Wiener klinische Wochenschrift
-
Wien. Klin. Wochenschr. · Aug 2010
Review[Sedation and analgesia in intensive care: physiology and application].
Many therapeutic and diagnostic procedures in intensive care medicine are perceived as painful by most patients. As a consequence analgesia and sedation represent two of the main pillars in the treatment of the critically ill. Adaptation to the individual needs of the patients poses one of the biggest challenges that we are confronted with. ⋯ In the first part of this review we will discuss the physiology of sleep patterns and pain. Furthermore modes of action and side effects of the most common anesthetics and analgetics will be presented. Finally, the last part of the manuscript deals with the practical application of these therapeutics and their monitoring in intensive care medicine.
-
Wien. Klin. Wochenschr. · Aug 2010
Case ReportsPersistent spontaneous dissection of the left anterior descending coronary artery after emotional pressure.
A 51-year-old woman without cardiovascular risk factors experienced severe chest pain, accompanied by ST-segment elevation in lead II, III, AVF, and V4-V6. An immediately started thrombolytic therapy in a peripheral hospital successfully eliminated the cardiac symptoms and achieved complete ST-segment resolution. ⋯ Due to the small vessel size we decided on conservative therapeutic procedure with acetyl salicylamide, clopidogrel, statin, and beta blocker. Three months later, control angiography presented no resolution of the dissection and the patient showed excellent performance on stress test with no signs of ischemia.