Search results for " anaesthesia"

Management of incomplete regional anaesthesia in Germany: results of a nation-wide survey.

2007

Background:  Regional anaesthesia (RA) provides well-defined benefits with known attendant risks. However, incomplete blockade may introduce unanticipated risks depending on the compensatory measures employed. Until now, no data were available characterizing the pattern of response of German anaesthesiologists in this situation. This study analyses interventions in response to incomplete RA in a nation-wide setting. Methods:  A questionnaire was sent to every German anaesthesia department (n= 1381). Questions focused on interventions coping with an incomplete RA and differentiated between a pre- and a peri-surgical setting and measures to face pain outside the surgical field. If systemic su…

WHO needs high FIO2?

2017

World Health Organization and the United States Center for Disease Control have recently recommended the use of 0.8 FIO2 in all adult surgical patients undergoing general anaesthesia, to prevent surgical site infections. This recommendation has arisen several discussions: As a matter of fact, there are numerous studies with different results about the effect of FIO2 on surgical site infection. Moreover, the clinical effects of FIO2 are not limited to infection control. We asked some prominent authors about their comments regarding the recent recommendations.

2017

IntroductionThe direct laryngoscopy technique using a Macintosh blade is the first choice globally for most anaesthetists. In case of an unanticipated difficult airway, the complication rate increases with the number of intubation attempts. Recently, McGrath MAC (McGrath) video laryngoscopy has become a widely accepted method for securing an airway by tracheal intubation because it allows the visualisation of the glottis without a direct line of sight. Several studies and case reports have highlighted the benefit of the video laryngoscope in the visualisation of the glottis and found it to be superior in difficult intubation situations. The aim of this study was to compare the first-pass in…

Intraoperative wound instillation of ropivacaine extraperitoneally subfascially fails to provide analgesia after remifentanil–isoflurane for abdomina…

2005

Summary Background Intraoperative local anaesthetic wound instillation has been shown previously to provide analgesia after abdominal surgery. This pain relief may be important, if remifentanil is used for general anaesthesia, because the rapid offset of action may mean that there is not enough analgesia at the end of surgery and in the recovery period. The aim of this randomized, placebo-controlled, double-blind study was to evaluate the analgesic efficacy of preventative wound instillation of ropivacaine after abdominal hysterectomy (AH). We hypothesized that this approach will significantly reduce postoperative morphine consumption. Patients and methods After ethics approval, 40 patients…

Efficacy and Safety of Using High-Flow Nasal Oxygenation in Patients Undergoing Rapid Sequence Intubation

2017

Objective To assess the efficacy and safety of high-flow nasal oxygen (HFNO) therapy in patients undergoing rapid sequence intubation (RSI) for emergency abdominal surgery. Methods HFNO of 60 L.min-1 at an inspiratory oxygen fraction of 1 was delivered 4 min before laryngoscopy and maintained until the patient was intubated, and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. Transcutaneous oxygenation (SpO2), heart rate and non-invasive mean arterial pressure were monitored at baseline (T0), after 4 min on HFNO (T1) and at the time of laryngoscopy (T2) and endotracheal intubation (ETI) (T3). An SpO2 of <3% from baseline was recorded at any sampled t…

Angiographien im Kleinkindes- und Kindesalter

1993

Between 1973 and 1991 we performed 160 percutaneous angiograms (130 arteriograms, 30 phlebograms) in children and infants; 12 patients were less than one year and 52 less than ten years old. 44 of the examinations were done by a DSA technique. The examinations were carried out under general anaesthesia except in 8 cases. In 50.7% an arteriogram was carried out for the investigation of a suspected or known tumour, in 9.3% an arteriogram was required following trauma. The most common phlebographic examination was for the demonstration of the spermatic vein; in 27 patients this was done for cryptorchidism or a varicocele. The only complication following a diagnostic angiogram was perforation o…

Pure oxygen ventilation during general anaesthesia does not result in increased postoperative respiratory morbidity but decreases surgical site infec…

2014

Background. Pure oxygen ventilation during anaesthesia is debatable, as it may lead to development of atelectasis. Rationale of the study was to demonstrate the harmlessness of ventilation with pure oxygen. Methods. This is a single-centre, one-department observational trial. Prospectively collected routine-data of 76,784 patients undergoing general, gynaecological, orthopaedic, and vascular surgery during 1995–2009 were retrospectively analysed. Postoperative hypoxia, unplanned ICU-admission, surgical site infection (SSI), postoperative nausea and vomiting (PONV), and hospital mortality were continuously recorded. During 1996 the anaesthetic ventilation for all patients was changed from 30…

Current practice in regional anaesthesia in Germany

2005

Several new techniques and agents (e.g. ropivacaine) have been introduced in regional anaesthesia to improve patients outcome and safety. The beneficial effects on patient outcome are clear with these techniques, however, no information is available about their pattern and frequency of use in clinical practice. This study presents data concerning the current practice of regional anaesthesia in Germany.A questionnaire was sent to every German anaesthesia department (n = 1381). Questions focused on the frequency and range of regional anaesthetic procedures employed, with attention also to the organizational structural of the individual institution.Six hundred and sixty-seven questionnaires we…

Fast-Track Surgery and Early Rehabilitation for Total Hip Replacement in Hospital of Traumatology and Orthopaedics

2019

Abstract Due to an ageing population, the necessity for hip replacement has grown, and therefore, new options are being sought, such as the Fast-track principle, to improve patient condition, reduce their hospital stay and enhance the hospital’s ability to treat more patients. The aim of this study was to investigate the effects of same-day patient mobilisation on pain, side effects, complications, duration of hospital stay, and recovery after primary hip replacement, using intermediate-acting local anaesthetics in spinal anaesthesia (SA). A prospective, randomised study was conducted at the Hospital of Traumatology and Orthopaedics. Forty-six patients undergoing total hip replacement were …

Is MRI imaging in pediatric age totally safe? A critical reprisal.

2017

Current radiological literature is strongly focussed on radiation imaging risks. Indeed, given there is a small but actual augment in cancer risk from exposure to ionizing radiation in children, it is important to understand what the risk of alternative techniques could be. We retrospectively review literature data concerning possible MR imaging risks, focussing on the biological effects of MR, sedation and gadolinium compound risks when dealing with infant patients. The main concerns can be summarized in: (1) Biological effects of non-ionizing electromagnetic fields (EMF) employed—whose mechanisms of interaction with human tissues are polarization, induced current, and thermal heating, res…