Search results for "Pain"
showing 10 items of 6371 documents
Available Instruments to Assess Pain in Infants
2021
Pain assessment in newborns and infants is challenging for clinicians. Although behavioral and behavioral-physiological scales are validated pain assessment instruments, their use in this age group has significant limitations. In this review, we summarize the methods currently available for assessing pain in neonates and infants. It is possible that these pain detection methods are also useful for assessing the quality of anesthesia and analgosedation in these populations. Further research should be aimed at confirming the usefulness of these tools in infants and identifying additional pain assessment options for clinical practice.
A double blind placebo-controlled study on the rectal administration of morphine as a premedication in abdominal hysterectomy
2000
Abstract Benzodiazepines are now commonly used as anxiolytic premedication prior to surgery. However, the role of opioids, as a premedication, has diminished over the last decades and they are no longer routinely used for premedication. Rather, opioids are generally used to treat severe pain in the postoperative period. Studies have shown that both NSAIDs and opioids improve analgesia in the early postoperative period. Until now, there have been no studies investigating the effect of morphine as a rectal premedication in adults in combination with blood levels of morphine. The effect of a rectal premedication with 30 mg of morphine sulphate, on postoperative pain levels and opioid consumpti…
Analgosedierung bei neurochirurgischen Intensivpatienten
1990
Different concepts for analgosedation of neurosurgical patients are recommended during postoperative ventilation. In 30 neurosurgical patients (2 groups of 15 patients), we studied a continuous i.v. application of alfentanil (Rapifen) and midazolam (Dormicum) compared to an application of continuously given alfentanil with discontinuously given midazolam. A good analgosedation (i.e. sufficient sedation with good neurological judgement) was more frequently achieved (8/15 patients) by continuous application of both substances (alfentanil 0.023 mg/kg b.w./h, midazolam 0.10 mg/kg b.w./h), compared to discontinuous application of midazolam (4.5/15 patients; alfentanil 0.028 mg/kg b.w./h, midazol…
Current state of critically ill patients sedation with volatile anesthetics. Its role in renal and hepatic toxicity
2013
Summary The anesthetic-conserving device (AnaConDa™) facilitated, from a technical viewpoint, the routine use of volatile anesthetics in intensive care patients using ICU ventilators. To date, its use is currently time-limited by clinicians due to the potential renal and hepatic toxicity associated with the production of plasma fluoride after its metabolism, despite its advantages. We reviewed the available human and animal studies literature examining the use of volatile anesthetics as sedative agents and its role in renal and/or hepatic toxicity. We have very few studies concerning the prolonged administration of sevoflurane through the AnaConDa™ and its effect on renal and hepatic functi…
1-Year Outcomes of FFRCT-Guided Care in Patients With Suspected Coronary Disease
2016
Abstract Background Coronary computed tomographic angiography (CTA) plus estimation of fractional flow reserve using CTA (FFR CT ) safely and effectively guides initial care over 90 days in patients with stable chest pain. Longer-term outcomes are unknown. Objectives The study sought to determine the 1-year clinical, economic, and quality-of-life (QOL) outcomes of using FFR CT instead of usual care. Methods Consecutive patients with stable, new onset chest pain were managed by either usual testing (n = 287) or CTA (n = 297) with selective FFR CT (submitted in 201, analyzed in 177); 581 of 584 (99.5%) completed 1-year follow-up. Endpoints were adjudicated major adverse cardiac events (MACE) …
Applying Modern Pain Neuroscience in Clinical Practice: Criteria for the Classification of Central Sensitization Pain
2014
Background: The awareness is growing that central sensitization is of prime importance for the assessment and management of chronic pain, but its classification is challenging clinically since no gold standard method of assessment exists. Objectives: Designing the first set of classification criteria for the classification of central sensitization pain. Methods: A body of evidence from original research papers was used by 18 pain experts from 7 different countries to design the first classification criteria for central sensitization pain. Results: It is proposed that the classification of central sensitization pain entails 2 major steps: the exclusion of neuropathic pain and the differentia…
Akute emphysematöse Cholezystitis als Ursache eines Pneumoperitoneums
2008
A 48-year-old man developed progressively more severe epigastric pain, pain on pressure in the right upper abdomen and fever up to 38.6 degrees C so that acute cholecystitis was suspected. Ultrasound did not demonstrate a gall-bladder but a sickle shaped, dense echo with a distal adjoining echo-free zone. Computed tomography revealed air in the gall-bladder lumen as well as intramural and pericholecystic air pockets, findings pathognomonic for emphysematous cholecystitis. In addition pneumoperitoneum was diagnosed. Subsequent cholecystectomy intraoperatively revealed a gangrenous, nonperforating gall-bladder in which E. coli was demonstrated. During the first postoperative week, there were …
AIRWAY MANAGEMENT IN TRAUMA PATIENTS
1999
Complications related to airway management in traumatized patients are common and, because of the importance and vulnerability of the ventilatory system, can be life threatening within a very short time. 25,39,48 Therefore, airway management is perhaps the most vital component in the treatment of traumatized patients. Patients who have suffered major trauma can present the most complex airway management problems, especially in the prehospital setting. 19 Because the treatment is time-critical, the evaluation of injuries is usually incomplete at the time airway management is undertaken. If the airway is injured, attempts to secure the airway by performing endotracheal intubation or insertion…
The “Jacobsen Flap” for the Treatment of Stage III–IV Dupuytren’s Disease at Little Finger: Our Review of 123 Cases
2011
For selective fasciectomy in patients with Dupuytren’s disease at Tubiana Stage I–II, midline longitudinal incisions with serial Z-plasties, Bruner zigzag incisions, and V-Y plasties over the palm and most severely affected fingers are accepted methods. Advantages of these approaches are good intraoperative visualization of the fibrous tissue, rapid dissection, minor tissue trauma, and usually the possibility of a tension-free wound closure (Brenner and Rayan 2003). In cases of Dupuytren’s disease at Stage III and IV, with severe digital flexion, inelastic overlying skin, and expected skin shortage after contracture release, these incisions may sometimes be useful, but in our experience, qu…
The study on the importance of effects after the ultrasound use in the recovery of patients with lower lumbar discopathy
2018
The low back pain is a public health problem, affecting the adult population and the young one. It is estimated that 90% of the population will experience at least one episode of lower lumbar pain during their lifetime, half of whom may have a second painful episode during the same year. Frequently, the mechanical cause (the pain is somatic and deep, caused by lesions in the musculoskeletal tendon or ligament, in non-specific degenerative or inflammatory diseases) but also the psychosocial factors are incriminated. In low back pain, ultrasounds were used for the analgesic effect, muscle relaxing and for the hyperemia effect. The paper has as purpose the study of the effects of applying ultr…