Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Sep 2014
Sympathetic nerve blocks for the management of postherpetic neuralgia - 19 years of pain clinic experience.
Sympathetic system involvement in postherpetic neuralgia (PHN) has been targeted using peripheral sympathetic nerve blocks for a number of years with variable efficacy. The aim of this report is to present the outcomes of PHN management with concomitant use of pharmacological treatment and sympathetic nerve blocks. ⋯ Major progress in the pharmacological treatment of PHN appears to be an obvious factor contributing to the overall improvement in PHN management (introduction of gabapentin). Nevertheless, safely administered regional anaesthesia techniques, although performed in a very similar manner for many years, appear to provide some support as part of a multimodal approach to PHN management.
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Anaesthesiol Intensive Ther · Sep 2014
Case ReportsSubarachnoid haemorrhage imitating acute coronary syndrome as a cause of out-of-hospital cardiac arrest - case report.
Severe subarachnoid haemorrhage (SAH) is a common cause of cardiac arrest. The survival of patients with out-of-hospital cardiac arrest (OHCA) due to SAH is extremely poor. Electrocardiographic and echocardiographic changes associated with SAH may mimic changes caused by acute coronary syndromes (ACS) and thus lead to delayed treatment of the primary disease. Misdiagnosed SAH due to ACS mask can have an influence on patient outcomes. ⋯ It appears that an urgent CT of the head is the most effective method for the early identification of SAH-induced OHCA, especially in patients with prodromal headache, no history of the symptoms of ACS and CA due to asystole/pulseless electrical activity (PEA). Out-of-hospital cardiac arrest (OHCA) predominantly develops due to acute coronary syndrome (ACS). Extra-cardiac causes, e.g., subarachnoid haemorrhage (SAH), are less common. The purpose of the present case report was to describe a patient with OHCA due to subarachnoid haemorrhage imitating acute coronary syndrome.
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Anaesthesiol Intensive Ther · Sep 2014
Serum procalcitonin is a sensitive marker for septic shock and mortality in secondary peritonitis.
Serum procalcitonin (PCT) is considered to be a sensitive marker for the early recognition of severe infection. The aim of this study was to review the diagnostic accuracy of serum procalcitonin levels to predict the risk of septic shock and mortality in patients with secondary peritonitis. ⋯ An increase in PCT levels is an indirect sign of diffuse secondary peritonitis and this is associated with an increased risk of septic shock. Increased PCT level on admission is associated with an increased risk of mortality in this category of patients.
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The objective of this study was to review all published articles in the English language literature about the coagulation management of epidural corticosteroid injections (ESI) in humans. ESI are among the most commonly used procedures to manage chronic spinal pain, yet there is no conclusive review on the coagulation management of this popular procedure. ⋯ Reports were also located through references of articles. We conclude that even though epidural steroid injection is one of the most used techniques in treating radicular pain, correct management of coagulation is necessary.