Annales chirurgiae et gynaecologiae
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The metabolic response to major thermal injury is characterized by gross hypermetabolism with increased basal metabolic rate, increased oxygen consumption, negative nitrogen balance and weight loss. Failure to provide burn patients with sufficient exogenous caloric and nitrogen intake results in catabolic sequelae; impaired wound healing, severe disturbances in regulation of cardiovascular, pulmonary and hepatorenal functions, as well as decreased resistance to infections leading to overt septic episodes. Vigorous nutritional therapy is therefore essential for the survival and optimal care of burn victims. In addition to enteral nutrition -- either by the oral route or with the help of tube feeding, parenteral nutrition is usually required to satisfy the extremely increased energy and protein requirements of the severely burned patient.
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Randomized Controlled Trial Clinical Trial
Epidural anaesthesia with mixtures of bupivacaine-lidocaine and etidocaine-lidocaine.
The mixtures of 0.5% bupivacaine- 1% lidocaine and 1% etidocaine- 1% lidocaine were used in a double-blind manner for lumbar epidural anaesthesia in 48 patients undergoing prostatectomy in order to study whether these mixtures speed up the onset of analgesia, shorten the long motor block, motor block, or improve the quality of analgesia caused by bupivacaine or etidocaine alone. The mixture of bupivacaine-lidocaine caused an analgesia with a somewhat faster onset, similar duration and markedly shorter motor block than bupivacaine alone. ⋯ The analgesia was complete in all 12 patients who received bupivacaine and in 11/12 patients who received the mixture of bupivacaine-lidocaine, but 6/12 patients anaesthetized with etidocaine and 5/12 patients with the mixture of etidocaine-lidocaine experienced considerable visceral pain during the operation. The results suggest that the mixture of bupivacaine-lidocaine produces a block with somewhat better properties than bupivacaine alone, but the mixture of etidocaine-lidocaine does not offer any advantages as compared to etidocaine alone, except the shorter motor block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of lysine acetylsalicylate and oxycodone in postoperative pain following upper abdominal surgery.
Intravenous lysine acetylsalicylate (LAS) and oxycodone were compared under double-blind conditions for analgesia after upper abdominal surgery in sixty patients anaesthetized by N2O--O2--halothane--relaxant technique. Either 125 mg/10 kg or 250 mg/10 kg LAS or 0.4 mg/10 kg or 0.8 mg/10 kg oxycodone was randomly administered when the patients complained of moderate or severe postoperative pain. When 30 min had elapsed following the injection of the test drug, oxycodone was given in 4 mg increments on demand until adequate pain relief was achieved. ⋯ However, LAS had a slower onset of action. Sweating seemed to occur more frequently after LAS than oxycodone, but significant changes in respiratory rate or sedation following LAS-oxycodone combinations when compared to oxycodone alone were not noted. The results show that for analgesia after upper abdominal surgery, 1.8 g of LAS may be substituted for about 6 mg of oxycodone.