Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[Tramadol in postoperative pain therapy. Patient-controlled analgesia versus continuous infusion].
Patient-controlled analgesia (PCA) is a well-proven procedure for individual pain relief in the post-operative period. Despite its superior approach regarding pharmacokinetic and pharmacodynamic considerations, PCA equipment is not available to many in the clinical practice. The goal of this study was to compare the efficacy and safety of PCA with continuous infusion (CI), an easily feasible method, using tramadol (T) as a centrally acting opioid with minor side effects on circulation and ventilation. ⋯ T is well suitable for postoperative pain relief after major gynecological surgery using both PCA and CI. PCA ensures adjustment of the medication to the individual demand, whereas CI provides better analgesia after sleeping periods. We recommend antiemetic prophylaxis before treatment with T.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Etomidate using a new solubilizer. Experimental clinical studies on venous tolerance and bioavailability].
Pain following intravenous injection as well as thrombophlebitis are substantial side effects of etomidate that have been reported from the first clinical study (1972-1973) onwards. Investigations of our own and by Gran et al. have pointed out that injectable etomidate with intralipid as a solvent removes side effects without impairing the good hypnotic action. The idea of using a lipid emulsion as a solvent was presented a few years later, inducing two further studies. ⋯ The same results have been obtained in the study with volunteers. CONCLUSION. Two unpleasant side effects of etomidate, pain on injection and postoperative thrombophlebitis, were abolished by the solvent "lipid emulsion".
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Randomized Controlled Trial Comparative Study Clinical Trial
[Continuous application of morphine is more effective than a bolus administration in the postoperative analgesia and sedation of children].
In ventilated children the cardiorespiratory and metabolic reserve capacities can be extremely limited. Therefore, these children have low thresholds of tolerance for additional stress factors. One of the most obvious aims in the critical postoperative period after heart surgery in children is protection of the cardiorespiratory system against stress reactions. ⋯ Continuous application of morphine was more effective in sparing VO2 than bolus injections in ventilated children after cardiac surgery. We conclude that continuous application of morphine represents stress prevention whereas bolus application of morphine is stress therapy. From the clinical point of view it is more effective to prevent than to treat pain and other stress factors in pediatric patients.