ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Patient-controlled epidural analgesia, intermittent top-up and continuous infusion are equally effective in providing epidural pain relief during labour. Patient-controlled epidural analgesia is associated with a significant reduction in hourly dose requirements when compared with continuous infusion, and by transferring the responsibility for epidural top-up, it offers the parturient the psychological benefit of being in control. For these reasons, patient-controlled epidural analgesia may become the method of choice for epidural pain relief during labour. However, the safety of the method needs to be documented more extensively, and the advantage of a reduction in hourly dose requirements needs to be visualized in terms of an improvement in labour or neonatal outcome. Moreover, the optimal dose, drug combination and settings still remain to be determined.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Most studies indicate that epidural analgesia during labor is associated with maternal fever, although the nature of this fever is unclear. The consequences of maternal fever may include increased neonatal evaluations for sepsis, the increased use of antibiotics, and prolonged hospital stay. However, the need for such measures after epidural analgesia during labor is controversial. This article discusses currently held views on this issue.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Acid aspiration syndrome still contributes to the few anaesthesia-related deaths in caesarean section. Although none of the numerous measures intended to prevent such fatalities is based on clear evidence, many different regimens are being used. As obstetric acid aspiration syndrome occurs mainly in general anaesthesia, using regional techniques wherever possible may be the most effective prophylactic measure.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

In the following text recently published data on postoperative pain therapy after caesarean section will be summarized. As most papers discuss epidural and intrathecal strategies of pain relief, these aspects of pain therapy for the often underestimated pain after caesarean section will be emphasized.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Recently, with the introduction of the novel μ-opioid receptor agonist remifentanil, anaesthesiologists have acquired a unique tool to provide adequate, titratable and predictable analgesia throughout surgery, without the risk of opioid-related delay in postoperative recovery. This new compound will therefore mandate a change in anaesthesia practice from opioid-restricted to opioid-dominated anaesthesia. It is the first in the class of esterase-metabolized opioids within the 4-anilidopiperidine series of drugs, and it possesses an analgesic potency similar to that of fentanyl. The advantages of remifentanil are mainly related to its unique pharmacokinetics, whereas its pharmacodynamics are the same as those of fentanyl. Because of these characteristics, remifentanil-based anaesthesia allows profound opioid analgesia intraoperatively, with rapid and predicatable awakening thereafter. Review of the recent literature reveals the potential of remifentanil for improving analgesia in gynaecological procedures and its theoretical advantage in obstetric procedures.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Major improvements in the diagnosis and treatment of fetal malformations, including in-utero surgical repair, have occurred in the past decade. As opposed to anaesthesia for caesarean sections, a high placental drug transfer is warranted to provide adequate fetal anaesthesia and immobility, strongly favouring the use of general anaesthesia for these cases. Even though the question of fetal pain perception is still debated, studies suggest that attenuation of the fetal stress response can improve outcome. Other major concerns include the maintenance of uterine blood flow and uterine relaxation, as premature labour and delivery severely limit fetal benefits from surgery. When performing these procedures, physicians have a special responsibility to weigh maternal risks against fetal benefits and should not jeopardize the life of the mother for procedures with questionable fetal outcome.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The elimination of pain should be of outstanding importance for all people caring for children. A concept of balanced analgesia including non-steroidal anti-inflammatory drugs, opioids and local anaesthetics is widely accepted. This review focuses on extending analgesia beyond the immediate postoperative period, the understanding of pharmacokinetic-pharmacodynamic interactions of paracetamol, the side-effects of opioids during patient-controlled administration, and the position of ropivacaine in paediatric pain management. For the majority of clinical situations, however, we already have established and functioning concepts for analgesia; we only have to use them!

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Lung injury after aspiration, although very rare, is a feared and potentially devastating sequela after anaesthesia. This paper summarizes the most recent studies in aspiration lung injury focusing on its clinical epidemiology, new insights in its pathophysiology and innovative concepts in its prevention and therapy.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID