Ugeskrift for laeger
-
Twenty-seven patients with pain from non-curable cancer, who did not respond to systemic pain treatment with opioids and coanalgesics without the occurrence of unacceptable side effects, were treated with intrathecal infusions. Two patients were treated satisfactorily with morphine alone, while the remainder were given a mixture of morphine and bupivacaine. Complete or good pain relief was reported by 23 patients and some relief by three patients. ⋯ No serious complications were recorded. The treatment of severe cancer pain by intrathecal infusion of morphine and bupivacaine seems to be a promising method. As the adjustment of doses takes some days, and as the main complication, post-spinal headache, occurs early in the course, the method is most suitable for use in patients expected to survive for at least a couple of weeks.
-
Ugeskrift for laeger · Nov 1996
Randomized Controlled Trial Comparative Study Clinical Trial[The combination of oral lysine-acetylsalicylate and metoclopramide compared with oral sumatriptan in the treatment of migraine attacks. A randomized, double-blind, placebo-controlled clinical trial].
A combination of lysine acetylsalicylate (equivalent to 900 mg aspirin) and 10 mg metoclopramide (LAS + MTC) was compared with oral sumatriptan (100 mg) and placebo in 421 patients with migraine in a randomized, double-blind, clinical trial. LAS + MTC was as effective as sumatriptan with a decrease in headache from severe or moderate to mild or none in 57% and 53%, respectively, for the first migraine attack treated, the primary efficacy parameter. Both treatments were better than placebo (success rate 24%, p < 0.001). LAS + MTC was better tolerated than sumatriptan (adverse events in 18% and 28%, respectively, p < 0.05).
-
Ugeskrift for laeger · Oct 1996
[Thoracic electric impedance and fluid balance during aortic surgery].
Indices of fluid balance were evaluated during and after aortic surgery in 16 consecutive patients. Thoracic electrical impedance (TI), heart rate (HR), central venous (CVP), pulmonary artery mean (PAMP), pulmonary wedge (PWP) and mean arterial (MAP) pressures as well as fourteen arterial and venous blood gas variables were followed. ⋯ Of the determined variables only TI revealed a meaningful correlation to fluid balance (rho = -0.41; p < 0.01). The results indicate that while central venous and pulmonary artery mean pressures gave the impression of a volume deficit, the positive fluid balance was mirrored by thoracic electrical impedance.
-
Ugeskrift for laeger · Oct 1996
[Duchenne muscular dystrophy and anesthesia. A retrospective study].
This retrospective study comprising 37 patients with Duchenne's muscular dystrophy undergoing 56 general anaesthesias shows that 1) no atypical reactions occurred when suxamethonium was omitted, that 2) wherever atypical reactions were observed they were always preceded by the use of halothane and suxamethonium. Haemodynamic instability and intubation difficulties were the major complications encountered. Preoperative optimization and cautious anaesthetic practice avoiding suxamethonium and preferably also avoiding potent inhaled anaesthetics is recommended.
-
Centralized trauma care is developing in Denmark, and is producing an increasing interest in the scoring systems used in traumatology. A large number of scoring systems have been developed within the trauma field. After reviewing the literature, we recommend the Revised Trauma Score at strategic intervals during admission, and scoring of the Abbreviated Injury Scale (AIS) according to the 1990 revision at discharge or by autopsy. This will allow calculation of the Injury Severity Scale (ISS) and The Trauma Score--Injury Severity Score (TRISS) making scientific studies in accordance with international standards possible.