Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of premedication with clonidine and midazolam combined with TCI for orthopaedic shoulder surgery].
The most frequently used drugs for premedication are benzodiazepines and alpha (2)-adrenoceptor agonists. In this study we examined midazolam and clonidine for premedication in combination with target controlled infusion anaesthesia (TCI) in patients undergoing orthopaedic shoulder surgery and analysed the effects on the peri- and postoperative course. ⋯ Premedication with the alpha(2)-adrenoceptor agonist clonidine is as good as with benzodiazepines in combination with TCI. Because of the lower incidence of PONV and the need of piritramid in the postoperative period patients premedicated with 5 microg x kg(-1) clonidine may benefit from this premedication.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Effects of esmolol- and sodium nitroprusside-induced controlled hypotension on hepatocellular integrity in patients undergoing endonasal sinus surgery].
Controlled hypotension (CH) is an established method to reduce intraoperative bleeding. The aim of the study was to investigate the influence of CH induced by sodium nitroprusside (SN) or esmolol on hepatocellular integrity. ⋯ The small but significant increase of alpha-GST in both hypotension groups suggests that hypotension induces a mild damage of hepatocellular integrity.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2003
Review[Phantom limb pain: aspects of neuroplasticity and intervention].
Phantom-limb pain is a common sequel of amputation, occurring in up to 80 % of the amputee population. It must be differentiated from non-painful phantom phenomena, residual-limb pain, and non-painful residual-limb phenomena. ⋯ Special emphasis is put on the role of cortical reorganization in the development of phantom limb pain. Finally, new approaches to the prevention and treatment of phantom limb pain are presented that have a positive influence on phantom limb pain by preventing or reversing cortical reorganization.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2003
Review[Analysis of ventricular fibrillation signals for the evaluation of defibrillation success in the treatment of ventricular fibrillation].
Precise detection of ventricular fibrillation (VF), reliable prediction of defibrillation success and adjustment of the discharge waveform to the patient's transthoracic impedance may contribute to a reduction of electricity-associated myocardial injury caused by unnecessary counter shocks. Specifically, asystole thresholds distinguish between VF and asystole, and thus prevent unnecessary defibrillation attempts. We reviewed various studies and manufacturer characteristics regarding the parameters and algorithms for analyzing arrhythmia ECG signals. ⋯ Analysis of VF ECG signals should allow adequate VF detection as well as prediction of defibrillation success. Suitable asystole thresholds for analysis of ECG signals have to be determined, and the adverse effects of CPR associated artefacts on data analysis have to be reduced. Analysis of VF ECG signals is a precondition of individually optimized defibrillation and may contribute substantially to an increased quality of CPR.