Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Nov 2010
Randomized Controlled Trial Multicenter StudyOpiate sparing effect of fixed combination of diclophenac and orphenadrine after unilateral total hip arthroplasty: A double-blind, randomized, placebo-controlled, multi-centre clinical trial.
Multimodal pain management combines analgesics to improve analgesia and reduce side effects. This study investigates the fixed combination of diclophenac and orphenadrin (Neodolpasse(®) Infusion Solution) in patients after unilateral total hip arthroplasty (THA). This prospective, randomized, double-blind, placebo-controlled, multi-centre clinical study enrolled 120 patients receiving patient-controlled analgesia (PCA). ⋯ Analgesia was monitored by visual analogue scale and verbal rating. Infusion of the Neodolpasse(®) Infusion Solution resulted in a significant reduction in the PCA analgesic requirements by approximately 30% (38.7 ± 21.3 mg vs. 55.9 ± 31.1 mg; p = 0.0004) while maintaining adequate analgesia and patient safety. This study demonstrates that Neodolpasse(®) Infusion Solution significantly reduces PCA analgesic requirements without compromising analgesic effectiveness and safety in THA patients.
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Wien Med Wochenschr · Nov 2010
Review Comparative Study[Possibilities in oncoplastic and reconstructive surgery for patients with breast cancer].
Although systemic treatment strategies are improving continuously, breast surgery still plays a central role in the management of breast cancer. Because breast conserving therapy is feasible in more than two thirds of breast cancer patients, breast surgeons should be aware of the different oncoplastic techniques. The development of skin sparing techniques combined with immediate reconstruction provides good cosmetic results in many cases in which mastectomy is required. Therefore the reconstructive element should be offered and integrated in the therapy plan as soon as mastectomy is indicated.
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Complete axillary lymph node dissection has been the traditional operation to determine whether cancer has spread beyond the breast. In the large majority of patients with breast cancer, lymphatic mapping and γ-probe-guided and/or blue dye sentinel node biopsy can be used to locate the first node in the axilla, and thereby provide important information about the status of axillary nodes. ⋯ Thus, they may be spared complete axillary dissection if the sentinel node is negative. Decreased arm swelling and pain are associated with sentinel lymph node biopsy compared with axillary lymph node dissection.