Acta clinica Croatica
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Acta clinica Croatica · Jun 2009
Clinical TrialThe efficacy of gabapentin in migraine prophylaxis: an observational open label study.
Migraine is often a chronic and disabling disorder. The objective of our study was to assess the efficacy and safety of gabapentin in the prophylaxis of migraine in patients refractory to other prophylactic treatments. The study included 67 migraine patients, 55 women and 12 men; 52 patients completed this prospective, open-label study. ⋯ Adverse events were reported by 32/67 (47.8%) patients, in 15 (22.4%) of them causing discontinuation of the drug. The most frequently reported adverse events were drowsiness, dizziness and slowness. Prophylactic treatment with gabapentin was found to be associated with a significant reduction in the number of days with headache, use of acute medications and pain intensity.
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Acta clinica Croatica · Mar 2009
Randomized Controlled TrialThe analgesic effect of magnesium sulfate in patients undergoing thoracotomy.
Magnesium can act as an adjuvant in analgesia due to its properties of calcium channel blocker and N-methyl-D-aspartate antagonist. The aim of our study was to determine if magnesium sulfate reduces perioperative analgesic requirements in patients undergoing thoracotomy procedure. Our study included 68 patients undergoing elective thoracotomy that received a bolus of 30-50 mg/kg MgSO4 followed by continuous infusion of 500 mg/h intraoperatively and 500 mg/h during the first 24 hours after the operation, or the same volume of isotonic solution (control group). ⋯ The measured VAS score at all intervals was similar in both groups. Postoperative TORDA scores were similar in both groups during the first 24 hours; however, a statistically significant difference was recorded in 40-48 h measurements. Results of our study revealed that magnesium reduced intraoperative analgesic requirements and also contributed to effective control of the static component of postthoracotomy pain.
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The aim of the study was to determine duration of delirium in patients with acute stroke according to sex, age, type and localization of lesion. We assessed delirium prospectively in a sample of 233 consecutive patients with an acute (< or =4 days) stroke using the Delirium Rating Scale (DRS-R-98) and Diagnostic and Statistical Manual of Mental Disorders (DSM IV). The average duration of delirium was 4 days in patients with ischemic stroke and 3 days in patients with hemorrhagic stroke. ⋯ Mortality rate was significantly higher in patients with delirium in the acute phase of stroke than in those without delirium (p=0.009). In conclusion, delirium is a temporary manifestation in two thirds of patients in the acute phase of stroke. Patient sex and age, and type and stroke localization have no influence on delirium duration.
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Damage to the somatosensory nervous system poses a risk for the development of neuropathic pain. Such an injury to the nervous system results in a series of neurobiological events resulting in sensitization of both the peripheral and central nervous system. The symptoms include continuous background pain (often burning or crushing in nature) and spasmodic pain (shooting, stabbing or "electrical"). ⋯ Opioid analgesics can provide some relief but are less effective than for nociceptive pain; adverse effects may prevent adequate analgesia. Topical drugs and a lidocaine-containing patch may be effective for peripheral syndromes. Sympathetic blockade is usually ineffective except for some patients with complex regional pain syndrome.
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Acta clinica Croatica · Jun 2008
Comparative StudySuperficial versus combined (deep and superficial) cervical plexus block for carotid endarterectomy.
It is not clear if any technique of regional anesthesia for carotid endarterectomy has an advantage over another. Therefore, we analyzed analgesic efficacy side effects and complication rate in patients undergoing carotid surgery either under combined (deep and superficial) or superficial cervical block alone. Data on 324 patients that received either combined (n = 107) or superficial (n = 216) cervical block were prospectively analyzed. ⋯ Accordingly combined block provided a slightly better analgesia during the surgery which was probably clinically irrelevant. There was no difference in postoperative analgesia and hemodynamic stability. So far, this is the largest prospective study in which superficial cervical block was found to be as efficacious as combined block which is associated with a considerably higher risk of complications.