Folia medica Cracoviensia
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Folia medica Cracoviensia · Jan 2001
Review Comparative Study[Point systems for evaluating coma in patients with injuries of the central nervous system (CNS)].
Paper reviews various coma scales which are used to monitor consciousness after sustaining severe injuries of CNS. Glasgow Coma Scale, at present the most frequently used, was compared to recently developed scales, which are more useful for monitoring persistent comas, allows to evaluate discrete changes in patient's state more precisely and to predict the outcome. The necessity of evoked potentials' measurements, such as Trigeminal-Auditory Glasgow (Coma Scale) has been stressed.
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Folia medica Cracoviensia · Jan 2001
Clinical Trial Controlled Clinical Trial[Mivacurium--use for complications of facial-cranial surgery--personal experience].
The aim of this study was to evaluate the effectiveness of mivacurium (Mivacron--GlaxoWellcome) during combined general anaesthesia in the operations on the facial cranium, after tracheal intubation performed using suxamethonium chloride (Chlorsuccillin--Polfa PL). We examined 20 patients, 17-65 years old, who were underwent operations due to facial and neck neoplasms or trauma. Patients were divided into two 10-person groups. ⋯ By 4 patient with heart failure prolongation of the activity time of Mivacurium was observed. The dose of 0.1 mg/kg, is efficient to maintain of the neuromuscular block on the stabile level. This allows the reduction of the total dose, and the decrease of the costs of the operation.
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The day surgery, known also as an office based practice, is a major change in the clinical medicine of the last two decades. In some countries (for instance in Austria) exists a clear difference between the ambulatory and the day surgery. While the ambulatory patient does not need a hospital bed at all, the day surgery patient occupies a bed for at least few hours, but never stays in the unit overnight. ⋯ There is no clear definition of the magnitude of the operation, which can be performed in the settings of day surgery, it varies according to organisation of such units and from the proximity of the hospital in its background. Generally from the day surgery programs should be excluded patients with the risk class above ASA 2, operations lasting more then 90 minutes, all intracranial and intrathoracic operations and all procedures requiring blood transfusion. Day surgery is generally free from mortality and major complications like myocardial infarction, pulmonary embolism or neurological consequences, therefore the assessment of outcome should include minor morbidity, pain relief and satisfaction of the patient.
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Folia medica Cracoviensia · Jan 2001
Review[Anesthesiology consulting unit in perioperative medicine].
There is a demand, caused by increase of one-day surgery, surgery of high risk patients with coexisting diseases, and growing need for patient education, for such improvement of preoperative preparation, which will enable an optimalization in patient care. That became a special task of Preanesthetic Evaluation Clinic. The aim of the paper was to analyze activity of local Preanesthetic Evaluation Clinic in years 1993-2000. ⋯ As conclusions perspectives of further development of the Clinic were shown. Growing significance of an anesthetic nurse in perioperative patient preparation was foreseen. A demand for improving electronic patient records as well as use of new technologies was proven.
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Folia medica Cracoviensia · Jan 2001
Clinical Trial Controlled Clinical Trial[Does intravenous administration of magnesium have an effect on postoperative analgesia?].
The study involved 67 patients operated for malignant tumours of stomach and of the colon. The patients have been divided into 3 groups: the NORMO group--20 patients in whom the serum magnesium level remained normal during the whole period studied; the HYPO group--22 patients who developed hypomagnesaemia in the postoperative course; the MAG i.v. group--25 patients who on the day of surgery and on 4 days following surgery, received intravenously daily doses of 2.5 ml of 20% MgSO4 per each 500 ml of transfused fluids. ⋯ In all three groups, the daily amounts of morphine and noramidopirine received by patients was the same. The intravenous administration of daily doses of 8 to 14 mmol magnesium in the postoperative period does not affect the amount of analgesics given to patients.