Ugeskrift for laeger
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Ugeskrift for laeger · Jun 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Reduction of traumatic primary anterior shoulder dislocation under local analgesia].
The aim of the present study was to evaluate the value of local versus intravenous anaesthesia in the reduction of acute shoulder dislocations. Patients with a primary traumatic dislocation of the shoulder were randomized to either local lidocaine or intravenous anaesthesia with pethidine/diazepam. The local method was performed with 20 ml of 1% lidocaine. ⋯ We did not observe any superficial or deep infection in the lidocaine group. There was no statistical difference between the average VAS value in the two groups. Local anaesthesia used to reduce acute primary anterior dislocation of the shoulder is a simple, safe and well-accepted method with significantly fewer respiratory complications.
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Post obstructive pulmonary edema (POPE) is a rare, but potentially dangerous condition. We present two patients with post-anaesthetic POPE. The literature is reviewed and aetiology, risk factors, pathogenesis, symptoms, prophylaxis and management are discussed. ⋯ In severe cases, intubation and mechanical ventilation by respirator with positive end-expiratory pressure is necessary. Further therapy is controversial and without significant effect. With sufficient therapy, almost all patients regain their habitual condition within 24-48 hours and present a normal chest X-ray.
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Ugeskrift for laeger · Jun 1995
Case Reports[Ketamine in the management of intractable phantom pain].
A case of phantom limb pain, which had not successfully responded to a long list of medical therapy or neurosurgery, is presented. After oral ketamine treatment was instituted the patient became free of pain. A possible mode of action is described.
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Ugeskrift for laeger · Jun 1995
Review[Morphine-induced hyperalgesia, allodynia and myoclonus--new side-effects of morphine?].
During the last ten years hyperalgesia (H), allodynia (A) and myoclonia (M) has been reported at an increased frequency in human beings treated with morphine. The side effects are most common in cancer patients treated with high dose morphine, and has been reported for all routes of administration. ⋯ The first mentioned theory is the most likely. The treatment of morphine induced H, A, and M seems to be to discontinue morphine administration and to initiate therapy with other opioids (fentanyl, sufentanyl, methadone or ketobemidone).