Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2001
Case Reports[Frozen shoulder--MRI-verified continuous block of suprascapular nerve].
Suprascapular nerve block may provide sufficient analgesia in painful immobilisation of the shoulder joint. In the following case report a 41 year old male presenting with adhesive capsulitis (frozen shoulder) has been treated successfully by performing continuous delivery of local anesthetics to the suprascapular nerve via catheter. The location of the catheter has been verified using MRI examination. ⋯ The technique of catheterization using a nerve stimulator and alternative peripheral nerve blocks are discussed. In summary, continuous suprascapular nerve block offers an advantageous alternative for pain relief in patients with frozen shoulder. It may provide better pain control and earlier discharge in the ambulatory setting than repetetive single dose blocks.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2001
[Do baseline haemoglobin-rates point to the efficacy of blood saving techniques?].
We tested the hypothesis that blood saving techniques are more effective in patients with a low baseline haemoglobin. ⋯ From our data is derived that the likelihood of homologous blood transfusion is greater in patients with a low baseline haemoglobin. However, in case of hip arthroplasty patients with a high baseline haemoglobin also profit from blood saving techniques while in case of knee arthroplasty the efficiency of blood saving techniques in a patient population with a high baseline haemoglobin is negligible. It seems to make sense to evaluate for the different kinds of surgery those patients who profit most from the different blood saving techniques.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Prophylaxis of nausea and vomiting after thyroid surgery: comparison of oral and intravenous dolasetron with intravenous droperidol and placebo].
Postoperative nausea and vomiting (PONV) are among the most common complications in operative medicine. Especially thyroid surgery is frequently associated with PONV. It was the aim of this study to determine the efficacy of oral and intravenous dolasetron in comparison to intravenous droperidol (DHB) and placebo in the prevention of PONV. ⋯ Our results confirm the expected high incidence of PONV after thyroid surgery, especially in female patients. Single doses of oral and intravenous dolasetron and intravenous droperidol reduced PONV effectively in female patients undergoing thyroid surgery. Dolasetron seems to be the more effective substance in male patients. Both substances can be administered safely and are well tolerated.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2001
Comparative Study Clinical Trial Controlled Clinical Trial[Analgesic dosage with (S)-ketamine/propofol vs. (S)-ketamine/midazolam: sedation, stress response and hemodynamics--a controlled study of surgical intensive care patients].
The study was undertaken to investigate the influence of two different regimens of analgosedation on control and quality of sedation, stress response and haemodynamic parameters. ⋯ In surgical intensive care patients, analgosedation with SK/P showed some advantages over SK/M with respect to control and quality. The endocrine stress response was reduced by both regimens in course of time. Altogether higher levels of ADH and noradrenaline during SK/M-analgosedation let expect higher cardiocirculatory stability and possible reduction of catecholamine demand. Due to ketamine-typical beta-activity, a reliable assessment of sedation by the pEEG is not possible.