Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS最新文献

[Anesthetic Considerations in Pregnancy Terminations, Miscarriages, Stillbirths, and Neonatal Palliative Care - Clinical Management and Ethical Challenges]. 【妊娠终止、流产、死产和新生儿姑息治疗中的麻醉考虑——临床管理和伦理挑战】。

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-06-01 Epub Date: 2025-06-13 DOI: 10.1055/a-1727-8683

Celina Wolters, Phil Niggemann, Rick Enste, Lars Garten, Matthias David, Claudia Spies, Lutz Kaufner

引用次数: 0

[Pain Treatment for Herpes zoster]. [带状疱疹的疼痛治疗]。

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-06-01 Epub Date: 2025-06-13 DOI: 10.1055/a-2281-1256

Christine Gaik, Christian Volberg

{"title":"[Pain Treatment for Herpes zoster].","authors":"Christine Gaik, Christian Volberg","doi":"10.1055/a-2281-1256","DOIUrl":"https://doi.org/10.1055/a-2281-1256","url":null,"abstract":"Herpes zoster (HZ), caused by reactivation of the varicella-zoster virus, primarily affects older or immunocompromised individuals and can lead to painful skin rashes and long-term complications such as postherpetic neuralgia (PHN). In Europe, approximately 1.7 million people are affected annually, with a lifetime risk of 20-30% that increases with age. PHN develops in 10-20% of cases and in up to 50% of individuals over 85. The disease progresses through three stages: a prodromal phase with localized pain, an acute phase with a vesicular rash, and a chronic phase often marked by persistent neuropathic pain. PHN is defined as pain lasting three months or more after the rash has resolved. Diagnosis is usually clinical, with PCR testing used in atypical presentations. Vaccination with the recombinant adjuvanted vaccine (Shingrix) is recommended for adults aged 60 and older and has proven effective in preventing both HZ and PHN. Antiviral therapy, such as aciclovir, should be initiated within 72 hours of symptom onset. Pain management depends on the severity and type of pain and may involve NSAIDs, opioids, anticonvulsants like pregabalin, antidepressants, as well as topical or interventional approaches in difficult cases. HZ represents a significant health burden, particularly in older adults, and prevention through vaccination along with early treatment is essential to reduce complications and improve patient outcomes.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 6","pages":"371-375"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295580","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}

引用次数: 0

Palliativmedizin. . 2亿欧元

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-06-01 Epub Date: 2025-06-13 DOI: 10.1055/a-2592-7433

Christoph H R Wiese

引用次数: 0

[Palliative Patients and Prehospital Emergency Medicine - Which Aspects Should the Prehospital Emergency Physician Know?] 缓和病人与院前急诊医学——院前急诊医师应了解哪些方面？］

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-06-01 Epub Date: 2025-06-13 DOI: 10.1055/a-2351-8020

Christoph H R Wiese, Vera Peuckmann-Post

{"title":"[Palliative Patients and Prehospital Emergency Medicine - Which Aspects Should the Prehospital Emergency Physician Know?]","authors":"Christoph H R Wiese, Vera Peuckmann-Post","doi":"10.1055/a-2351-8020","DOIUrl":"https://doi.org/10.1055/a-2351-8020","url":null,"abstract":"Emergency medical care indications have changed in Germany in recent years. Emergency interventions in elder people and nursing homes, which used to be an exceptional indication, have now become a standard intervention and one of the main tasks of emergency medical care in Germany. Emergency care for the elderly and people with life-threatening illnesses has increasingly become the focus of modern emergency medicine. Emergency care is increasingly confronted with patients in the palliative stage of illness, with special treatment needs and with end-of-life decisions. The rapidity of these changes in emergency care has not yet been adequately addressed through appropriate training and the expansion of emergency medical and legal knowledge. In palliative care, too, developments and their implementation in practice need to be optimized. Since 2007, for example, there has been a legal entitlement to specialized outpatient palliative care for patients and their families, but is not yet sufficiently available and applicable on a broad basis (according to §§ 37b and 132d of the German Social Code, Book V). For this reason, decisions that needed to be made in anticipation of palliative care continue to be shifted to preclinical emergency care and subsequently to hospitals. The aim of this article is to explain the special features of \"palliative emergencies\" and to give recommendations for emergency physicians in order to provide excellent therapeutic care for people with life-limiting illnesses.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 6","pages":"329-344"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295582","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}

引用次数: 0

[Palliative Care in the Intensive Care Unit]. [重症监护病房的姑息治疗]。

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-06-01 Epub Date: 2025-06-13 DOI: 10.1055/a-2351-8004

Theresa Tenge, Manuela Schallenburger, Martin Neukirchen

{"title":"[Palliative Care in the Intensive Care Unit].","authors":"Theresa Tenge, Manuela Schallenburger, Martin Neukirchen","doi":"10.1055/a-2351-8004","DOIUrl":"https://doi.org/10.1055/a-2351-8004","url":null,"abstract":"The number of deaths in hospitals and intensive care units (ICUs) is rising, with particularly high mortality rates reported among ventilated ICU patients and those with mechanical circulatory support. Palliative care aims to improve the quality of life for patients with serious illnesses and their families. It focuses on addressing physical, psychological, social, and spiritual symptoms, clarifying care goals, and supporting communication within the healthcare team and with patients and their families. The multi-professional palliative care team typically includes physicians, nurses, social workers, psychologists, physiotherapists, chaplains, creative therapists and volunteers. General palliative care is provided by all healthcare workers, whereas specialist palliative care involves palliative care units, inpatient consultation teams, and outpatient services (specialist ambulatory palliative care). Despite the beneficial effects of palliative care in the ICU on care trajectories, symptom control, and care satisfaction, its practice is not standardized in German ICUs, and no specific guidelines exist for ICU palliative care. To identify patients in need of palliative care and facilitate timely integration, collaborative training, ward rounds, or trigger factors can be effective. In the German healthcare insurance system, specialist palliative care within ICU treatment is covered by operation and procedure codes.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 6","pages":"345-355"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295581","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}

引用次数: 0

[Preoperative Evaluation, Indications and Contextual Factors in Ambulant Anaesthesia]. [术前评估，指征和背景因素在门诊麻醉]。

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-05-01 Epub Date: 2025-06-02 DOI: 10.1055/a-2292-9420

Helmuth Komar, Frank Vescia

{"title":"[Preoperative Evaluation, Indications and Contextual Factors in Ambulant Anaesthesia].","authors":"Helmuth Komar, Frank Vescia","doi":"10.1055/a-2292-9420","DOIUrl":"https://doi.org/10.1055/a-2292-9420","url":null,"abstract":"Preoperative evaluation and indication are of paramount importance in the field of outpatient anesthesia. Timing, implementation, and recognition of anesthetic contraindications are important points for a good and comprehensive assessment. Not only is the patient's medical history taken, but the assessment also determines the management of any long-term medication. This is more important as uncoordinated discontinuation of long-term medication can lead to a problematic anesthetic outcome. Failure to observe fasting times, serious comorbidities and lack of home care are clear contraindications to outpatient anesthesia. Many comorbidities are not contraindications to outpatient anesthesia if the preoperative setting is good and the anesthetic management and monitoring is adapted to the patient. Knowledge of the management of comorbidities and their importance in outpatient anesthesia broadens the spectrum of anesthesia that can be performed in the outpatient setting. Knowledge of contraindications that may arise from the surgical procedure helps to make a wise decision for or against outpatient anesthesia. As Germany is only at the very beginning of the \"outpatientisation\" of medicine, we will discuss contextual factors that may lead to an operation/anesthesia that should actually be performed on an outpatient basis also being performed on an inpatient basis.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 5","pages":"277-290"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210707","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}

引用次数: 0

[Regional Anesthesia in the Outpatient Clinic: Chances and Risks]. 门诊区域麻醉：机会与风险

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-05-01 Epub Date: 2025-06-02 DOI: 10.1055/a-2292-9404

Laura Sophie Schäfer, Stefanie Schiele, Anke Schwarz, Grietje Beck, Thomas Frietsch

{"title":"[Regional Anesthesia in the Outpatient Clinic: Chances and Risks].","authors":"Laura Sophie Schäfer, Stefanie Schiele, Anke Schwarz, Grietje Beck, Thomas Frietsch","doi":"10.1055/a-2292-9404","DOIUrl":"https://doi.org/10.1055/a-2292-9404","url":null,"abstract":"Regional anaesthesia (RA) in the ambulatory setting presents both opportunities and risks, especially in an economically challenging healthcare system. Patients tend to associate RA with the risk of neuronal damage, paralysis and the need to be awake during surgery. However, the risks beyond the rare complications and associated claims are more likely to be variable neuronal blockade effects and disadvantages in high-throughput OR management. The use of RA techniques in the outpatient setting requires experienced selection of suitable patients, consideration of pre-existing risks such as coagulopathies, rapid standard set-up procedures, ultrasound guidance to avoid vascular and nerve damage and good psychological counselling of patients. A clinic with many outpatient procedures can become even more efficient through higher throughput, pain-free and awake procedures without patient discomfort. RA also offers significantly safer approaches for high-risk patients. Based on the experience of a university outpatient clinic, this short review discusses the use of RA with its risks and opportunities.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 5","pages":"291-305"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210710","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}

引用次数: 0

[Process-oriented Work in the Outpatient Setting]. [门诊环境中的流程导向工作]。

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-05-01 Epub Date: 2025-06-02 DOI: 10.1055/a-2292-9358

Andreas Krier, Marc Dominik Schmittner, Jörg Karst, Volker Gebhardt

{"title":"[Process-oriented Work in the Outpatient Setting].","authors":"Andreas Krier, Marc Dominik Schmittner, Jörg Karst, Volker Gebhardt","doi":"10.1055/a-2292-9358","DOIUrl":"https://doi.org/10.1055/a-2292-9358","url":null,"abstract":"Outpatient surgery presents unique challenges for medical teams, requiring seamless coordination of perioperative logistics and postoperative care. The increasing shift of complex procedures to outpatient settings, driven by economic and demographic changes, necessitates continuous process optimization. This article explores key factors for efficient outpatient anesthesia management, emphasizing interdisciplinary collaboration, structured workflow organization, and the role of modern anesthetic techniques.Key aspects include patient selection based on medical and social criteria, optimized OR scheduling, and the use of digital planning tools to enhance communication and efficiency. The choice of anesthetic techniques plays a crucial role in reducing turnaround times, minimizing postoperative complications, and improving overall patient outcomes. Additionally, standardized protocols, staff training, and digital documentation contribute to better workflows and patient safety.A successful outpatient anesthesia system balances efficiency and quality while ensuring economic sustainability. By fostering team motivation and implementing structured processes, high-quality patient care can be maintained without compromising safety.","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 5","pages":"263-275"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210709","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}

引用次数: 0

[Outpatient Anesthesia]. (门诊麻醉)。

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-05-01 Epub Date: 2025-06-02 DOI: 10.1055/a-2565-2875

Grietje Beck

引用次数: 0

[Preoperative Risk Assessment in Adult Congenital Heart Disease]. 成人先天性心脏病的术前风险评估

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS Pub Date : 2025-05-01 Epub Date: 2025-06-02 DOI: 10.1055/a-2259-7987

Nikolai Hulde, Ioana Maria Belciu, Vera von Dossow

引用次数: 0