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Anaesthesist 2020 Jul;69(7):514-517

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

Anaesthesist 2020 Jul 3. Epub 2020 Jul 3.

Schmerzambulanz der Klinik für Anästhesiologie mit S. op. Intensivmedizin, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland.

Prevention of phantom limb pain is one of the biggest and still largely unsolved challenges in perioperative medicine. Despite many study efforts and optimization of postoperative pain treatment over the last 30 years, a significant reduction in the incidence of phantom limb pain has not been achieved. Current studies have also shown that at least 50% of patients develop phantom pain after 6 months. Read More

Anaesthesist 2020 Jul 3. Epub 2020 Jul 3.

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. Read More

Anaesthesist 2020 Jul;69(7):469-470

Anaesthesist 2020 Jul 3. Epub 2020 Jul 3.

Klinik für Anästhesiologie, Anästhesie, Intensiv‑, Notfall- und Schmerzmedizin, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland.

Background: The prevalence of Vibrio vulnificus heavily depends on the temperature and salinity of the sea water. In the course of climate change an increase in cases of fatal sepsis caused by V. vulnificus at the German Baltic Sea coast could be detected. Read More

Anaesthesist 2020 Jul 2. Epub 2020 Jul 2.

Department of Anesthesiology and Intensive Care, Annastift, Hannover, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.

Background: Standard protocols or algorithms are considered essential to ensure adequate analgesia. Germany has widely adopted postoperative protocols for pain management including oral opioids for rescue medication, but the effectiveness of such protocols has only been evaluated longitudinally in a before and after setting. The aim of this cohort analysis was to compare the effectiveness of an oral opioid rescue medication algorithm for postoperative management of pain to the gold standard of patient-controlled intravenous analgesia (PCIA). Read More

Anaesthesist 2020 Jul 2. Epub 2020 Jul 2.

Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Background: In 2016 the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthetists (BDA) published 10 quality indicators (QI) to compare and improve the quality of anesthesia care in Germany. So far, there is no evidence for the feasibility of implementation of these QI in hospitals.

Objective: This study tested the hypothesis that the implementation of the 10 QI is feasible in German hospitals. Read More

Anaesthesist 2020 Jun 26. Epub 2020 Jun 26.

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

A 42-year-old female patient suffered an infranuclear hypoglossal nerve paresis with right-sided swelling and weakness of the tongue following a short duration mask anesthesia for a follicle puncture. This resulted in dysarthria and dysphagia persisting for more than 3 months. A return to work was initially impossible. Read More

Anaesthesist 2020 Jun 22. Epub 2020 Jun 22.

Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.

Perioperative phases of hypotension are associated with an increase in postoperative complications and organ damage. Whereas some years ago hemodynamic stabilization was primarily carried out by volume supplementation, in recent years the use and dosing of cardiovascular-active substances has significantly increased. But like intravascular volume therapy, also substances with a cardiovascular effect have therapeutic margins, and thus, potential side effects. Read More

Anaesthesist 2020 Jun 20. Epub 2020 Jun 20.

Klinik für Anästhesie, operative Intensiv- und Palliativmedizin, Klinikum Würzburg Mitte - Standort Juliusspital, Juliuspromenade 19, 97070, Würzburg, Deutschland.

This article presents the case of a multimorbid male patient with an accidental dabigatran overdose caused by kidney failure in the context of an acute intestinal disorder. After effective initial antagonizing of the dabigatran effect using idarucizumab a dabigatran rebound was detected caused by a single hemodialysis leading to a severe intrapulmonary hemorrhage. As dabigatran plasma level testing was not available and conventional coagulation analysis was out of interpretable range due to the impact of dabigatran, continuous thrombelastography (TEG) was used to detect the effect of dabigatran and monitor the treatment results. Read More

Anaesthesist 2020 Jun 19. Epub 2020 Jun 19.

Klinik für Anästhesiologie und Operative Intensivmedizin, Schmerzzentrum, Universitätsklinikum Mannheim GmbH, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.

Background: Chronic stress and high workload in physicians can lead to loss of interest, emotional exhaustion and finally in burnout syndrome. This can cause serious consequences not only for the physicians personally and their own health by developing extensive health impairments, e.g. Read More

Anaesthesist 2020 Jul;69(7):451-452

Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Anaesthesist 2020 Jun 16. Epub 2020 Jun 16.

Klinik für Anaesthesiologie, LMU Klinikum, Marchioninistr. 15, 81377, München, Deutschland.

Hypersensitivity reactions are one of the most feared side effects associated with the use of CT contrast agents. Bronchospasm and lung edema are known manifestations, whereby the latter occurs much less often. In anaphylaxis, numerous mechanisms can lead to cardiac failure with subsequent lung edema. Read More

Anaesthesist 2020 Jul;69(7):487-488

Intensivstation, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz.

Anaesthesist 2020 Jun;69(6):371-372

Klinik für Anaesthesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Kirrberger Str. 100, 66421, Homburg (Saar), Deutschland.

Anaesthesist 2020 Jun 3. Epub 2020 Jun 3.

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena (UKJ), Am Klinikum 1, 07747, Jena, Deutschland.

Anaesthesist 2020 Jun 2. Epub 2020 Jun 2.

Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland.

Adaequate antibiotic therapy is crucial for successful anti-infective therapy. In addition to the choice of the right antibiotic and the duration of therapy, the dose also plays a decisive role. Obesity has an influence on the pharmacokinetics of antibiotics, which can lead to underdosing if previous weight-independent dosing regimes are used. Read More

Anaesthesist 2020 Jun 2. Epub 2020 Jun 2.

Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.

Objective: Studies on stress factors for patients in intensive care units (ICU) have so far concentrated on whether certain stressors have occurred or how stressful they were. There are no studies on stress for patients in ICUs that measured both the perception of stress and the chances perceived to control it; however, loss of control can result in long-term psychopathological consequences, such as depression or posttraumatic stress disorder. Therefore, a questionnaire was developed to evaluate the influence of controllability on perception of stress. Read More

Anaesthesist 2020 Jul;69(7):477-486

Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Konstanz, Konstanz, Deutschland.

Background: There is a risk of terror attacks in the Federal Republic of Germany, which might increase in the future. A timely comprehensive strategy for treatment and care of a large number of casualties helps minimize chaos and improve the outcome of patients. Adequate training is vital for successful implementation of an emergency plan. Read More

Anaesthesist 2020 Jul;69(7):521-532

Abteilung für Anästhesie, Intensiv‑, Rettungs- und Schmerzmedizin, BG-Klinikum Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Deutschland.

As a single and reliable parameter for prediction of the difficult airway is missing, the specialist societies for anesthesiology recommend the use of scores that combine the individual parameters. Contemporary scores include head-neck mobility, mouth opening and anatomical distances. Their training and correct performance are essential. Read More

Anaesthesist 2020 May 23. Epub 2020 May 23.

Klinik und Poliklinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.

Critical incidents in hospitals can often be predicted hours before the event and can mostly be detected earlier and presumably avoided. Quality management programs from US hospitals to reduce deaths following a severe postoperative complication (failure to rescue, FTR), have in this form not yet become established in Germany. A sensitive score-based early warning system for looming complications is decisive for successful in-hospital emergency management. Read More

Anaesthesist 2020 Jun;69(6):404-413

Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Kassel, Kassel, Deutschland.

Background: The chances of surviving out-of-hospital cardiac arrest (OHCA) are still very low. Despite intensive efforts the outcome has remained relatively poor over many years. In specific situations, new technologies, such as extracorporeal cardiopulmonary resuscitation (eCPR) could significantly improve survival with a good neurological outcome. Read More

Anaesthesist 2020 Jun;69(6):439-450

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

Although the Berlin definition of the acute respiratory distress syndrome (ARDS) is generally recognized, the differentiation from other diseases with severe gas exchange disturbances is often difficult in clinical practice. In particular, the assessment of radiological findings and identification of primary noncardiogenic lung edema pose problems. In ARDS typical inflammatory processes can be found with involvement of activated neutrophilic granulocytes. Read More

Anaesthesist 2020 Jul;69(7):471-476

Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.

Background: Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare progressive disease with acute neurological episodes caused by a mitochondriopathy. Due to a defect of oxidative phosphorylation in the respiratory chain, there is impaired mitochondrial energy production with subsequent lactic acidosis, especially in situations with increased stress. Due to the high risk of metabolic derailment MELAS syndrome is a great challenge with respect to the perioperative management of anesthesia. Read More

Anaesthesist 2020 Jul 3. Epub 2020 Jul 3.

Klinik für Anästhesiologie, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Anaesthesist 2020 May 15. Epub 2020 May 15.

Klinik für Anästhesiologie, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Anaesthesist 2020 May 15. Epub 2020 May 15.

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.

Anaesthesist 2020 Jul 14;69(7):489-496. Epub 2020 May 14.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus R3, 24105, Kiel, Deutschland.

Background: After insertion of a central venous catheter (CVC) the catheter position must be controlled and a pneumothorax ruled out.

Objective: The aim was to examine whether the use of two standard acoustic windows known from emergency sonography examination techniques is feasible to 1) verify the correct intravenous localization and direction of the guidewire before final CVC insertion and 2) correctly predict the required CVC length for positioning of the catheter tip in the lower third of the superior vena cava.

Material And Methods: This single center prospective observational study included adult patients (age ≥18 years) with an indication for CVC insertion after institutional ethics approval was obtained. Read More

Anaesthesist 2020 May 13. Epub 2020 May 13.

Klinik für Anaesthesiologie, Klinikum der Universität München, LMU München, Marchioninistr. 15, 81377, München, Deutschland.

In recent years, the social media, the press and the internet have reported more about the topic of "legal highs" and new psychoactive substances (NPS). The use of these drugs is accompanied by a serious risk of undesired side effects, intoxication and even death. The often unknown chemical composition, unspecific clinical presentations and lack of quickly available routine diagnostic tests are aggravating factors in this situation. Read More

Anaesthesist 2020 Jul;69(7):463-469

Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Von-Siebold-Str. 3, 37075, Göttingen, Deutschland.

Background: In the last five decades a continuous increase in the average global temperature has been recorded. Furthermore, natural disasters (e.g. Read More

Anaesthesist 2020 May;69(5):299-300

Klinik für Anaesthesiologie und op. Intensivmedizin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland.

Anaesthesist 2020 May;69(5):297-298

Klinik für Anaesthesiologie, Klinikum der Universität München, LMU München, München, Deutschland.

Anaesthesist 2020 Jul 6. Epub 2020 Jul 6.

Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.

Background: In 2016 the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthetists (BDA) published 10 quality indicators (QI) to compare and improve the quality of anesthesia care in Germany. So far, there is no evidence for the feasibility of implementation of these QI in hospitals.

Objective: This study tested the hypothesis that the implementation of the 10 QI is feasible in German hospitals. Read More

Anaesthesist 2020 Jun 6;69(6):432-435. Epub 2020 May 6.

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.

Crouzon syndrome (CS) is a rare autosomal dominant inherited disorder caused by mutations in the fibroblast growth factor receptor 2 (FGFR2) gene. The disease is characterized by premature fusion of the coronal and sagittal sutures of the skull, resulting in clinical manifestations of midfacial hypoplasia, shallow orbit, maxillary dysplasia, and occasional upper respiratory obstruction. This article presents the case of a child aged 2 years and 7 months with CS scheduled for bilateral tonsillectomy and adenoidectomy. Read More

Anaesthesist 2020 Jun;69(6):436-438

Klinik für Anästhesiologie, Universitätsklinikum, RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Deutschland.

Anaesthesist 2020 05;69(5):323-330

Klinik für Neurologische Intensivmedizin und Frührehabilitation, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Steinweg 13-17, 26122, Oldenburg, Deutschland.

Due to the current COVID-19 pandemic there is a need for a rapid increase in intensive care and ventilation capacities. Delivery times for additional intensive care respirators are currently not foreseeable. An option to increase ventilation capacities not only for COVID-19, but for all patients requiring mechanical ventilation is to use home respirators. Read More

Anaesthesist 2020 Jun 28;69(6):388-396. Epub 2020 Apr 28.

Universitätsklinik für Anästhesiologie, Intensiv‑, Palliativ- und Schmerzmedizin, BG Universitätsklinikum Bergmannsheil GmbH der Ruhr Universität Bochum, Bochum, Deutschland.

Background: The incorporation into the routine operating procedure of patients with small but acute hand and forearm injuries requiring surgery who present in the emergency admission department, represents a challenge due to limited resources. The prompt treatment in the emergency admission department represents an alternative. This article retrospectively reports the authors' experiences with a treatment algorithm in which emergency patients were treated by ultrasound-guided axillary brachial plexus blocks (ABPB) and surgery carried out in the emergency department without further anesthesia attendance. Read More

Anaesthesist 2020 Jul;69(7):453-462

Klinik für Anästhesie und Intensivmedizin, Diakonie Klinikum Stuttgart, Stuttgart, Deutschland.

Background: The climate crisis is the most serious threat to global health in the twenty-first century. In western countries 5-10% of all greenhouse gas emissions originate from the healthcare sector and the main contributing factors are energy-intense departments (intensive care units, operating suits and prehospital emergency services).

Objective: The aim of this review is to provide background knowledge and practical ideas to achieve climate-neutral hospitals. Read More

Anaesthesist 2020 05;69(5):316-322

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

The current coronavirus disease 2019 (Covid-19) pandemia is a highly dynamic situation characterized by therapeutic and logistic uncertainties. Depending on the effectiveness of social distancing, a shortage of intensive care respirators must be expected. Concomitantly, many physicians and nursing staff are unaware of the capabilities of alternative types of ventilators, hence being unsure if they can be used in intensive care patients. Read More

Anaesthesist 2020 Jul 24;69(7):497-505. Epub 2020 Apr 24.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln (AöR), Medizinische Fakultät, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

Background: In patients up to the age of 40 years old severe trauma is the most frequent cause of death in Germany. According to the current S3 guidelines on treatment of polytrauma and the severely injured, since 2011 the presence of a shock room coordinator should be considered, who can improve the survival of patients by optimized treatment quality and times. The aim of the present study was to analyze various parameters of shock room treatment for polytraumatized patients before and after implementation of a shock room coordinator for treatment of polytrauma. Read More

Anaesthesist 2020 May;69(5):314-315

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

Anaesthesist 2020 Apr 21. Epub 2020 Apr 21.

Klinik und Poliklinik für Anästhesiologie, Zentrum für Anästhesiologie und Intensivmedizin, Martinistr. 52, 20246, Hamburg, Deutschland.

The application of artificial intelligence (AI) is currently changing very different areas of life. Artificial intelligence involves the emulation of human behavior with the aid of methods from mathematics and informatics. Machine learning (ML) represents a subdivision of AI. Read More

Anaesthesist 2020 Jul 21;69(7):506-513. Epub 2020 Apr 21.

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland.

A 58-year-old woman developed rapidly progressive neurological symptoms and finally loss of vigilance 5 weeks following primarily successful lung transplantation. A posterior reversible encephalopathy syndrome (PRES) under treatment with tacrolimus as well as hyperammonemia due to sepsis with Ureaplasma urealyticum could be identified as the causes. Infections with Ureaplasma, bacteria which produce ammonia as a product of metabolism, are increasingly being identified in immunocompromised people by specific PCR (polymerase chain reaction) procedures and should routinely be taken into consideration as the cause of unspecific neurological symptoms. Read More

Anaesthesist 2020 Jun 17;69(6):397-403. Epub 2020 Apr 17.

Department of General Surgery, Ataturk University School of Medicine, Erzurum, Turkey.

Objective: The efficacy of quadratus lumborum muscle block (QLB) in abdominal surgery is known; however, the efficacy of different QLB types is unclear. The objective of this study was to investigate the effects of ultrasound-guided QLB type 2 and type 3 on postoperative opioid consumption and pain scores in patients undergoing inguinal hernia surgery.

Material And Methods: In this study 60 patients undergoing open inguinal hernia surgery were randomly assigned to 3 groups. Read More

Anaesthesist 2020 Jun 17;69(6):421-431. Epub 2020 Apr 17.

Klinik für Anästhesiologie, Intensiv‑, Rettungs- und Schmerzmedizin, Kantonsspital St. Gallen, 9007, St. Gallen, Schweiz.

Severe pulmonary impairment can occur after traumatic brain injury or stroke. The resulting brain-lung interactions represent key points for the treatment and the subsequent outcome of the patient. Established treatment approaches, such as permissive hypercapnia and prone positioning, present the intensive care physician with divergent treatment goals in these patients with partially increased intracranial pressure. Read More

Anaesthesist 2020 Apr 15. Epub 2020 Apr 15.

Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.

Background: Measurement of blood pressure is part of standard monitoring procedures in anesthesia, in addition to the other vital parameters of heart frequency and peripheral oxygen saturation. In recent years the relevance of the duration and extent of perioperative episodes of hypotension for the occurrence of postoperative complications or even increased mortality have become the focus of scientific investigations.

Objective: The aim of this review is to briefly recapitulate the physiological aspects of blood pressure and to describe the pathophysiology and risk factors of perioperative hypotension. Read More

Anaesthesist 2020 Jul;69(7):518-520

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

Anaesthesist 2020 Jun 8;69(6):414-420. Epub 2020 Apr 8.

Klinik für Anästhesiologie und operative Intensivmedizin, Ortenauklinikum Lahr-Ettenheim, Lahr, Deutschland.

Acute eosinophilic pneumonia (AEP) is a rare disease characteristically involving eosinophilic infiltration of lung parenchyma as well as fever, dyspnea, and coughing. A differentiation is made between primary and secondary AEP depending on the underlying etiology. Substances that most frequently cause secondary AEP are antibiotics, such as the lipopeptide daptomycin. Read More

Anaesthesist 2020 Apr;69(4):236-237

Klinik für Anaesthesiologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland.

Anaesthesist 2020 04;69(4):223-224

Klinik für Anaesthesiologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland.