Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2004
Review[Pain treatment in neonates, infants and children--is the current treatment sufficient?].
Paediatric patients quite often have to undergo painful or stressful procedures, e. g. blood sampling, dressing of wounds or removal of a drainage. The key problem is to decide if a child has pain or if there are other reasons for crying. Establishing a high standard in an institution requires regular evaluation and documentation of pain scores. ⋯ However, despite successful pain prevention, circumcision remains a stressful procedure for the small patients. Pain treatment per se is not sufficient to relieve all the suffering connected with surgery in children. The concept of balanced analgesia is successful under many circumstances, but continuous efforts are needed to improve the management for difficult situations, e. g. tonsillectomy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2004
[Evaluation of the disability of ventilated patients].
It is very important to investigate the patient's disability and pain. Interviews of intubated and tracheotomised patients were neglected because of inadaequate measuring methods. This is the first prospective study that evaluates the disability and pain of intubated and tracheotomised patients. ⋯ A high disability has to be taken in account in the therapy of intubated and tracheotomised patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2004
Historical Article[100 years of Draeger Medical Technology (1902 - 2002) -- working for the applicability of oxygen].
This survey analyses the history of 100 years of Draeger Medical Technology. Between 1889 and 1902 a number of inventions on the field of pressure gas technology allowed to solve application problems, which until then proved major obstacles to the safe and efficient use of compressed gases such as oxygen, nitrous oxide or carbon dioxide for medical and industrial purposes. ⋯ Consequently, starting in 1902, Draeger Inc. increasingly put an emphasis on developing medical and rescue technology and -- by doing so -- gained an important influence on the history of the implementation of modern oxygen therapy and of inhalative anaesthesia. A survey of the historically most important Draeger-Developments is provided.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2004
[Use of opioids in the elderly -- pharmacokinetic and pharmacodynamic considerations].
Perioperative management of geriatric patients is becoming an important component in anaesthetic practice in the 21st century. This phenomenon is due to the fact that people aged 65 and over are the segment with the fastest growing population. Thus, it is estimated that by the year 2025 20 % of the population in the western hemisphere will be > 65 years of age. ⋯ They include slow titration of opioids to allow for long circulation times, lower total doses because of increased sensitivity, and anticipation of a longer duration of action because of reduced clearance. Since elderly patients present multimorbidity, therapy of chronic pain has to be considered in the light of multidrug intake, which, due to interaction, results in marked side-effects, and a prolonged duration of action. Those opioids should be used which, due to their pharmacokinetic properties, have a reduced volume of distribution, present a low plasma protein binding and finally result in the formation of no pharmacologically active metabolites.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2004
[How did the earth's oxygen atmosphere originate?].
The planet earth did not carry an oxygen atmosphere from the beginning. Though oxygen could arise from radiation mediated water splitting, these processes were not efficient enough to create a global gas atmosphere. Oxygen in the latter is a product of the photosynthetic activity of early green organisms. ⋯ This took billions of years. The basics of the processes of biological oxygen liberation and utilization are described in the following as well as the importance of their steady state equilibrium. Also a hint is given to oxygen as a toxic compound though being a chemical prerequisite for aerobic life on earth.