Intravenous versus epidural analgesia to reduce the incidence of gastrointestinal complications after elective pancreatoduodenectomy (the PAKMAN trial, DRKS 00007784): study protocol for a randomized controlled trial.

Background: Despite substantial improvements in surgical and anesthesiological practices leading to decreased mortality of less than 5 % at high-volume centers, pancreatic surgery is still associated with high morbidity rates of up to 50 %. Attention is increasingly directed toward the optimization of perioperative management to reduce complications and enhance postoperative recovery. Currently, two different strategies for postoperative pain management after pancreatoduodenectomy are being routinely used: patient-controlled intravenous analgesia and thoracic epidural analgesia.

The diagnosis and treatment of acute pulmonary embolism.

Background: Pulmonary embolism (PE) is a cardiovascular emergency with high morbidity and mortality.

Methods: Review of relevant literature retrieved by a selective Medline search, including current guidelines.

Results: Hemodynamically unstable patients are considered to have high-risk PE, whereas hemodynamically stable patients are considered to have non-high-risk PE.

Crystalloid/colloid versus crystalloid intravascular volume administration before spinal anesthesia in elderly patients: the influence on cardiac output and stroke volume.

Background: Hypotension is the most common cardiovascular response to spinal anesthesia. We compared the effects of crystalloid/colloid versus crystalloid administration before spinal anesthesia on cardiac output (CO) in elderly patients undergoing transurethral resection of the prostate.

Methods: Sixty male ASA I-III patients were randomized to one of three groups the control group received no intravascular volume preload, the saline group received 500 mL saline, and the hydroxyethyl starch (HES) group received 500 mL of saline plus 500 mL of 6% HES 130/0.

[How to judge a good anaesthesia from a bad one - a critical review of recovery scores and other techniques to assess the result quality of anaesthesia procedures].

Patients, general public and health insurance funds focus more and more on the quality of medical performance. Anaesthesia related severe morbidity and mortality are unsuitable to judge the quality of an anaesthesia procedure. Other aspects like rapid and comfortable postoperative recovery or satisfaction of the patients with the anaesthesia procedure experience therefore rising attention.

Short-term sevoflurane sedation using the Anaesthetic Conserving Device after cardiothoracic surgery.

Objective: We evaluated the procedure of postoperative inhalational sedation with sevoflurane using the Anaesthetic Conserving Device (ACD) with regard to recovery times, feasibility and consumption of anaesthetics in comparison to propofol.

Design And Setting: Prospective, randomised, single-blinded, controlled study in a surgical intensive care unit (ICU) of a 1,000-bed academic hospital.

Patients And Interventions: A total of 70 patients after elective coronary artery bypass graft surgery either received sevoflurane via ACD (n = 35) or propofol (n = 35) for short-term postoperative sedation in the ICU.

Bispectral index-guided general anesthesia in combination with thoracic epidural analgesia reduces recovery time in fast-track colon surgery.

Background: The impact of bispectral index (BIS)-guided general anesthesia on recovery from general anesthesia has been evaluated in different patient populations. The benefit of using BIS has been inconsistent. We designed this study to examine the value of BIS-guided anesthesia in a fast-track setting where the goal is rapid recovery.