Przegla̧d lekarski
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In recent years there has been much progress in the understanding of the pathophysiology of acute pain and analgesic pharmacology. The most important role in postoperative pain management is still played by opioids administered through various modes, including spinal and local ones. ⋯ Paracetamol, owing to its safe therapeutical profile, should be the primary postoperative pain management tool in a majority of surgical procedures. A combination of opioids, NSAIDs and paracetamol in order to relieve pain allows both for a significant reduction in the dosage of respective drugs, fewer side effects and an improved pain relief.
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We present a review of our recent experience of operating on infants below 2500 g suffering from congenital heart disease. A retrospective review was performed in 73 children who had undergone cardiac operations at our institution from 1990 to 1999. There were 43 (59%) females and 30 (41%) males; the mean age at operation was 28 days (range 4 to 92). ⋯ A higher mortality rate was noted in premature children and in children who had undergone palliative procedures. At a 1-116-month follow-up (mean 39 months), of 57 (93.4%) patients, 46 (80.7%) were in NYHA class I and 11 (19.3%) in NYHA class II. In conclusion the authors believe that early intervention can be performed in infants below 2500 g, and the associated mortality and morbidity rates are low.
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Historical Article
The history of development and perspectives of breast cancer surgery.