Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[A comparison of a tramadol/metamizole infusion with the combination tramadol infusion plus ibuprofen suppositories for postoperative pain management following hysterectomy].
Postoperative pain management is still a grossly neglected field. In most cases, antipyretic analgesics alone are insufficient during the early postoperative period. Powerful narcotics are often avoided or underdosed because they are associated with the risk of respiratory depression. ⋯ CONCLUSIONS. Satisfactory pain reduction occurred rather late despite high doses of both the tramadol/metamizole and the tramadol/ibuprofen. Both analgesic combination must be regarded as insufficient after inhalational anaesthesia because of the very slow onset of action and the high failure rate.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Cardiorespiratory and microcirculatory effects following volume replacement using a new hydroxyethyl starch preparation].
Volume therapy is often necessary in cardiac surgery to maintain stable haemodynamics. Various different hydroxyethyl starch (HAES) solutions with different concentrations, mean molecular weights, and degrees of substitution are available for this purpose. In determining the ideal type of volume therapy, not only changes in macrohaemodynamics, but also the influence on microcirculatory blood flow have to be taken into account. ⋯ The improvement in macrohaemodynamics was of shorter duration after infusion of the new HAES 130 solution than after standard HAES 200. Volume replacement with HAES 200 resulted in an increase in microcirculatory blood flow that was more pronounced and of longer duration than in the HAES 130 patients. Thus, HAES 130 seems to be less effective than HAES 200 for volume replacement; HAES 200 should be preferred in patients undergoing cardiac surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Propofol versus midazolam. Long-term sedation in the intensive care unit].
Sedative-analgesic treatment of patients on long-term artificial ventilation aims at protection from stress related to their disease or therapy. By stabilising both the patient's vital functions and psychological state this treatment may contribute to therapeutic success. The choice of drugs depends primarily on the nature and course of the underlying disease. ⋯ In both groups this increase was associated with a reduction in peripheral resistance and an increase in rectal temperature. To achieve the desired sedation depth, midazolam was administered at a mean dosage of 0.11 mg/kg.h and propofol at 1.9 mg/kg.h. Catecholamine levels decreased in both groups within the first 8 h: after 8 h of sedation the plasma levels of noradrenaline and adrenaline were 525 and 65 pg/ml, respectively, in the midazolam group and 327 and 51 pg/ml in the propofol group. (ABSTRACT TRUNCATED AT 400 WORDS)