Folia medica Cracoviensia
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Folia medica Cracoviensia · Jan 2001
Clinical Trial Controlled Clinical Trial[Mivacurium--use for complications of facial-cranial surgery--personal experience].
The aim of this study was to evaluate the effectiveness of mivacurium (Mivacron--GlaxoWellcome) during combined general anaesthesia in the operations on the facial cranium, after tracheal intubation performed using suxamethonium chloride (Chlorsuccillin--Polfa PL). We examined 20 patients, 17-65 years old, who were underwent operations due to facial and neck neoplasms or trauma. Patients were divided into two 10-person groups. ⋯ By 4 patient with heart failure prolongation of the activity time of Mivacurium was observed. The dose of 0.1 mg/kg, is efficient to maintain of the neuromuscular block on the stabile level. This allows the reduction of the total dose, and the decrease of the costs of the operation.
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Folia medica Cracoviensia · Jan 2001
ReviewEvaluation on the effectiveness of perioperative nutritional therapy.
In the last three decade very important advances in venous access, enteral feeding techniques and parenteral and enteral nutrient formulations have made it possible to provide sufficient nutritional support to almost all patients. The clinical nutritional therapy became a progressive medical subspecialty. Despite the widespread use of nutritional management of different patient groups, many fields of nutritional support remain controversial. ⋯ The historical background and development of perioperative artificial nutritional therapy are cited. Whenever possible, prospective randomised clinical trials (PRCTs) are evaluated because this is the most reliable method for evaluating clinical efficacy of a treatment. The incidence of postoperative complications, the length of postoperative hospitalisation and the mortality are considered good general indicator of effectiveness of perioperative nutritional therapy.
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Folia medica Cracoviensia · Jan 2001
Review Comparative Study[Point systems for evaluating coma in patients with injuries of the central nervous system (CNS)].
Paper reviews various coma scales which are used to monitor consciousness after sustaining severe injuries of CNS. Glasgow Coma Scale, at present the most frequently used, was compared to recently developed scales, which are more useful for monitoring persistent comas, allows to evaluate discrete changes in patient's state more precisely and to predict the outcome. The necessity of evoked potentials' measurements, such as Trigeminal-Auditory Glasgow (Coma Scale) has been stressed.
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Folia medica Cracoviensia · Jan 2001
Clinical Trial Controlled Clinical Trial[Does intravenous administration of magnesium have an effect on postoperative analgesia?].
The study involved 67 patients operated for malignant tumours of stomach and of the colon. The patients have been divided into 3 groups: the NORMO group--20 patients in whom the serum magnesium level remained normal during the whole period studied; the HYPO group--22 patients who developed hypomagnesaemia in the postoperative course; the MAG i.v. group--25 patients who on the day of surgery and on 4 days following surgery, received intravenously daily doses of 2.5 ml of 20% MgSO4 per each 500 ml of transfused fluids. ⋯ In all three groups, the daily amounts of morphine and noramidopirine received by patients was the same. The intravenous administration of daily doses of 8 to 14 mmol magnesium in the postoperative period does not affect the amount of analgesics given to patients.
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Folia medica Cracoviensia · Jan 2001
Arterial to end-tidal carbon dioxide difference during craniotomy in severely head-injured patients.
Clinical data suggest that cerebral blood flow (CBF) can be abnormally low within the first four to eight hours after severe head injury (SHI). An aggressive hyperventilation can additionally worsen CBF and provoke cerebral ischemia. Therefore an accurate PCO2 monitoring in SHI patients (pts) is necessary. ⋯ No relationships between P(a-et)CO2 and pts age and mean arterial pressure were found. P(a-et)CO2 was higher in normocapneic pts than in hyperventilated ones and tended to decrease with an increase in heart rate. We can conclude that during an acute craniotomy in SHI pts, PetCO2 does not reflect accurately PaCO2 and the monitoring of adequacy of ventilation should be based on repeated or continuous measurements of an arterial PCO2.