Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1992
Randomized Controlled Trial Comparative Study Clinical Trial[Clinical comparison of various infusion regimens within the scope of postoperative on demand analgesia with fentanyl].
80 patients (ASA I-III, mean age 40-50 years, mean weight 59-68 kg) recovering from major gynaecological surgery (170-200 min) under balanced anaesthesia were randomly assigned to four groups to self-administer intravenous fentanyl during the early postoperative period. PCA devices were ODAC and Prominject with fentanyl demand doses of 34.5 or 34 micrograms, respectively, and lockout times of 1 or 5 min. Concurrent fentanyl infusion was none (group Prom), fixed-rate with 4 micrograms/h (group ODACf), tail-dose, i.e., a fixed-rate infusion with 17 mg/h for a maximum of 60 minutes following a valid demand (group Prom(t)), or adaptive, starting with 4 micrograms/h and being adapted to individual needs depending on total fentanyl consumption in the latest 60-minute period (group ODACa). ⋯ Mean duration of a single fentanyl bolus dose was highly variable, ranging from 58 to 90 min if calculated for the total observation period. Statistically significant differences were found for none of the above mentioned PCA parameters. As a trend, the adaptive-rate infusion strategy was favoured (lowest demand rate, best retrospective pain scores).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1992
[Potential risks of high-dose adrenaline for resuscitation following short-term heart arrest in animal experiments].
We compared the haemodynamic effects of epinephrine 10 micrograms/kg iv (group A, n = 8) and 50 micrograms/kg iv (group B, n = 8) in a porcine CPR-model after 3 min of circulatory arrest induced by ventricular fibrillation. All animals of group A were successfully resuscitated after 4.9 +/- 2.8 min and 2.8 +/- 1.6 defibrillations, in group B only 6 of 8 animals were successfully resuscitated after 6.3 +/- 1.1 min and 4.0 +/- 2.7 defibrillations (Mean +/- SD). ⋯ It is concluded that in acute or short-term cardiac arrest the currently recommended epinephrine dosages are sufficient. Higher doses of epinephrine for CPR seem to be recommendable only after prolonged cardiac arrest and/or during prolonged resuscitation.