist. 2018 Nov 28;: Authors: Zoremba N, Coburn M, Schalte G Abstract PMID: 30488146 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 28, 2018 Category: Anesthesiology Authors: Zoremba N, Coburn M, Schalte G Tags: Anaesthesist Source Type: research

[Erratum to: Management of the difficult airway : Overview of the current guidelines].
r T Abstract PMID: 30470913 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 23, 2018 Category: Anesthesiology Authors: Schäuble JC, Heidegger T Tags: Anaesthesist Source Type: research

[Transfer of a cockpit strategy to anesthesiology : Clinical example: introduction of canned decisions to solve cannot intubate cannot oxygenate situations].
The objective is to reduce anesthesia-related mortality caused by the unexpected difficult airway through early detection and solution of cannot intubate cannot oxygenate (CICO) situations. METHODS: After approval by the responsible ethics committee, a prospective pilot study was conducted to analyze the process quality of uncomplicated induction of anesthesia on a simulator using audiovisual recording. An evaluation list with 44 items was created, which met the following requirements: items were dichotomous, accessible to an audiovisual evaluation and according to current scientific consensus should be...
Source: Der Anaesthesist - November 16, 2018 Category: Anesthesiology Authors: Vogelsang H, Botteck NM, Herzog-Niescery J, Kirov J, Litschko D, Weber TP, Gude P Tags: Anaesthesist Source Type: research