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Anaesthesist 2022 May 5. Epub 2022 May 5.

Klinik für Anästhesie und Intensivtherapie, Universitätsklinikum Gießen und Marburg, Philipps-Universität Marburg, Baldingerstraße, 35043, Marburg, Deutschland.

Background: Rebound pain as a side effect of regional anaesthesia is an excessive sensation of pain after the effect of local anaesthesia has subsided. This sensation goes well beyond the normal wound pain following a surgical intervention. This phenomenon has entered focus of research in the past 10 years now, but the specific causes are so far unclear and there are still no targeted treatment recommendations. Read More

Anaesthesist 2022 05 4;71(5):362-372. Epub 2022 May 4.

Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.

Background: Practical experiences in clinical traineeships can shape the later specialty choice of medical students.

Key Question: The following study aimed to find factors in anesthesiological clinical traineeship that encourage students to specialize in the field.

Material And Methods: As part of a nationwide online survey conducted by the working group for education of the German Association for Orthopedics and Trauma Surgery (Deutsche Gesellschaft für Orthopädie und Unfallchirurgie, DGOU), study participants (n = 479) answered questions about their minimum 4‑week traineeship in anesthesiology. Read More

Anaesthesist 2022 05 4;71(5):331-332. Epub 2022 May 4.

Klinik für Intensivmedizin und Notfallmedizin, Klinikum Bremen Mitte, St.-Jürgen-Str. 1, 28177, Bremen, Deutschland.

Anaesthesist 2022 May 4. Epub 2022 May 4.

Klinik für Anästhesiologie und operative Intensivmedizin, Krankenhaus Köln-Merheim, Kliniken der Stadt Köln gGmbH, Klinikum der Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland.

Background: While many hospitals in Germany perform thoracic surgery, anesthetic techniques and methods that are actually used are usually only known for individual departments. This study describes the general anesthetic management of three typical thoracic surgical procedures across multiple institutions.

Material And Methods: The German Thoracic Registry recorded 4614 patients in 5 institutions between 2016 and 2019. Read More

Anaesthesist 2022 May 2. Epub 2022 May 2.

Department of Anaesthesiology and Reanimation, Yıldırım Bayezit University Yenimahalle Education and Research Hospital, Sakarya, Turkey.

Background And Objective: In today's rapidly changing world, the technology of social media is widely used for educational purposes. Our aim in this study was to investigate the accuracy and efficacy of video presentations of percutaneous dilatational tracheostomy procedures available on the international video sharing website YouTube.

Methods: On 1 December 2020, the terms "percutaneous dilatational tracheostomy" and "percutaneous tracheostomy" were entered into the search feature of YouTube ( www. Read More

Anaesthesist 2022 May 2. Epub 2022 May 2.

Departement Anästhesie, Spital Grabs, Spitalregion Rheintal Werdenberg Sarganserland, Spitalstr. 44, 9472, Grabs, Schweiz.

Anaesthesist 2022 Apr 25. Epub 2022 Apr 25.

Klinik für Anästhesie und Intensivtherapie Universitätsklinikum Marburg, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland.

One of the main limitations concerning the use of local anesthetics is due to their restricted duration of action. In recent years, liposomal formulations with prolonged release kinetics have been developed to extend the pharmacological duration of action of the 1‑stage peripheral regional anesthesia (single-shot procedure) and thus bring about a longer duration of action. The focus here is particularly on achieving postoperative freedom from pain for at least 24 h (or even better 48 h) and thus early mobilization of patients using on-demand medication causing (at most) minor local sensory blockade without causing motor impairments (at least that is the ideal). Read More

Anaesthesist 2022 Apr 20. Epub 2022 Apr 20.

Medizinische Klinik, und Poliklinik 1, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

Anaesthesist 2022 Apr 14. Epub 2022 Apr 14.

Klinik für Anästhesiologie, Operative Intensivmedizin, Schmerz- und Palliativmedizin, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Deutschland.

This is a case report of a 45-year-old patient, 39 weeks of gestation, who was intubated via rapid sequence induction (RSI) for an emergency cesarean. The indication for emergency cesarean was a pathological cardiotocography during the ejection phase following labor induction.Despite the primary use of a video laryngoscope, there was difficulty aligning the laryngeal axis. Read More

Anaesthesist 2022 05 9;71(5):333-339. Epub 2022 Apr 9.

Klinik für Anästhesiologie, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland.

The controversy surrounding ventilation in coronavirus disease 2019 (COVID-19) continues. Early in the pandemic it was postulated that the high intensive care unit (ICU) mortality may have been due to too early intubation. As the pandemic progressed recommendations changed and the use of noninvasive respiratory support (NIRS) increased; however, this did not result in a clear reduction in ICU mortality. Read More

Anaesthesist 2022 Apr 7. Epub 2022 Apr 7.

Universitätsklinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.

Study Goal: The study goals were to analyze the course and compare it with patients who were only resuscitated manually as well as to record the influencing factors in patients in whom the mechanical chest compression aid LUCAS2™ was used as an add-on treatment at the NEF Innsbruck.

Material And Methodology: Retrospective history data analysis of patients in the study period from 01.01. Read More

Anaesthesist 2022 04 6;71(4):253-254. Epub 2022 Apr 6.

Universitätsklinikum Hamburg-Eppendorf, Zentrum für Anästhesiologie und Intensivmedizin, Klinik und Poliklinik für Anästhesiologie, Hamburg, Deutschland.

Anaesthesist 2022 05 31;71(5):403-412. Epub 2022 Mar 31.

Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland.

Acute decompensation in patients with liver cirrhosis is characterized by the development of ascites, gastrointestinal bleeding, hepatic encephalopathy, or bacterial infection and is often accompanied by further extrahepatic organ dysfunction. Since critically ill patients with decompensated cirrhosis have a high mortality risk, rapid identification and treatment of the triggering event of decompensation (e.g. Read More

Anaesthesist 2022 04 29;71(4):321-330. Epub 2022 Mar 29.

Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland.

Porphyrias are a group of rare, mostly inherited metabolic disorders of heme biosynthesis. Each type of porphyria results from a specific deficiency of one of the pathway enzymes, causing a characteristic accumulation and excretion of heme precursors. Diagnosis is confirmed by the biochemical detection of these porphyrins and the precursors in urine, feces and blood. Read More

Anaesthesist 2022 04 28;71(4):255-263. Epub 2022 Mar 28.

Department of Anesthesiology, Sophia Children's Hospital, Erasmus Medical Center, Dr. Molewaterplein 40, 3015, GD Rotterdam, Niederlande.

In 1989 the United Nations passed the "United Nations Convention on the Rights of the Child" (UNCRC) and, among others, demanded the highest attainable standard of health for children. Safe Anesthesia for Every Tot (SAFETOTS, www.safetots. Read More

Anaesthesist 2022 Mar 22. Epub 2022 Mar 22.

Klinik für Anästhesiologie, Medizinische Fakultät, RWTH Aachen University, Uniklinik RWTH Aachen, Aachen, Deutschland.

Background: Each year there are 7.3 million emergencies for the German rescue service, trend rising and around 59% of the emergency patients are treated by paramedics only; however, most of the studies focus on physicians, while their practical skills at the scene are rarely necessary. Accordingly, the responsibility for the patient lies with the paramedics most of the time. Read More

Anaesthesist 2022 Mar 16. Epub 2022 Mar 16.

Klinik für Palliativmedizin, Medizinische Fakultät, Uniklinik RWTH Aachen, RWTH Aachen University, Aachen, Deutschland.

Background: Opioids are part of the daily routine in anesthesiology and palliative care; however, treatment of dyspnea with opioids is presented heterogeneously in guidelines. This may result in an uncertainty concerning opioid indications and ethical concerns, especially when caring for COVID-19 patients.

Objective: We aimed to examine the perception of anesthesiologists concerning the handling of morphine as the reference opioid (subsequently termed M/O) for symptom control within and outside of a palliative care setting, including care for COVID-19 patients. Read More

Anaesthesist 2022 03 9;71(3):169-170. Epub 2022 Mar 9.

Klinik für Anästhesiologie und operative Intensivmedizin, Kepler Universitätsklinikum, Johannes-Kepler-Universität, Altenberger Str. 69, 4040, Linz, Österreich.

Anaesthesist 2022 Mar 7. Epub 2022 Mar 7.

Universitäres Notfallzentrum, Inselspital, Universitätsspital Bern, Universität Bern, Bern, Schweiz.

Hemorrhage is the cause of death in 30-40% of severely injured patients due to trauma and the most frequent avoidable cause of death. In civilian emergency medical services, the majority of life-threatening hemorrhages are found in incompressible body regions (e.g. Read More

Anaesthesist 2022 03 4;71(3):181-189. Epub 2022 Mar 4.

Klinik und Poliklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.

Postpartum hemorrhage (PPH) nowadays still represents a severe complication of both a vaginal delivery and a cesarean section. In German-speaking areas a new definition of the term has recently become established and the nomenclature with respect to the severe form of PPH was dropped. The handling of misoprostol as a uterotonic during treatment of PPH is also new, which is available in Germany only as a medical direct import. Read More

Anaesthesist 2022 Mar 3. Epub 2022 Mar 3.

Klinik für Anästhesiologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland.

Background: The coronavirus pandemic caused a sudden change in medical education worldwide and induced a shift towards digital teaching. Previously, most courses were organized for students in physical presence on campus, while a few institutions already complemented these with blended learning methods, combining digital teaching with clinical presence; however, the use of digital teaching was heterogeneous, ranging from the use of PowerPoint slides to the application of virtual patients and telemedicine.

Objective: This study aimed to identify challenges and opportunities arising from the different tools used in digital teaching, such as recorded lectures or online seminars, and the role of hands-on clinical experience. Read More

Anaesthesist 2022 03 2;71(3):171-180. Epub 2022 Mar 2.

Klinik und Poliklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.

The implementation of patient blood management (PBM) is increasingly becoming standard in operative medicine. Recently, interest has also been shown for the vulnerable collective of pregnant women and neonates. As the information regarding anesthesiological procedures for pregnant women and the peripartum period including an informed consent process should be carried out long before childbirth, this provides a good possibility in this connection to incorporate PBM. Read More

Anaesthesist 2022 Feb 28. Epub 2022 Feb 28.

Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.

Acute adrenal cortex insufficiency is a rare disease, which is hard to diagnose because of its diffuse symptoms. Symptoms, such as general weakness, nausea or vomiting, fatigue, hyponatremia, hyperkalemia, hypoglycemia and pronounced hypotension up to shock can be crucial in the diagnosis of an adrenal cortex crisis. The underlying disease of adrenal cortex insufficiency is also characterized by not always obvious symptoms, which are differently expressed depending on whether it is the primary or secondary type. Read More

Anaesthesist 2022 03 25;71(3):190-192. Epub 2022 Feb 25.

Interdisziplinäre Arbeitsgemeinschaft für Klinische Hämotherapie, An den Lahnbergen, 35043, Marburg, Deutschland.

Anaesthesist 2022 05 23;71(5):400-402. Epub 2022 Feb 23.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

Anaesthesist 2022 Feb 18. Epub 2022 Feb 18.

Klinik für Anästhesiologie und operative Intensivmedizin, Klinikum der Universität Witten/Herdecke, Kliniken der Stadt Köln, Köln, Deutschland.

Background: A good safety culture may be predominantly defined by an open and unsanctioned communication about critical and erroneous courses. In an effort to improve patient safety various instruments, such as the critical incident reporting system (CIRS) or in terms of patient handover, the use of the situation, background, assessment, recommendation (SBAR) system patient handover, have been developed and are recommended by the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). This study aimed at identifying how anesthesiologists perceive the safety culture in their current department and whether CIRS or SBAR are already established or not. Read More

Anaesthesist 2022 04 18;71(4):318-320. Epub 2022 Feb 18.

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.

Anaesthesist 2022 Feb 17. Epub 2022 Feb 17.

Univ.Klinik f. Anästhesiologie, perioperative Medizin und allgemeine Intensivmedizin, LKH Salzburg, Müllner Hauptstr. 48, 5020, Salzburg, Österreich.

Epidermolysis bullosa causes blistering due to altered structural proteins of the dermoepidermal junction, resulting in scarring and strictures of the skin and mucous membranes. Affected individuals typically require frequent surgical interventions due to burdensome symptoms and complications of the disease. The anesthesiological management of these patients is inherently challenging. Read More

Anaesthesist 2022 Feb 15. Epub 2022 Feb 15.

Physikalische und Rehabilitative Medizin, Muskuloskelettales Universitätszentrum München, LMU Klinikum München, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.

Background: A considerable number of critically ill and mechanically ventilated intensive care patients show pronounced dysphagia after extubation. Many studies have shown that postextubation dysphagia (PED) leads to a significant decline of outcome. The awareness, timely diagnostic procedures and integration of suitable treatment methods in intensive care units are therefore of great importance. Read More

Anaesthesist 2022 05 11;71(5):377-383. Epub 2022 Feb 11.

Klinik für Anästhesiologie und operative Intensivmedizin, Klinikum Köln-Merheim, Universität Witten/Herdecke, Köln, Deutschland.

The current S2k guidelines on treatment of thermal injuries in adults are summarized in this article from the perspective of anesthesiology, emergency medicine and intensive care medicine. The guidelines were prepared under the auspices of the German Society for Burn Medicine with the participation of other professional societies and interest groups and were published last year in revised form by the AWMF. Read More