This updated second edition of Gupta and Gelb's Essentials of Neuroanesthesia and Neurointensive Care contains the ideal combination of updated information for the practitioner, presented in easy-to-digest short chapters. With an essential clinical focus on key neuroanesthesia and neurointensive care knowledge, it is a practical guide for any practitioner of neuroanesthesia, beginner, occasional or experienced. The user-friendly format contains bullet points to ensure retention of important data, key points to summarize the take-home messages, suitable images to enhance understanding, and pertinent and appropriate references to allow for further exploration of the topics. This book is ideal for residents and others undergoing neuroanesthesia training. It is also a great tool for Operating Room nurses and other OR support workers, neurosurgical residents and neurointensive care professionals. This will also be a useful book to supplement knowledge for postgraduate fellowship and Board examinations.

In this issue of Anesthesiology Clinics, guest editors Drs. Philipp Lirk and Kamen Vlassakov bring their considerable expertise to the topic of Orthopedic Anesthesiology. Top experts in the field cover key topics such as rebound pain, anesthesia for the general orthopedic patient, anesthesia and analgesia for the pediatric orthopedic patient, same-day major orthopedic surgery, hip fracture, and more. Contains 18 relevant, practice-oriented topics including perioperative care of the orthopedic patient, including geriatric assessment and follow-up; outcomes after orthopedic and trauma surgery; evidence base for peripheral nerve blocks in orthopedic and trauma anesthesia; alternatives to nerve blockade: pericapsular infiltration and multimodal analgesia; and more. Provides in-depth clinical reviews on orthopedic anesthesiology, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

The anesthesia and intensive care in infants and children have assumed positions of primary importance in contemporary medicine. In these delicate sectors of medicine, clinical research activities must be continually supported by interdisciplinary collaborations. Neonatal and pediatric intensive care requires that all involved physicians, including the surgeon and anesthesiologist, be willing to work together as a team. However, coordination of the various pathophysiological and clinical aspects of neonatal and pediatric critical medicine is highly complex. A complete and current review of the anaethesia and intensive care of infants and children must include discussions of morbidity rates, so as to guide the clincians in choosing the diagnostic approach, as well as of monotoring techniques appropriate to support the therapeutic decision. Recent progress in intensive care medicine for infants and children has been significant.

Sepsis represents a life threatening condition to ICU patients. The evolution of sepsis to severe sepsis or septic shock may occur in an unpredictable way. In the coming millennium the prevention and management of sepsis and organ dysfunction will present a real challenge for researchers and clinicians.

The management of the critically ill patients has been in the past few years a discipline at the forefront of development which continues to make progress with the support of basic and clinical research. This work is a collection of material that deals with the management of critically ill patients, published on the occasion of the 13th APICE congress in November 1998, which celebrated 40 years of Critical Care Medicine.

The management of critically ill patients has, in the past few years, been a discipline at the forefront of development which continues to make progress with the support of basic and clinical research in the broadest sense. The application of biotechnology in this particular area has revealed itself to be essential in an attempt to provide the best interpretation of the bio-humoral and functional alterations present in a long series of often complex clinical conditions. The care of the critically ill is also at the forefront in the application of increasingly sophisticated clinical monitoring systems that also contribute to standardizing certain procedures, establish guidelines, and evaluate the efficacy of therapeutic interventions and their costs

Die Elektrokonvulsionstherapie (EKT), d.h. die Auslosung eines generalisierten Krampfanfalls unter kontrollierten Bedingungen aus therapeutischen Grunden, erlebt seit ihrer Einfuhrung 1938 derzeit beinahe eine Renaissance. Trotz aller Fortschritte der Entwicklung neuer psychopharmakologischer und nicht-pharmakologischer Therapieverfahren bleibt die EKT weiterhin die wirksamste Therapieform fur einige psychiatrische Krankheitsbilder. Moderne Weiterenwicklungen der Anasthesiologie und Intensivmedizin liessen es in den letzten Jahren zu, viele medizinischen Kontraindikationen der EKT zu relativieren und diese Behandlungsform einer grosseren Patientenzahl anzubieten. Erstmals wird fur den deutschen Sprachraum ein Lehrbuch angeboten, das den aktuellen Stand der wissenschaftlichen Erkenntnisse bezuglich der EKT und anderer biologischer nichtpharmaklologischer Therapieverfahren zusammenfasst. Sowohl auf die wissenschaftliche Aufarbeitung des Themas mit der Darstellung neuester Erkenntnisse bezuglich der Grundlagen- und Therapieforschung als auch auf einen umfassenden Leitfaden fur die klinische Praxis wurde besonderer Wert gelegt."

Cancer: Palliative Care examines the nature of the care and support that can be provided to those in need of palliative care and their families. This covers not only the physical treatment, such as pain management, but also the psychological well-being of patients. Health workers, clinicians, specialist nurses and medical students will find a balanced and thoughtful overview of the subject which will be of value in managing patients and helping them to come to terms with their condition.

Post-Operative Recovery and Pain Relief describes the major problems that may be encountered during recovery from anaesthesia and suggest how they may be avoided by careful monitoring, vigilant nursing and sound organization. The behaviour of patients during recovery is influenced by their pre-operative medical condition, by drugs they may receive both pre- and intra-operatively and by the nature of the surgery they have undergone. This updated and revised version of Eltringham's "Post Anaesthetic Recovery" contains sections devoted to each of these areas which reflect the current best practice. Post-Operative Recovery and Pain Relief will be of interest not only to nursing staff working in operating theatres and post-operative care units but also to those working in surgical units, house officers and junior anaesthetists.

Das 4. Heidelberger Symposium uber "Hamostase in der Anasthesiologie" hat es sich zum Ziel gesetzt, fachubergreifend die noch ungelosten Fragen in der Hamostaseologie offenzulegen und auf der Basis einer kritischen Wertung der bekannten Studien klare Handlungsanweisungen fur den praktisch tatigen Arzt zu geben. Die angesprochenen Themen sind haufig in der Klinik auftretende Probleme wie die perioperative Einstellung von Hamophilen, die Betreuung von Patienten mit Massivtransfusion, Protein Z-Mangel, Lungenembolie, Katheterthrombose und Probleme der Gerinnungsanalyse und die Sicherheit von Praparaten mit Gerinnungsfaktoren. Das vorliegende Buch hat es sich zum Ziel gesetzt, den Leser uber die neuen Entwicklungen zu informieren und Anleitungen zum praktischen klinischen Handeln zu geben.

Rontgenthoraxaufnahmen richtig interpretieren

Thoraxaufnahmen, die auf der Intensivstation aufgenommen werden, unterscheiden sich in der Aufnahmetechnik und in den veranderten physiologischen und anatomischen Verhaltnissen von Standard-Thoraxaufnahmen, die am Rasterwandstativ angefertigt werden. Die Interpretation dieser Bilder bereitet selbst erfahrenen Radiologen und Intensivmedizinern haufig Schwierigkeiten.

Der Weg zur korrekten Interpretation: - Rontgen- und Aufnahmetechnik - Strahlenschutz und -belastung - Klinische Problematik und Interpretation von Thoraxaufnahmen auf der Intensivstation.

Neu in der 2. Auflage:

Bildmaterial moderner Aufnahmeverfahren

Indikationsstellung fur CT-Aufnahmen

Vergleich von Projektionsradiographie und Schnittbildradiographie und mogliche Pitfalls

Ein Praxisbuch von Radiologen, Intensivmedizinern und Medizinphysikern zum Lernen und Nachschlagen. Ein Muss fur jeden auf der Intensivstation tatigen Arzt "

There is no ideal analgesic and the most potent drug is not always the best because of its side-effects. Non-opioid analgesics, including the non-steroi- dal anti-inflammatory drugs and the non-narcotic analgesics, play an im- portant role in the relief of a wide spectrum of painful conditions, though they vary in efficacy and safety. This book reviews the role which non-opi- oid analgesics play in the relitff of pain, particularly with regard to post- operative and cancer pain. Emphasis is placed on the clinical indications for the non-acidic analgesic, dipyrone, and its relative safety in comparison to other non-opioid anlgesics. Michael J. Parnham 9 Introductory remarks Klaus A. Lehmann, Department of Anaesthesiology and Operative Intensive Care, University of Cologne, J osef-Stelzmann-Str. 9, D-50924 Cologne, Germany Opioids are considered to be the most potent analgesics for the manage- ment of acute and chronic pain. Much progress has been achieved with respect to their general availability in most countries, and health care per- sonnel have been encouraged to use these drugs more generously in a vari- ety of pain syndromes, including post-operative or cancer pain. The intro- duction of new techniques such as Patient-Controlled Analgesia (PCA) or guidelines such as the WHO ladder concept for cancer pain mangement have considerably increased our knowledge of their benefits and prob- lems.

Dipyrone is widely acknowledged to be an effective antipyretic analgesic with an additional intrinsic spasmolytic activity. It has stood the test of time over the last 75 years in many clinical settings throughout the world. Some 20 years ago, however, concern arose over the implications of isolat ed reports of agranulocytosis following use of dipyrone. Based on these initial cases the Swedish authorities ordered the withdrawal of the drug from the market. Subsequently, dipyrone has been subjected to extensive comparative epidemiological and clinical studies. The results of these in vestigations have allayed the earlier concerns and have shown dipyrone to be a versatile analgesic drug with an overall risk of serious adverse events lower than most other non-opioid analgesics. Based on these results, the Swedish authorities (Lakemedelsverket) have approved the reintroduc tion of dipyrone to clinical use as a valuable contribution to pain treat ment. In connection with this further milestone in the story of the drug, a symposium was held in Stockholm on March 14, 1996, under the chairman ship of Professor N. Rawal to review the current understanding of the ac tion, efficacy and safety of dipyrone. The highlights of this Hoechst symposium emphasize particularly the therapeutic basis for the use of dipyrone in the modern treatment of acute post-operative pain. 9 Mode of action of dipyrone Professor K. Brune, M. D. Erlangen, Germany Most non-opioid analgesic drugs are inhibitors of cydo-oxygenase, the en zyme catalysing the formation of prostaglandins (PGs).

Largely reorganised and much expanded in this second edition, Practice and Procedures brings together in a single volume general methods of pain assessment and presents the wide range of therapies that can be provided by a range of health care disciplines. Authored by a multidisciplinary team of experts, chapters can stand alone for readers looking for a general overview of the methods of techniques for pain management available to them or work to complement chapters in the preceeding three volumes, providing practical procedures and applications in the management of acute, chronic and cancer pain. The book is divided into three parts. Part One covers the principles of measurement and diagnosis, including history taking and examination, the selection of pain measures, diagnostic tests and novel imaging techniques. Part Two discusses the full range of therapeutic protocols available, from pharmacological therapies, through psychological techniques, physical therapy and international procedures, to techniques specific to pain assessment and management in paediatric patients. Part Three provides information on planning, conducting, analysing and publishing clinical trials, with invaluable guidance on the techniques of systematic review and meta-analysis in pain research. Part Four considers the role of multidisciplinary pain management teams, their organization, their place within different health care systems, and how best to manage change when implementing such a service. Part Five concludes the volume, investigating the use of guidelines, standards and quality improvement initiatives in the management of post-operative pain, and discussing the expert medicolegal report.

Covering both the pharmacological and the more controversial non-pharmacological management of pain relief, this comprehensive text, edited by an internationally renowned specialist, provides practical guidance to all involved in this aspect of labour care.

Acute Pain Medicine is the first comprehensive, case-based text of its kind that explores the essential topics of acute pain medicine, including interventional, pharmacologic, and diagnostic considerations. Written and edited under the auspices of the American Academy of Pain Medicine by members of the Academy's Shared Interest Group for Acute Pain Medicine, the text includes an introduction to acute pain medicine and an easily referenced interventional section. Chapters focus on patients experiencing acute pain from either surgery or other medical conditions and include detailed information on the diagnosis and treatment of specific cases in acute pain medicine. The text is rounded out by the complete content of the thoroughly revised Military Advanced Regional Anesthesia and Analgesia Handbook (MARAA II). Although the MARAA handbook gained its reputation as a useful resource for managing the pain associated with battlefield trauma, its beautifully illustrated step-by-step guidance is useful for providing vital acute pain services in all settings. Acute Pain Medicine is an ideal, complete resource for physicians, fellows, and residents managing acute pain patients.

At the APICE '96 research scientists and clinicians were provided with updated guidelines for the treatment of patients with acute and chronic critical conditions. This volume contains 100 chapters,in which the main pathophysiological concepts were reviewed, with special emphasis on the cardiovascular, respiratory, metabolic, and neurologic systems. Special reference is made to the pharmacologic and biotechnologic strategies currently being used to support those vital functions that are affected by severe and sometimes devastating diseases. The topics of infection, sepsis,and SIRS have been reviewed and updated in keeping with the most recent information available, and particular focus has been directed to ethics.

This book is a critical response to a range of problems - some theoretical, others empirical - that shape questions surrounding the lived experience of suffering. It explores how moral and ethical questions of personal suffering are experienced, contested, negotiated and institutionalised. Bodies and Suffering investigates the moral labour and significance invested in actions to care for others, or in failing to do so. It also explores circumstances - personal, political and social - under which that which is perceived as non-moral becomes moral. Drawing on case studies and empirical research, Bodies and Suffering examines the idea of the suffering body across different cultures and contexts and the experience and treatment of these suffering bodies. The book draws on theories of affect, embodiment, the phenomenology of illness and moralities of care, to produce a nuanced understanding of suffering as being located across the assumed borders of time, space, bodies, persons and things. Suitable for bioethicists, medical anthropologists, health sociologists and body studies scholars, Bodies and Suffering will also be of use on health science courses as essential reading on suffering bodies, mental health and morality and ethics issues.

This critical care medicine book substantially differs from others due to the range of peculiarities that characterize it. Since it deals with acute patients in critical conditions, this is, as it were, a 'borderline'book, in the sense that it is intended for those, who, in their activity, need a continuous and in-depth interdisciplinary approach to optimize the quality of the treatments offered to critically-ill patients. This book helps to have a better understanding of the current limits of human intervention and aims at supplying updated guidelines; in particular, it is intended for those who, although having to guarantee continuity and top-quality therapies, must decide when and why the collaboration with and intervention by experts is necessary

Pain in oncology, and especially in patients with advanced disease, is an essential issue which cannot be overlooked. Today, pain is worldwide recognised as a very complex symptom which includes different aspects such as somatic, spiritual, social and psychological pain. Practical and scientific knowledge of pain in cancer should be part of the pre and post training of general practioners and oncologists. This manual reflects the opinion of different authors, contributors to pain clinic. These guidelines cover all different aspects of cancer pain. It responds to a need for information, education and training in the field of diagnosis and treatment of cancer pain. The reader will find useful information and suggestions as how to diagnose and treat pain from a pharmacological, surgical and psychosocial point of vIew. Pain therapy is a very important part of quality of life; due to its relevance, we think that this manual will be a useful tool for all health professionals, and we are grateful to Drs. K. Foley and F. De Conno for their generous contribution in making this effort successful. Alberto Costa Director European School of Oncology Vlll Acknowledgements The European School of Oncology wishes to acknowledge Janssen Pharmaceutica for an educational grant for the sponsorship of this manual. Pain - definitions, classification and pain. Patients who are aware that their causes pain is temporary have a more positive attitude.

INTRATHECAL DRUG THERAPY FOR SPASTICITY AND PAIN is a practical manual for nurses and physician assistants who use Intrathecal Drug Infusion for treating patients suffering from spasticity and chronic pain. This book supplies users of this new technology with the information they need to utilize it effectively, including pump mechanics and the pharmacology of drug delivery. No other book of its kind exists, and its users at the over 100 facilities that use implanted drug delivery have relied solely on the pump manufacturer's manuals. The authors are from a leading center for research and applied use of these pumps and, working with Dr. Richard Penn, have spent years developing the skills necessary to utilize this system efficiently. Dr. Penn, who writes the Foreword, has personally implanted over 3000 pumps.

Das Buch richtet sich vor allem an junge Anasthesiologen und Assistenzarzte auf Intensivstationen, die die Technik der transoesophageale Echokardiographie erlernen moechten, aber ebenso an Kardiologen und Internisten, die Patienten kardiologisch betreuen.

Ein vertieftes pathophysiologisches Verstandnis der respiratorischen Insuffizienz und die technischen Entwicklungen der letzten Jahre haben die Beatmung, uber die reine Substitution bei Atmungsausfall durch zentrale oder periphere Atemlahmung hinaus, zu einer Therapie der respiratorischen Insuffizienz und pulmonaler Erkrankungen werden lassen. Es gibt heute ein breites Indikationsspektrum fur vielerlei Beatmungsverfahren, die von einfachen Atemhilfen bis hin zu komplexen, computergesteuerten Beatmungsmustern und zur Lungenersatztherapie reichen. Dieses Buch enthalt neben den pathophysiologischen Grundlagen eine systematische Darstellung der Verfahren und Gerate und gibt Anasthesisten und Intensivmedizinern wertvolle Hinweise fur indikationsgerechte Entscheidungen.

This monograph presents electric therapy for the reduction of pain in a different way than the classical well known manner to use electric currents of various kinds for this purpose. It started when Melzack and Wall published their theory of pain. But contrary to most researchers, the author looked for a proof which objectively could demonstrate, that electric current would have an influence on nerve fibers conducting pain. Starting from this model of demonstration, an optimal type of current could be selected as well as optimal electrode positions and sizes of electrodes. It is an absolute new approach presenting the results of applying the type of current to more than 17.000 patients suffering from any kind of pain. Anatomic sketches and photo-documentation of electrode positions for many conditions allow the reader to obtain identical degree of pain reduction as the author describes from his great experience. In addition, a brief theoretical introduction and discussion of the influence of weather on pain is given. Practical forms for the management of pain are presented in an appendix. 256 references and a table of suitable apparatus with their essential technical characteristics facilitates correct application of this new principle.