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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 60 (2005), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Total hip replacement is a major surgical procedure usually associated with significant pain in the early postoperative period. Several anaesthetic and analgesic techniques are in common clinical use for this procedure but, to date, clinical studies of pain after total hip replacement have not been systematically assessed. Using the Cochrane protocol, we have conducted a systematic review of analgesic, anaesthetic and surgical interventions affecting postoperative pain after total hip replacement. In addition to the review, transferable evidence from other relevant procedures and clinical practice observations collated by the Delphi method were used to develop evidence-based recommendations for the treatment of postoperative pain. For primary total hip replacement, PROSPECT recommends either general anaesthesia combined with a peripheral nerve block that is continued after surgery or an intrathecal (spinal) injection of local anaesthetic and opioid. The primary analgesic technique should be combined with a step-down approach using paracetamol plus conventional non-steroidal anti-inflammatory drugs, with strong or weak opioids as required.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0385
    Keywords: Key words: Prospective study ; Phantom pain ; Pain intensity ; Patient satisfaction ; Salmon-calcitonin. ; Schlüsselwörter: Prospektive Beobachtungsstudie ; Phantomschmerz ; Schmerzintensität ; Patientenzufriedenheit ; Lachscalcitonin.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Die vorliegende prospektive Beobachtungsstudie untersucht die Anwendung von intravenösem Lachscalcitonin an 8 schmerztherapeutischen Problempatienten, die nach einer Amputation an der unteren Extremität unter stärksten Phantomschmerzen (visuelle Analogskala = 50–100) litten und dem hausinternen akuten Schmerzdienst vorgestellt wurden. Sechs von 8 Patienten (75 %) waren nach maximal 10 Tagen (maximal 5 Calcitonininfusionen) phantomschmerzfrei bis zum „follow-up“ nach 3, 6 und 12 Monaten. Als zusätzliches Kriterium zur Beurteilung einer erfolgreichen Phantomschmerztherapie wurde die Patientenzufriedenheit erfaßt (numerische Rating-Skala: 1–6). Der subjektive Therapieerfolg des Calcitonins zwischen den einzelnen Infusionszyklen liefert dem Arzt wichtige Anhaltspunkte zur Infusionsintervallverlängerung bzw. Dosisveränderung. In der vorliegenden Studie zeigt sich eine „gute“ Therapiezufriedenheit bei 6 von 8 Patienten (75 %). Größere Patientenzahlen in einer randomisierten prospektiven Studie sind jedoch notwendig, um die bisher aufgezeigten Therapieerfolge zu bestätigen. In einer kritischen Literaturanalyse werden der Calcitonintherapie zahlreiche alternative Behandlungsmethoden zur Phantomschmerztherapie gegenübergestellt.
    Notes: Summary. In this prospective clinical study we examined the intravenous application of salmon-calcitonin in eight patients with severe phantom limb pain (Visual Analogue Scale = 50–100). The patients presented at the Acute Pain Service (APS) section of the Second Department of Surgery, University of Cologne. Six of eight patients (75 %) had no phantom limb pain after 10 days of intravenous treatment with salmon-calcitonin (maximum of five cycles of calcitonin infusion). Systematic follow-up examinations after 3, 6 and 12 months showed long-term success. Patient satisfaction was examined with a numeric rating scale (NRS 1–6) between the single infusion cycles. When patient satisfaction was low, the physician modified the time period or drug dosage between infusions. This study shows good or excellent results in patient satisfaction for six of eight patients (75 %). A prospective randomized trial is required to verify the excellent results of intravenous salmon-calcitonin in a larger population. Alternative pharmacological and operative treatments of phantom limb pain are critically reviewed and assessed.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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