Expert opinion on pharmacotherapy
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The development of guidelines for sepsis management has improved disease survival and reduced treatment costs. Adequate antibiotic therapy is the cornerstone of sepsis treatment. Specific rules should be established in every institution according to its profiles. ⋯ For most septic shock patients, monotherapy is adequate and treatment should be initiated in the first hour after first sepsis-induced organ dysfunction. The drug of choice varies in different situations and choosing the right antibiotic enables better survival, fewer complications and shorter stays in intensive care.
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Expert Opin Pharmacother · Nov 2008
Randomized Controlled TrialPatient-controlled versus continuous anesthesiologist-controlled sedation using propofol during regional anesthesia in orthopedic procedures--a pilot study.
In the present study, we compared patient-controlled (PCS) and anesthesiologist-controlled sedation (ACS) with respect to adverse effects and patient centered outcomes. ⋯ PCS using propofol boluses of 0.25 mg kg(-1), without a lockout interval, appeared to be safe for sedation during knee- and hip replacements, with a high degree of patient satisfaction. PCS and ACS provided comparable satisfaction levels but PCS was associated with lower mean calculated plasma concentrations. Individual propofol consumption and associated plasma levels to obtain satisfactory levels of sedation are highly variable.