Der Anaesthesist
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Randomized Controlled Trial Comparative Study
[Propofol for paediatric patients in ear, nose and throat surgery. Practicability, quality and cost-effectiveness of different anaesthesia procedures for adenoidectomy in infants].
The aim of this study was an improvement in patient comfort, reduction of anaesthesia costs and room contamination by the use of propofol for adenoidectomy. ⋯ The use of propofol for preschool children undergoing ear, nose and throat (ENT) surgery seems to be advantageous because of less postoperative agitation, emesis and costs.
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Randomized Controlled Trial Comparative Study
[Pharmacodynamics of two different propofol formulations].
Propofol is nowadays available in various lipid formulations. We compared two different propofol formulations with respect to pharmacodynamics, using the EEG and clinical signs. ⋯ The investigated lipid formulations have no influence on the pharmacodynamics of propofol.
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Randomized Controlled Trial
[Video laryngoscopy for modified rapid sequence induction of anaesthesia: Sellick manoever with and without video laryngoscopic control].
There is evidence that cricoid pressure, one of the key elements of rapid sequence induction (RSI) in patients at risk of aspiration, can distort the glottic view obtained by direct laryngoscopy (DL) and consequently impair or delay endotracheal intubation (ETI). The fact that cricoid pressure is applied by an assistant "blindly", i.e. without any visual feedback, is believed to be a contributing factor. Video laryngoscopy (VIL) offers the advantage that both the anaesthetist and the assistant can follow laryngoscopy. This could be useful for ETI during RSI. ⋯ Visualisation of the larynx during RSI can be improved using VIL. Time to ETI is not decreased by use of video laryngoscopy-guided application of cricoid pressure.
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Randomized Controlled Trial Comparative Study
[Acute pain management in proximal femoral fractures: femoral nerve block (catheter technique) vs. systemic pain therapy using a clinic internal organisation model].
The aim of this study was to compare safety and efficacy of catheter-mediated femoral nerve block analgesia with systemic pain therapy in patients with proximal femoral fractures in the pre-operative and post-operative setting using a protocol for coordinating pain management. ⋯ All patients presenting with proximal femoral fractures should receive adequate analgesia within the emergency department even prior to radiographic imaging. Femoral nerve block should be considered as the method of choice. The insertion of a femoral nerve block catheter has the dual advantage of early analgesia permitting repeated clinical examination in addition to continued post-operative pain management. The cumbersome logistics inherent in this technique within the clinical setting limits its practical application. An initial single-shot regional nerve block followed by a systemic post-operative analgesia protocol was considered an appropriate alternative. The execution of safe, consistent and appropriate regional nerve block anaesthesia is reliant on formal guidelines and protocols as agreed by the multidisciplinary teams involved with patient-directed pain management and good clinical practice.
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Randomized Controlled Trial
[Delta(9)-tetrahydrocannabinol and the opioid receptor agonist piritramide do not act synergistically in postoperative pain].
It is concluded from animal experiments that cannabinoid receptor and mu-opioid receptor agonists act synergistically with respect to antinociception. In order to demonstrate this effect under clinical conditions, we conducted a randomized double blind trial with patients after radical prostatectomy. ⋯ We found neither a synergistic nor even an additive antinociceptive interaction between Delta(9)-tetrahydrocannabinol and the micro-opioid agonist piritramide in a setting of acute postoperative pain.