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Because of an ageing population and a relative lack of professionals, the German health system is under great pressure. In rural regions in particular, anesthesiology is also affected - nursing staff, anesthetists, intensive care physicians, and emergency physicians often have to be supported by freelancers from other regions and from abroad - at least periodically. In addition to the increasing number of treatments, the potential quality of therapy is also increasing owing to progress in medical research. Against this background the need for resources is increasing to ensure the optimal quality of treatment. This applies to all clinical disciplines, including all sections of anesthesiology - especially in economically underdeveloped regions where highly qualified experts are lacking. In various cases it is not the physical attendance or manual skills of experts that is primarily requested on-site, but rather their medical expertise and experience. Therefore, telemedicine systems are suitable for closing these gaps very effectively and efficiently. In the various anesthesiological sub-sections the number of scientific papers published to date varies. For anesthesia and pain therapy only a few telemedical applications or concepts have been reported in the literature. However, in tele-intensive care medicine and tele-emergency medicine several national and international research projects have successfully been carried out, leading to established routine systems in some cases.

Background: The goal of the present study was to evaluate the publication rate of abstracts presented during the German Anesthesia Congress (Deutscher Anästhesiecongress, DAC) and the meeting of the European Society of Anesthesiologists (ESA) in the years 2000 and 2005 in Medline listed journals (http://www.ncbi.nlm.nih.gov/pubmed). In addition, the respective impact factors of the journals in which the articles were published were evaluated (http://www.isiknowledge.com)., Methods: All abstracts of free papers and posters presented at the DAC and ESA from the years 2000 and 2005 were included into the study. The presence of authors and the topics of abstracts in the literature were analyzed by a Medline based inquiry over a time period of 5 years. The search was based on the last name and initials of authors and when these could not be identified in Medline the search was extended by keywords of relevant topics of the abstract. Umlauts "ä/ö/ü" were replaced by "ae/oe/ue" and "ß" was replaced by "ss". Only original papers were included in this analysis. Once an original paper was found the impact factor of the journal in that year was identified., Results: A total of 465 abstracts from the DAC 2000, 378 abstracts from the DAC 2005, 644 abstracts from the ESA 2000 and 720 abstracts from the ESA 2005 were included. Of the abstracts from the DAC 2000, 183 (39%) were published in Medline listed journals, 179 (47%) from DAC 2005, 218 (34%) from ESA 2000 and 233 (32%) from ESA 2005. The ESA abstracts were published in English more often than the DAC abstracts (ESA 2000: 95%; ESA 2005: 95%; DAC 2000: 78%; DAC 2005: 86%). While the publication rate after the ESA remained nearly unchanged between 2000 and 2005, the publication rate after the DAC increased by about 7%. The average impact factors of the publications were 1.777 (DAC 2000), 2.836 (DAC 2005), 1.825 (ESA 2000) and 2.36 (ESA 2005). Independent of the congress (DAC or ESA) where the abstract was presented, most articles were published in the journal Anesthesia & Analgesia., Conclusion: In the year 2005 more abstracts of the DAC were published in Medline listed papers than in 2000. When comparing the number of abstracts published in Medline listed journals, more abstracts of the DAC were published compared to abstracts of the ESA. The increase in papers written in English after abstract presentation on the DAC is mostly due to the wider readership which can be reached with manuscripts in the English language. Besides a larger readership, English journals often also have a higher ranked impact factor. This analysis does not claim to be a complete registration of all published abstracts due to the limitation on Medline listed journals and publications in other journals were not rated. Medline was selected because of the widespread and international use of this database.

Background: To evaluate the publication rate of abstracts presented during the German Anaesthesia Congress (DAK) in MEDLINE-listed journals in comparison to the publication rate of abstracts presented during the meeting of the European Society of Anaesthesiologists (ESA)., Methods: All abstracts of free papers (FP, orals) and posters of the 1994 DAK and the 1994 ESA meeting were included. Over a period of approximately 7 years (1993 to May 1999) the appearance of authors and abstracts topics in the literature were searched with the help of MEDLINE. Only original papers were included in the analysis., Results: All 322 abstracts (268 FPs and 54 posters) of the DAK and all 244 abstracts (81 FP and 163 posters) of the ESA were analyzed. A total 122 of the DAK abstracts (37.9% of all abstracts) and 111 of the ESA abstracts (45.5% of all abstracts) were published in MEDLINE-listed journals. Posters presented at the DAK were as published often (37%) as were oral presentations (38%). Of the 122 abstracts of the DAK that were published 71 (58.2%) were published in English (in 38 different journals) and 51 (41.8%) were published in German (in 8 different journals), whereas 102 (92%) of the ESA abstracts were published in english (in 42 different journals)., Conclusion: The overall portion of abstracts of the DAK published in MEDLINE indexed journals within 7 years was disappointing. The reasons for this may include deliberate avoidance of a publication (e.g. due to lack of interest to publish, no time) or low quality of the abstract that hinders publication in a MEDLINE indexed journal.

Every action taken by a physician comes under the jurisdiction of the courts. The physician is sentenced when he offends against the duties of care, set down by the respective standard, or when he carries out treatment without having first obtained the patient's consent. Using the examples of many decisions made by the chief justice and the supreme court relating to the field of anaesthesia, this paper sets out to indicate which rules on diligence apply in this area. In the second part, 14 guiding principles on the physician's obligation to obtain informed consent are set out. The burden of proof for fulfillment of this obligation lies with the physician. The final part of the paper is a discussion of the documentational obligations, which are important for litigation on the physician's liability. A description of a variety of topics from a physician's everyday work is also given.