International journal of clinical practice
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Int. J. Clin. Pract. · Feb 2008
Randomized Controlled TrialCombined spinal-epidural analgesia vs. intermittent bolus epidural analgesia for pain relief after major abdominal surgery. A prospective, randomised, double-blind clinical trial.
The primary aim of this study was to compare the efficacy of combined spinal-epidural (CSE) analgesia vs. intermittent bolus epidural analgesia (EA) for pain relief after major abdominal surgery. The secondary aim was to assess the effects of fentanyl addition to subarachnoid morphine and bupivacaine. ⋯ Combined spinal-epidural improved intra-operative analgesia and reduced pain with cough in the immediate postoperative period. The addition of fentanyl to subarachnoid morphine and bupivacaine decreased the need for additional i.v. fentanyl and epidural bupivacaine analgesia.
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Int. J. Clin. Pract. · Feb 2008
Randomized Controlled TrialThe efficacy of oxycodone for management of acute pain episodes in chronic neck pain patients.
Most treatments of acute pain associated with non-malignant chronic pains are not satisfactory. The aim of this study is to evaluate the efficacy and side effects of oxycondone controlled release (Oxy-CR) in managing chronic neck pain with acute pain episodes. ⋯ Oxycondone controlled release could be an important optional drug for the management of refractory and frequent acute episodes of chronic neck pain in patients who failed to respond to non-opioid conservative treatment.
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Int. J. Clin. Pract. · Feb 2008
Randomized Controlled Trial Comparative StudyEffect of levosimendan on right ventricular systolic and diastolic functions in patients with ischaemic heart failure.
Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. In this study, the effect of levosimendan on the right ventricular systolic and diastolic functions was evaluated by tissue Doppler comparing them with dobutamine in patients with ischaemic heart failure. ⋯ Levosimendan improves right ventricular systolic and diastolic functions.
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Int. J. Clin. Pract. · Feb 2008
ReviewA clinically relevant review of tizanidine hydrochloride dose relationships to pharmacokinetics, drug safety and effectiveness in healthy subjects and patients.
Tizanidine, one of the few oral antispastic therapies approved for use in the USA, has a narrow therapeutic index that can often make optimal patient dosing difficult. We surveyed the published literature for data on potential tizanidine dose relationships to pharmacokinetics, drug safety and effectiveness, as well as to provide practical drug dosing advice. ⋯ There is substantial evidence to show that plasma tizanidine concentrations are linearly related to dose in healthy subjects and patients, although there is a high degree of intersubject variability. The most common adverse events and pharmacodynamic effects are related to plasma concentrations. The clinical implications of the large interpatient variability in plasma tizanidine concentrations and its narrow therapeutic index make it necessary to individualise patient therapy. Practical advice on tizanidine dosing and/or switching between formulations is provided.
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Int. J. Clin. Pract. · Feb 2008
The clinical value of rapid assay for plasma B-type natriuretic peptide in differentiating congestive heart failure from pulmonary causes of dyspnoea.
B-type natriuretic peptide (BNP) is a cardiac neurohormone secreted from the cardiac ventricles in response to pressure overload. ⋯ A value of 100 pg/ml or more for a rapid BNP assay may be the most accurate independent predictor of the presence or absence of CHF.