Ugeskrift for laeger
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Ugeskrift for laeger · Jan 1994
Review[Opioid analgesics in the treatment of non-malignant chronic pain].
Opioid sensitivity, residual pain, development of tolerance, physical and psychological dependence are described and discussed in relation to long-term opioid therapy. Based on this, guidelines for long-term opioid administration are established for chronic pain conditions of non-cancer origin. The indication must be well-considered--a life-long treatment may be instituted. ⋯ The single dosages should be identical and administered with identical time intervals, which are determined by the duration of action of the drug in use. P.r.n.-administration should not be allowed. Only one physician should be responsible for the treatment and for the prescription of the opioid analgesic drugs.
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Ugeskrift for laeger · Jan 1994
[Efforts of general practitioners in the treatment of heart arrest in a rural area. A prospective pilot study].
During a two year period, general practitioners in a local area were called to all 112 alarms (the number dialled in Denmark in emergencies) in order to improve the prognosis of patients with cardiac arrest. In 55% of the calls, the practitioners arrived within five minutes, whereas the ambulance arrived within five minutes in only 16% of the cases (p < 0.01). Three of ten patients with cardiac arrest survived without cerebral damage. In 23% of the cases final treatment was completed by the local practitioner.
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Ugeskrift for laeger · Jan 1994
Comparative Study[Knee arthroscopy under local anesthesia with or without anesthesiologic assistance. A cost-benefit analysis].
The benefit of anaesthesiological assistance during arthroscopy of the knee in local anaesthesia was evaluated in a cost-effectiveness analysis. One hundred consecutive patients had arthroscopy of the knee performed in local anaesthesia without anesthesiological assistance. In 15% of the cases the arthroscopy was insufficient because of pain reaction. ⋯ The cost for this procedure, including the costs of possible general anaesthesia were calculated to Dkr. 2458. Any significant difference in the sensation of pain during the arthroscopy could not be demonstrated between the two groups. Based on this study it is recommended that arthroscopy of the knee in local anaesthesia is planned without anaesthesiological assistance.
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Ugeskrift for laeger · Jan 1994
Case Reports[Treatment of carbon monoxide poisoning. Background and guidelines for oxygen therapy].
Treatment of carbon monoxide (CO) poisoning is still controversial. Standard treatment is pure oxygen either by means of a nasal catheter or oral-facial mask (normobaric oxygen treatment). Since 1960, hyperbaric oxygen (HBO) therapy has been applied in various centres, i.e. treatment in hyperbaric chambers with 100% O2 at 2-2.8 bars absolute pressure. ⋯ Aetiology, pathogenesis and possible sequelae of CO poisoning are reviewed. It is recommended, that all CO-victims, who have been or are unconscious at admission to the emergency ward, should be treated with HBO. In spite of there being comprehensive clinical literature concerning treatment of CO poisoning, there is still a great need for clinically controlled studies.