Search results for "anesthesiology"

The EasyTube during general anesthesia for minor surgery

2017

BACKGROUND The EasyTube (EzT) is a supraglottic airway device that is used for emergency airway situations. Ventilation during general anesthesia should also be feasible, but literature on the EzT is scarce. We evaluated the EzT in comparison with the endotracheal tube (ETT) in its use during general anesthesia in a comparative study. METHODS A total of 400 patients with American Society of Anesthesiologists (ASA) physical status I to II scheduled for minor surgery in 4 centers were randomized for ventilation via the ETT or EzT. RESULTS In all patients, the EzT and the ETT could be inserted within 3 attempts. In all EzT patients, the inspiratory and expiratory minute volumes (6.64 ± 0.71 an…

Analgesic Effect of Intravenous Ketamine in Cancer Patients on Morphine Therapy

2000

Pain not responsive to morphine is often problematic. Animal and clinical studies have suggested that N-methyl-D-aspartate (NMDA) antagonists, such as ketamine, may be effective in improving opioid analgesia in difficult pain syndromes, such as neuropathic pain. A slow bolus of subhypnotic doses of ketamine (0.25 mg/kg or 0.50 mg/kg) was given to 10 cancer patients whose pain was unrelieved by morphine in a randomized, double-blind, crossover, double-dose study. Pain intensity on a 0 to 10 numerical scale; nausea and vomiting, drowsiness, confusion, and dry mouth, using a scale from 0 to 3 (not at all, slight, a lot, awful); Mini-Mental State Examination (MMSE) (0-30); and arterial pressure…

Friedrich Wilhelm Ahnefeld

2013

Rapid onset opioids for breakthrough pain: Titrating or not titrating, this is the question!

2011

Abstract Breakthrough cancer pain (BTcP) has been defined as a transitory increase in pain intensity that occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain. Traditional dosing recommendations for BTcP have suggested that the effective dose of oral opioids should be a percentage of a patient’s total daily opioid dose. In the last years a number of new formulations that deliver fentanyl directly through mucous membranes have been developed in an effort to provide a more rapid onset of effect (rapid onset opioids, ROOs). Recent recommendations suggest that the dose of ROOs for BTcP…

Opioid Poorly-Responsive Cancer Pain. Part 2

2001

Basic research in experimental pain models may illuminate the phenomenon of cancer pain that is poorly responsive to opioid drugs. Research findings can be valuable in formulating new strategies in clinical practice. This review evaluated experimental observations in terms of the events that occur in cancer patients receiving opioid therapy for pain.

Spinal neuronal correlates of tapentadol analgesia in cancer pain: A back-translational approach

2014

Background Pain is a common and highly debilitating complication for cancer patients significantly compromising their quality of life. Cancer-induced bone pain involves a complex interplay of multiple mechanisms including both inflammatory and neuropathic processes and also some unique changes. Strong opioids are a mainstay of treatments but side effects are problematic and can compromise optimal pain control. Tapentadol is a novel dual-action drug, both stimulating inhibitory μ-opioid receptors (MOR) and mediating noradrenaline reuptake inhibition (NRI) leading to activation of the inhibitory α-2 adrenoceptor. It has been demonstrated to treat effectively both acute and chronic pain. We he…

Manejo perioperatorio del dolor en el paciente en tratamiento crónico con opiáceos

2011

Pain is one of the most common reasons for seeking medical care and the frequency of prescription of opioid analgesics by both primary care physicians and specialists has increased. It is therefore unsurprising that many patients with chronic pain who must undergo scheduled or emergency surgery will be on long-term medication, including opioids. Managing postoperative pain, even with high doses of drugs, seems to be more difficult in regular users of such analgesics, possibly because of an apparent association of opioid use with increased tolerance and hyperalgesia. Postoperative pain relief should be carefully tailored in these cases by means of a management plan worked out along with the …

Perioperative diaphragm point-of-care ultrasound as a prediction tool of postoperative respiratory failure in high-risk patients: A feasibility study…

2021

Abstract Introduction Respiratory muscle function in the postoperative period is a key to whether a patient develops Postoperative Respiratory Failure (PRF) or not. PRF occurs when the gas exchange does not meet metabolic needs. Ipsilateral paralysis of the hemidiaphragm after interscalenic brachial plexus block (ISB) causes an acute reduction of respiratory muscle function. This reduction does not cause PRF when the contralateral hemidiaphragm generates enough gas exchange to meet metabolic demands. Objectives To study the evolution of hemidiaphragmatic muscle function during the perioperative period with diaphragmatic ultrasound (D-POCUS), and use it as an innovative tool to predict PRF, …

Hirnprotektion unter Notfallbedingungen: Sind Anästhetika neuroprotektiv?

1997

Intubationsbedingungen nach Rocuronium und Succinylcholin

1996

OBJECTIVE Rocuronium is a new non-depolarising steroidal muscle relaxant with a short onset time. The present study was undertaken to compare intubating conditions as well as onset and clinical duration of a single dose of 0.6 mg/kg (2 x ED95) with a single dose of 1 mg/kg suxamethonium (3 x ED95). METHODS After obtaining informed consent and approval of the Ethics Committee, 40 adult patients (ASA I-III) participated in this study. After premedication with oxazepam, anaesthesia was induced with fentanyl and propofol and maintained with propofol, N2O and supplements of fentanyl as needed. Muscular relaxation was assessed by EMG recording of adductor pollicis muscle after supramaximal single…