Der Schmerz
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Many studies investigated patient-controlled analgesia (PCA) in the postoperative period in recovery rooms under anaesthesiologic monitoring but reports on the advantages and indications of PCA in surgical wards are scarce. The aim of this prospective study therefore was to investigate PCA as a routine technique in surgical wards. In particular we were interested in safety and in the efficacy of analgesia. ⋯ We conclude that PCA with piritramide is a safe technique when performed under routine conditions on surgical wards. However, standardized monitoring is mandatory. PCA leads to effective analgesia and consequently to greater comfort of surgical patients in the postoperative period. These conclusions hold only for patients with ASA status I-II who have undergone operations of the types listed above.
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An increasing number of papers deal with immunological factors in headache syndromes such as migraine and cluster headache. The aim of this review is to give an overview of the factors that have been measured and to assess their reliability and relevance for the pathogenesis of these headaches. Most of the studies are handicapped by methodological problems, especially the different classifications of headaches, the lack of adequate controls and methodological problems with the measurement of certain immune parameters. ⋯ Although the immunological changes have been shown to be valid, their pathogenesis in these headaches is unclear. With the increasing recognition of the existence of a neuroimmunologic network, alterations in each system should always be considered to be associated with changes in an other. Acute or chronic pain seems to trigger immunological abnormalities.