Publications by authors named "U Schwemmer"

61 Publications

[Internal medical emergencies in the pregnant patient : Peripartum sepsis, metabolic derailment, endocrinological emergencies and pulmonary edema].

Anaesthesist 2021 Jun 18. Epub 2021 Jun 18.

Klinik für Anästhesiologie und Intensivmedizin, Klinikum Neumarkt i.d.OPf., Neumarkt i.d.OPf., Deutschland.

Peripartum emergencies that require intensive medical care represent a major challenge for the interdisciplinary treatment team. Due to physiological changes in pregnant women symptoms can be masked and the initiation of treatment is delayed. Peripartum sepsis has a relatively high incidence. The anti-infective treatment depends on the spectrum of pathogens to be expected. Endocrinological emergencies are rare but can be fulminant and fatal. The development of ketoacidosis is favored by decreased bicarbonate buffer and placental hormones. In the case of thyrotoxicosis, propylthiouracil and thiamazole are available for treatment depending on the stage of gestation. Sheehan's syndrome is an infarction of the anterior lobe of the pituitary gland during a hemorrhage. Due to the loss of production of vital hormones, this can be fatal. The development of pulmonary edema is just as acute. This is favored by physiological changes during pregnancy. The differentiation between hypertensive and hypotensive pulmonary edema is important for the causal treatment.
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http://dx.doi.org/10.1007/s00101-021-00944-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8212281PMC
June 2021

Direct oral anticoagulants in traumatology - an underestimated problem?

MMW Fortschr Med 2020 10;162(18):64-69

Friedrich-Alexander-Univ. Erlangen-Nürnberg, Nürnberger Str. 12, 92318, Neumarkt i.d.OPf., Germany.

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http://dx.doi.org/10.1007/s15006-020-4409-5DOI Listing
October 2020

[Peripheral truncal blocks-Overview and assessment].

Anaesthesist 2020 12;69(12):860-877

Klinik für Anästhesie und Intensivtherapie, UKGM Gießen-Marburg, Standort Marburg, Baldingerstr., 35033, Marburg, Deutschland.

By implementation of sonography for regional anesthesia, truncal blocks became more relevant in the daily practice of anesthesia and pain therapy. Due to visualized needle guidance ultrasound supports more safety and helps to avoid complications during needle placement. Additionally, complex punctures are possible that were associated with higher risk using landmarks alone. Next to the blocking of specific nerve structures, interfascial and compartment blocks have also become established, whereby the visualization of individual nerves and plexus structures is not of relevance. The present review article describes published and clinically established puncture techniques with respect to the indications and procedures. The clinical value is reported according to the scientific evidence and the analgesic profile. Moreover, the authors explain potential risks, complications and dosing of local anesthetic agents.
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http://dx.doi.org/10.1007/s00101-020-00809-3DOI Listing
December 2020

[Prevention of postoperative delirium].

MMW Fortschr Med 2020 04;162(8):50-57

Muskuloskelettales Zentrum, Kliniken des Landkreises Neumarkt i. d. OPf., Deutschland.

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http://dx.doi.org/10.1007/s15006-020-0013-yDOI Listing
April 2020

Breast surgery and peripheral blocks. Is it worth it?

Authors:
Ulrich Schwemmer

Curr Opin Anaesthesiol 2020 Jun;33(3):311-315

Department of Anesthesiology and Intensive Care Medicine, Kliniken des Landkreises Neumarkt i.d. Opf, Neumarkt, Germany.

Purpose Of Review: The objective of this review is to identify the potential of peripheral nerve blocks established over the last years for perioperative pain management in breast surgery. These new blocks will be discussed with respect to their clinical effect and necessity.

Recent Findings: After case reports and cadaver studies for the Pecs block and its variations sufficient clinical data from randomized controlled trial (RCT) and meta-analyses exist now. The modified Pecs block or Pecs II leads to a reduction of postoperative 24-h opioid consumption. The recently invented Erector spine block addresses the intercostal nerves. The benefits in analgesia of this approach were tested in few RCTs and showed superiority to the control group in terms of requested postoperative morphine. Most studies showed low intraoperative opioid doses and no study more than low to moderate postoperative pain scores.

Summary: Taking the pain levels after breast surgery into account, the request of additional nerve blocks has to be pondered against the potential risks and resource requirement. To reduce or avoid intraoperative or postoperative opioids, an ultrasound-guided Pecs II block proves to be the best option for perioperative pain relief.
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http://dx.doi.org/10.1097/ACO.0000000000000863DOI Listing
June 2020
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