Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2000
Randomized Controlled Trial Comparative Study Clinical Trial[Premedication in maxillofacial surgery under total intravenous anesthesia . Effects of clonidine compared to midazolam on the perioperative course].
The effects of the currently favoured preanaesthetic drugs (benzodiazepines, alpha 2-adrenoceptor agonists) on the perioperative course are inadequately investigated for new ways of performing anaesthesia with recently introduced drugs (e.g. remifentanil). Therefore clonidine and midazolam were used for premedication in maxillo-facial surgery under total intravenous anesthesia, and the perioperative courses were analyzed. ⋯ After remifentanil supplemented anesthesia there is, especially in the postoperative period, a benefit in using clonidine compared to the premedication with midazolam.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2000
Clinical Trial[Nasotracheal intubation with laryngeal mask and fiber bronchoscope].
An alternative way to the usual mode of nasotracheal intubation is described. 50 patients had to be intubated nasotracheally for surgical procedures. After induction of anaesthesia and insertion of the laryngeal mask a fiberoptic bronchoscope was nasally inserted during sufficient breathing. After view of the laryngeal mask, it was taken out and a tube via fiberoptic bronchoscope was placed endotracheally. Way and avoidance of complications by this method are described.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2000
Case Reports[Emergency pain treatment--ambulatory intravenous morphine titration in a patient with cancer pain].
Even when the guidelines for cancer pain management are followed, acute severe pain requiring immediate treatment will occur in some patients. Titration with intravenous morphine may provide fast and efficient pain relief and give an indication of the amount of opioid necessary for continuous treatment. In cooperation with a general practitioner we performed an intravenous morphine titration in a patient with severe cancer pain at home. ⋯ No side effects were reported during the titration, and the previous regimen with tramadol 150 mg per day was switched to slow release morphine 300 mg per day. This medication was prescribed by the general practitioner and provided good pain relief until the patient died two weeks later. We conclude that intravenous morphine titration may be performed even in cancer patients at home, adequate monitoring, however, should be available.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2000
Review[Anesthesia in breast feeding. Which restrictions are justified?].
In the last years knowledge of the excretion of drugs into breast milk has increased significantly. But information concerning anesthetic and analgesic drugs seems to be dispersed and limited. This paper describes the pharmacokinetic principles of drug transfer to milk and offers a comprehensive survey for drugs used in the perianesthetic period. ⋯ With the information given in this article the individual duration of breast-milk-free interval can be discussed. Thus it will be possible to anesthetize a breast-feeding mother with minimal risks for the child without giving up the advantages of mother milk. Through careful selection of appropriate drugs even elective operations don't need to be postponed and breastfeeding can be continued as soon as in the immediate postoperative period.