[COVID-19 in obstetric anesthesia : Prospective surveillance of peripartum infections with SARS-CoV-2 and peripartum course of disease in affected women].

Background: In the current pandemic regarding the infection with the SARS-CoV-2-virus and COVID-19 as the disease, concerns about pregnant women, effects on childbirth and the health of the newborn remain high. Initially, due to the early manifestation of the disease in younger patients, high numbers of COVID-19 patients in women needing peripartum care were expected.

Objective: This article aims to provide a general overview over the beginning of the pandemic as well as the second wave of infections in Germany and Switzerland, regarding SARS-CoV‑2 positive pregnant women hospitalized for childbirth.

Risks and Benefits of Ultrasound, Nerve Stimulation, and Their Combination for Guiding Peripheral Nerve Blocks: A Retrospective Registry Analysis.

Background: Ultrasound, nerve stimulation, and their combination are all considered acceptable ways to guide peripheral nerve blocks. Which approach is most effective and associated with the fewest complications is unknown. We therefore used a large registry to analyze whether there are differences in vascular punctures, multiple skin punctures, and unintended paresthesia.

Prolonged Catheter Use and Infection in Regional Anesthesia: A Retrospective Registry Analysis.

Background: Prolonged catheter use is controversial because of the risk of catheter-related infection, but the extent to which the risk increases over time remains unknown. We thus assessed the time-dependence of catheter-related infection risk up to 15 days.

Methods: Our analysis was based on the German Network for Regional Anesthesia, which includes 25 centers.

Psoas Versus Femoral Blocks: A Registry Analysis of Risks and Benefits.

Background And Objectives: Psoas blocks are an alternative to femoral nerve blocks and have the potential advantage of blocking the entire lumbar plexus. However, the psoas muscle is located deeply, making psoas blocks more difficult than femoral blocks. In contrast, while femoral blocks are generally easy to perform, the inguinal region is prone to infection.

[Hypercapnic Raised Intracerebral Pressure - Ecmo Therapy Despite Major Intracerebral Haemorrhage].

We report a case of a 29-year-old primigravida asian woman with severe peripartal HELLP-syndrome. During delivery she developed coma. HELLP syndrome, complicated by severe intracerebral hemorrhage was detected.

Single-dose Antibiotic Prophylaxis in Regional Anesthesia: A Retrospective Registry Analysis.

Background: Catheter-related infection is a serious complication of continuous regional anesthesia. The authors tested the hypothesis that single-dose antibiotic prophylaxis is associated with a lower incidence of catheter-related infections.

Methods: Our analysis was based on cases in the 25-center German Network for Regional Anesthesia database recorded between 2007 and 2014.

Awake, sedated or anaesthetised for regional anaesthesia block placements?: A retrospective registry analysis of acute complications and patient satisfaction in adults.

Background: Whether adults should be awake, sedated or anaesthetised during establishment of regional anaesthesia is still debated and there is little information on the relative safety of each. In paediatric practice, there is often little choice but to use sedation or anaesthesia as otherwise the procedures would be too distressing and patient movement would be hazardous.

Objective(s): The objective of this study was to evaluate complications related to central and peripheral regional block and patient satisfaction in awake, sedated and anaesthetised adult patients.

Diabetes: a risk factor for catheter-associated infections.

Background And Objectives: The incidence of infectious complications associated with continuous regional anesthesia techniques is a matter of concern. Our objective was to determine whether patients suffering from diabetes are at an increased risk of catheter-related infectious complications.

Methods: The German Network for Regional Anaesthesia database was analyzed between 2007 and 2012.

Spinal anesthesia protects against perioperative hyperglycemia in patients undergoing hip arthroplasty.

Study Objective: To determine whether spinal anesthesia blunts surgical stress reactions and results in less perioperative hyperglycemia.

Design: Prospective, randomized controlled study.

Setting: Operating room of a university hospital.

What do patients know about anesthesiologists? Results of a comparative survey in an U.S., Australian, and German university hospital.

Study Objectives: To determine patients' knowledge of the role of the anesthesiologist in the hospital.

Design: Prospective survey instrument.

Setting: Three university hospitals (University of Virginia, Charlottesville, VA, USA; St.

Is anesthesia dangerous?

Background: Recent years have seen a rise in overall anesthesia-related mortality.

Method: Selective review of the literature.

Results: Anesthesia-related mortality has fallen from 6.

[Regional anaesthesia and organ protection--the role of thoracic epidural anaesthesia].

Epidural anaesthesia results in a significant reduction of postoperative pain, opioid requirement and opioid related side effects. Additionally a reduction of duration of postoperative ileus and pulmonary complication has been shown, but influence on cardiac morbidity remains contradictory. Effects on mortality and long term outcome after tumor surgery is still a topic of intensive research.

Failed induction of heme oxygenase 1 in endothelial cells exposed to the hemoglobin based oxygen carrier Oxyglobin.

We investigated the effect of the bovine hemoglobin based oxygen carrier HBOC-200 (Oxyglobin) in rat aortic endothelial cells (RAEC) on the activation of heme oxygenase 1 (HO-1). RAEC were incubated in the presence of 75 microM (G1) or 225 microM (G2) HBOC-200. The positive control (G3) was performed by incubation with 50 microM Hemin.

[Epidural anesthesia: step by step to success].

Besides pain management in obstetric patients epidural anaesthesia plays a major role in the perioperative setting. Especially the technique of thoracic epidural anaesthesia (TEA) provides better postoperative analgesia when compared with systemic pain therapy. TEA is associated with improved outcome in high-risk patients and patients undergoing extensive surgery.

Improvement of impaired microcirculation and tissue oxygenation by hemodilution with hydroxyethyl starch plus cell-free hemoglobin in acute porcine pancreatitis.

Aims: To avoid the progression from mild edematous acute pancreatitis (AP) to the severe necrotizing form, one therapeutic option is to improve pancreatic microcirculation and tissue oxygenation. The aim of the study was to evaluate the influence of improved rheology (isovolemic hemodilution) plus enhanced oxygen supply (bovine hemoglobin HBOC-301) on pancreatic microcirculation, tissue oxygenation and survival in severe acute experimental pancreatitis.

Methods: Severe AP was induced in 39 pigs (25-30 kg BW) by stimulation with intravenous administration of cerulein plus a pressure- and volume-controlled 10-min intraductal infusion of glycodeoxycholic acid.

Influence of the hemoglobin solution HBOC-201 on tissue oxygenation in the rat R1H-tumor.

Background: HBOC-201 is an ultra purified bovine hemoglobin solution. It has already been used in clinical phase II/III trials for emergency treatments. Animal experiments have shown that HBOC-201 is highly effective in tissue oxygenation.

No effect of the hemoglobin solution HBOC-201 on the response of the rat R1H tumor to fractionated irradiation.

Background And Purpose: Tumor hypoxia is regarded as one important underlying feature of radioresistance. The authors report on an experimental approach to improve tumor response to radiation by combining fractionated irradiation with HBOC-201, an ultrapurified polymerized hemoglobin solution, which is currently used in clinical phase II/III trials as alternative oxygen carrier and proved to be highly effective in tissue oxygenation (tpO(2)).

Material And Methods: Subcutaneously growing rhabdomyosarcoma R1H tumors of the rat were treated with either 40 Gy (2 Gy/fraction, 20 fractions in 2 weeks, ambient) followed by graded top-up doses (clamped) alone, or in combination with HBOC-201, or with HBOC-201 plus carbogen (95% O(2) + 5% CO(2)).

Enhanced central organ oxygenation after application of bovine cell-free hemoglobin HBOC-201.

Purpose: While the effects of dilutional anemia or isovolemic hemodilution (IHD) on the oxygen extraction and tissue oxygenation in peripheral organs after application of hemoglobin-based oxygen carriers like HBOC-201 have been studied intensively, little is known about tissue oxygenation properties of hemoglobin solutions in central organs like the liver.

Methods: Twelve Foxhounds were anesthetized and then randomized to either a control group without hemodilution (Group 1) or underwent first step isovolemic hemodilution (pulmonary artery occlusion pressure constant) with Ringer's solution (Group 2) to a hematocrit of 25% with second step infusion of HBOC-201 until a hemoglobin concentration of +0.6 g.

A retrospective comparison of costs for regional and general anesthesia techniques.

In this retrospective study, we compared the costs for three different regional anesthesia techniques with the costs of general anesthesia (GA). A total of 1587 anesthesia cases which were performed for orthopedic and trauma patients over a 1-yr period in a tertiary level, university hospital setting were analyzed. The anesthesia technique-related costs were determined calculating case-specific costs for personnel, supplies, and drugs.

Quality of postoperative pain using an intraoperatively placed epidural catheter after major lumbar spinal surgery.

Background: Major spinal surgery is associated with high postoperative pain scores and opioid requirement. The aim of the current prospective, randomized, placebo-controlled, double-blind study was to assess the reduction of opioid requirement and pain scores using an intraoperatively placed epidural catheter with infusion of 0.1% ropivacaine during the postoperative period.

Epidural hematoma after spinal anesthesia in a patient with undiagnosed epidural lymphoma.

Unlabelled: The incidence of hemorrhagic complications after neuroaxial anesthesia is very infrequent. We report a case of a woman developing epidural bleeding 3 wk after performing an uneventful spinal anesthesia at the lumbar level L3-4 for removal of a wire loop in her left knee. No hemostasis altering medication had been taken before and after spinal puncture.

Cost drivers in patient-controlled epidural analgesia for postoperative pain management after major surgery.

Unlabelled: In this retrospective study, we determined efficiency, treatment length, and resource use for postoperative pain management with patient-controlled epidural analgesia (PCEA) in 350 consecutive patients undergoing major abdominal, thoracic, gynecological, or orthopedic surgery. Average pain scores on a visual analog scale were 16 +/- 23 and 9 +/- 16 (visual analog scale range, 0 to 100) on postoperative Days 1 and 3, respectively, and were similar among groups. The treatment length was 4.

Continuous wound infiltration with ropivacaine reduces pain and analgesic requirement after shoulder surgery.

Unlabelled: After achieving a reduction of pain scores for 10 h with a single dose wound infiltration after shoulder surgery, we examined in a prospective, placebo-controlled and double-blinded study the analgesic effects of continuous wound infiltration with different concentrations of ropivacaine. Forty-five patients undergoing shoulder surgery were randomly assigned into three groups to receive single dose wound infiltration with 30 mL saline (group S) or ropivacaine 7.5 mg/mL (groups R2 and R3.

Pre- and intraoperative epidural ropivacaine have no early preemptive analgesic effect in major gynecological tumour surgery.

Purpose: Thoracic epidural analgesia (TEA) is an established technique for postoperative pain relief after major abdominal surgery. However it is still under discussion whether pre-incisional TEA can reduce postoperative pain perception or postoperative analgesic consumption.

Methods: The present prospective, randomized, double-blind study was performed to investigate the effects of intra- and postoperative TEA vs only postoperative TEA using ropivacaine 0.