Ugeskrift for laeger
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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.
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Ugeskrift for laeger · Dec 1993
Randomized Controlled Trial Clinical Trial[Analgesic effect of 2 different doses of intra-articular morphine after ambulatory knee arthroscopy. A randomized, prospective, double-blind study].
The effect of intra-articular morphine following knee arthroscopy has been verified in several studies, but the optimal dose has not been established. An earlier study by the authors showed significant effect of one mg morphine versus placebo. In this study, fifty patients were randomized to receive either two or four mg of intra-articular morphine following day-case knee arthroscopy in infiltration analgesia. ⋯ The results showed no significant difference in VAS score between the two dose regimes at any time. Onset of pain after cessation of the local analgesia was not influenced by the morphine dose. On this basis it is recommended to limit the dose of intraarticular morphine, as local adverse reactions to morphine cannot be ruled out.
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Ugeskrift for laeger · Dec 1993
Randomized Controlled Trial Clinical Trial[Analgesic effect of low-dose intra-articular morphine after ambulatory knee arthroscopy].
The purpose of this study was to demonstrate the effect of intra-articular morphine following knee arthroscopy performed in infiltration analgesia. Fifty-two healthy patients were randomized to receive either morphine 1 mg or placebo. The pain was assessed two, five, eight and 24 hours after the procedure by 1) a VAS scale and 2) the amount of acetaminophen consumed. ⋯ Stratifying data in therapeutic vs. diagnostic arthroscopy suggests an additional effect of morphine in patients undergoing therapy (0.05 < p < 0.10), an aspect which supports the hypothesis of peripherally administered morphine acting as a potential suppressor of the substance P mediated cytokine cascade. Intraarticular morphine 1 mg after knee arthroscopy offers efficient analgesia lasting more than 24 hours. The method is devoid of side effects and deserves wider recognition.
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Ugeskrift for laeger · Dec 1993
[Patient satisfaction--a study of patients' assessment of the treatment at a department of orthopedic surgery].
A study among day-case and inpatients on an orthopaedic ward has been carried out to assess patient satisfaction. A single-page questionnaire were mailed to 445 patients, 388 (87.2%) returned the questionnaire. Three hundred and fifty five (79.8%) answers were usable. ⋯ The group of patients who underwent arthroscopic surgery were identified as being the most dissatisfied. There were among all patients a large group who were dissatisfied with the amount of perioperative information and especially the amount of postoperative out-patient control. We recommend a higher degree of written information including information about risk of complications and failures.