Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1988
ReviewNo decisive break-through yet for general anesthesia combined with locoregional anesthesia!
Although on theoretical grounds locoregional anesthesia, because of the claimed suppression of stress response and the ease with which prolonged analgesia can be achieved, seems preferable to general anesthesia, the shortcomings and drawbacks are such that its use is restricted to well chosen indications. The hope that combination anesthesia can overcome the limitations of both techniques remain to be proven whereas the problems that can arise during the combined technique could pose a major threat to the patient.
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Acta Anaesthesiol Belg · Jan 1988
ReviewThe relevance of metabolic and endocrine responses to anesthesia and surgery.
The development of anesthesia has reached a stage where the evaluation of the usefulness of metabolic and endocrine responses is highly important. At present, these responses are commonly modulated in patients known to benefit most (e.g. patients with ischemic cardiovascular disease and patients undergoing major abdominal surgery), but no methods of totally response-free anesthesia and surgery are available, nor are there methods for the modulation of the responses on a wide clinical scale. Fortunately, in most patients undergoing conventional elective operations good anesthetic care is sufficient for blunting of the responses. Better methods of modulating the responses may be available in the future, which will greatly change anesthesia practice.
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Acta Anaesthesiol Belg · Jan 1988
Clinical Trial Controlled Clinical TrialEfficacy of lorazepam oral fast dissolving drug formulation (FDDF) in anesthesia premedication in adults: a double-blind placebo controlled comparison.
Lorazepam 4 mg oral fast dissolving drug formulation was compared to placebo in a double-blind study as premedicant in adult anesthesia. Lorazepam induced in this trial a marked relief of anxiety after 60 minutes without changes in vital parameters nor in reflex activity or muscle tonus. Anterograde amnesia was present in about 60 percent of the patients. ⋯ Postoperative residual effects on attention, cognitive, somatic and visceral functions were present till 5 hours postmedication. Lorazepam FDDF (fast dissolving drug formulation) appeared to be an effective and clinically safe premedicant for its good anxiolytic and amnestic effect and its high acceptance by the patients. Its use is not recommended for outpatient anesthesia because it prolongs recovery from anesthesia.
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Acta Anaesthesiol Belg · Jan 1988
Case ReportsIntrathecal morphine and clonidine for control of intractable cancer pain. A case report.
The use of intrathecal clonidine, in combination with intrathecal morphine, for the treatment of a patient with intractable cancer pain is reported. The addition of clonidine overcame the problem of tolerance to the analgesic effects of morphine alone. The patient was maintained pain free for three months, without complications, until his death. At autopsy, no evidence of neurotoxicity associated with the prolonged intrathecal administration of clonidine and morphine was found.