Perioperative Medizin最新文献

{"title":"Heilung und Restitution: Teil 2 von 3: Anastomosenheilung","authors":"Frank Willeke,&nbsp;Anita Hees","doi":"10.1016/j.periop.2010.08.001","DOIUrl":"https://doi.org/10.1016/j.periop.2010.08.001","url":null,"abstract":"<div><p>Die Anastomosenheilung am Gastrointestinaltrakt unterliegt den gleichen Prinzipien wie im gesamten Organismus. Nach chirurgischer Verbindung zweier Abschnitte des Magen-Darm-Traktes durchläuft die Anastomosenregion eine exsudative und eine proliferative Phase. Vielfältige Störfaktoren lokaler und systemischer Art können mit einer ungestörten Anastomosenheilung interferieren. Wichtige lokale Voraussetzunge für eine Anastomosenheilung sind korrekte Technik, fehlende Spannung und gute Perfusion. Demgegenüber bleiben systemische oder lokale Versuche, die Anastomosenheilung zu beeinflussen, von nach geordneter Wichtigkeit.</p></div><div><p>Anastomotic healing in the gastrointestinal tract is identical to any wound healing. This physiological process is characterized by the exsudative and proliferative phase. Many local and systemic pathologic conditions interfere with undisturbed healing in the gastrointestinal tract. Important basics for anastomotic healing are a meticulous technique, no tension and excellent perfusion. Compared to these preconditions, systemic and local therapeutics to improve healing of anastomosis are of minor importance.</p></div>","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 4","pages":"Pages 137-147"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91600469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sitzung 5, Vortrag 4: Junge Frauen haben die größte Schmerzempfindlichkeit","authors":"W. Boemke,&nbsp;C. Barner,&nbsp;F.M. Radtke,&nbsp;M. Franck,&nbsp;C.D. Spies","doi":"10.1016/j.periop.2010.10.022","DOIUrl":"10.1016/j.periop.2010.10.022","url":null,"abstract":"","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 4","pages":"Page 229"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.10.022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84077937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sitzung 11, Vortrag 2: Multimodale perioperative Behandlung bei der Resektion von Ösophaguskarzinomen","authors":"W. Schwenk","doi":"10.1016/j.periop.2010.10.036","DOIUrl":"10.1016/j.periop.2010.10.036","url":null,"abstract":"","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 4","pages":"Page 236"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.10.036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82227195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kompliziert heilende Wunden und moderne Behandlungsstrategien von Braumann C, Henkel A, Günther N. Periop Med. 2010; 1: 5-16. - eine kritische Stellungnahme-","authors":"Dörthe Seidel","doi":"10.1016/j.periop.2010.04.001","DOIUrl":"10.1016/j.periop.2010.04.001","url":null,"abstract":"","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 3","pages":"Page 130"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87247868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kompliziert heilende Wunden und moderne Behandlungsstrategien von Braumann C, Henkel A, Günther N. Periop Med. 2010; 2: 5-16. - Eine kritische Stellungnahme -","authors":"Dörthe Seidel","doi":"10.1016/j.periop.2010.03.008","DOIUrl":"10.1016/j.periop.2010.03.008","url":null,"abstract":"","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 3","pages":"Pages 125-128"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.03.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89652482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dextromethorphan on postoperative pain after orthopedic surgery under spinal anesthesia","authors":"Andreas Hohn ,&nbsp;Nikola Magheli ,&nbsp;Hartmut Bürkle ,&nbsp;Jeannette Horn ,&nbsp;Stefan Soltesz ,&nbsp;Frank Wappler","doi":"10.1016/j.periop.2010.03.005","DOIUrl":"10.1016/j.periop.2010.03.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;p&gt;&lt;span&gt;Previous studies showed that pre-incisional administration of dextromethorphan&lt;span&gt;&lt;span&gt; (DM), a weak N-methyl-D-aspartic (NMDA) acid antagonist, reduces postoperative pain after epidural as well as &lt;/span&gt;general anesthesia. Aim of this study was therefore to proof the effects of DM on postoperative pain &lt;/span&gt;&lt;/span&gt;in patients&lt;span&gt; undergoing orthopedic surgery under spinal anesthesia.&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Forty-five patients undergoing elective orthopedic surgery were enrolled in this prospective, double-blinded and randomized study. Patients were randomly assigned to three groups (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;15) and received either placebo or dextromethorphan (45 or 90&lt;!--&gt; &lt;span&gt;mg) p.o. Afterwards, a spinal catheter was inserted at the L2/3 or L3/4 interspace and spinal anesthesia with bupivacaine&lt;span&gt; was induced and maintained at a level between Th 10 and Th 12. After completion of surgery patient controlled analgesia&lt;span&gt;&lt;span&gt; (PCA) with piritramide was started. Visual analogue pain scales (VAS) and &lt;/span&gt;analgesic requirements were assessed before surgery (control) as well as during the first 48&lt;/span&gt;&lt;/span&gt;&lt;/span&gt; &lt;!--&gt;hours.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;&lt;span&gt;The three groups were comparable with respect to biometric data, distribution of surgery as well as preoperative pain levels. VAS scores were not different between the three groups within 48&lt;/span&gt; &lt;!--&gt;hours postoperatively. Furthermore, administration of pre-incisional DM had no influence on postoperative requirements of opioids (group D90: 59.5&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;37.5&lt;!--&gt; &lt;!--&gt;mg; group D45: 56.2&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;37.1&lt;!--&gt; &lt;!--&gt;mg piritramide; and group P: 49.3&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;29.2&lt;!--&gt; &lt;!--&gt;mg piritramide) within 48&lt;!--&gt; &lt;!--&gt;hours.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;In this study DM enables neither reduction of postoperative pain intensity nor analgesic- or opioid-sparing effects. Further studies to find out ideal dosage, way of administration and applicable kind of surgery should be implemented.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hintergrund&lt;/h3&gt;&lt;p&gt;Zahlreiche Untersuchungen konnten die analgetische Wirksamkeit des NMDA-Rezeptor-Antagonisten Dextromethorphan (DM) bei präoperativer Verabreichung bei Eingriffen sowohl in Allgemeinanästhesie, als auch unter Epiduralanästhesie zeigen. Ziel dieser Studie war es, die analgetischen Effekte von DM bei orthopädischen Eingriffen in Spinalanästhesie zu überprüfen.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methoden&lt;/h3&gt;&lt;p&gt;In diese prospektive, randomisierte, doppelblinde Studie wurden 45 Patienten vor einem orthopädischen Gelenkersatz der Hüfte oder des Knies eingeschlossen. Die Patienten wurden in drei gleich große Gruppen (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;15) randomisiert und erhielten neben der oralen Prämedikation (Midazolam 7,5&lt;!--&gt; &lt;!--&gt;mg) ebenfalls oral entweder Placebo oder 45 bzw. 90&lt;!--&gt; &lt;!--&gt;mg Dextromethorphan. Die Spinalanästhesie mit Bupivacain wurde in Kathetertechnik durchgeführt und über Nachi","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 3","pages":"Pages 117-124"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.03.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75692253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"Priv.-Doz. Dr. med. Christian Simanski","doi":"10.1016/j.periop.2010.05.002","DOIUrl":"10.1016/j.periop.2010.05.002","url":null,"abstract":"","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 3","pages":"Page 131"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77742708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"Marcel Poels","doi":"10.1016/j.periop.2010.05.003","DOIUrl":"10.1016/j.periop.2010.05.003","url":null,"abstract":"","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 3","pages":"Page 129"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83759937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ausgewählte Organnotfälle: Akutes Lungenversagen","authors":"Thomas Bein","doi":"10.1016/j.periop.2010.03.006","DOIUrl":"10.1016/j.periop.2010.03.006","url":null,"abstract":"<div><p>Die schwere akute respiratorische Insuffizienz kann durch <em>direkte</em> pulmonale Schäden („pulmonales“ Lungenversagen) oder durch <em>indirekte</em> Faktoren („nicht-pulmonales“ Lungenversagen) induziert sein und erfordert ein umgehendes, gezieltes Handeln. Dieses umfasst neben der maschinellen Beatmung im lungenprotektiven Modus spezielle Techniken der pharmakologischen Intervention (z. B. Inhalation von Stickstoffmonoxid), der Lagerungstherapie (Beatmung in Bauchlage), sowie eine optimierte Intensivtherapie (Flüssigkeitsmanagement, Ernährung, Infektionskontrolle, Analgosedierung). Bei besonders schwerer Ausprägung mit Therapie-refraktärer Hypoxämie kommen in speziellen Zentren extrakorporale Lungenunterstützungsverfahren zum Einsatz, welche die lebenserhaltende Gasaustauschfunktion auf ein außerhalb der Lunge befindliches System übertragen und somit ein „bridging“ bis zur Erholung der Lungenfunktion übernehmen.</p></div><div><p>Severe acute respiratory insufficiency is induced by ‘direct’ pulmonary injury or by ‘non-pulmonary’ factors imparing the pulmonary gas exchange. A specific treatment strategy is mandatory including techniques of lung protective ventilation, pharmacologic intervention (f. e. inhaled nitric oxide), positioning therapy (prone position) and optimization of supportive intensive care management (balanced fluid administration, nutrition, analgosedation, infection control). In patients suffering from severe hypoxemic lung failure an extracorporeal lung support is advocated by specialized centers aimed at „bridging“ pulmonary gas exchange using extracorporeal devices to give the lung time to heal and to reduce ventilation induced lung injury.</p></div>","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 3","pages":"Pages 105-115"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.03.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74132745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fortbildungskalender","authors":"","doi":"10.1016/j.periop.2010.06.002","DOIUrl":"https://doi.org/10.1016/j.periop.2010.06.002","url":null,"abstract":"","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 3","pages":"Pages 132-133"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92147990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}