Eur Rev Med Pharmaco
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Eur Rev Med Pharmaco · Jul 2010
Randomized Controlled Trial Comparative StudyPost-operative analgesia following total knee arthroplasty: comparison of low-dose intrathecal morphine and single-shot ultrasound-guided femoral nerve block: a randomized, single blinded, controlled study.
Total knee arthroplasty often results in marked postoperative pain. A recent meta-analysis supports the use of femoral nerve block or alternatively spinal injection of morphine plus local anaesthetic for post-operative analgesia. On the other hand, the use of intrathecal morphine may be associated with a large number of distressing side effects (itching, urinary retention, nausea and vomiting, delayed respiratory depression). The aim of this study was to compare the effectiveness of femoral nerve block and low dose intrathecal morphine in post-operative analgesia after primary unilateral total knee arthroplasty. ⋯ Our results show that low dose of intrathecal morphine may be safe and more efficient than single-shot femoral nerve block for post-operative analgesia after total knee arthroplasty.
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Eur Rev Med Pharmaco · Jul 2010
Comparative Study Controlled Clinical TrialAcetaminophen plus codeine compared to ketorolac in polytrauma patients.
The management of pain in polytrauma patients is mandatory. While non-steroidal anti-inflammatory drugs (NSAIDs) represent the most used drugs in polytrauma patients, their use may be associated with an increased risk of haemorrhage. Opioids may represent a valid alternative to NSAIDs either alone or in combination with acetaminophen. Whether their efficacy is comparable to that produced by NSAIDs in polytrauma patients has never been studied. ⋯ Acetaminophen plus codeine is effective in pain control in polytrauma patients at least in our series. It may represent a valid alternative to NSAIDs, especially in patients with a documented haemorrhage or with a high hemorrhagic risk.
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Eur Rev Med Pharmaco · Jul 2010
Case ReportsAcute mastoiditis complicated with bezold abscess, sigmoid sinus thrombosis and occipital osteomyelitis in a child.
Acute otitis media complications are relative rare since the introduction of antibiotics. Still many controversies exist on the diagnosis and treatment of some of them. ⋯ The patient responded well to intravenous antibiotics and wall-intact mastoidectomy. We discuss methods of early diagnosis and appropriate treatment options.