Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Experiences with intrathecal morphine analgesia in 36 patients undergoing Wertheim-Held hysterectomy are reported. Postoperative painrelief, bloodgas-parameters (pO2, pCO2, pH, SBE, SAT), analgetica demand, side-effects are compared with 23 patients of a control group. 95% of patients with intrathecal morphine analgesia were postoperatively without pain for at least 24 hours. The postoperative demand of analgetic drugs could be reduced to less than 50% in the first 48 postoperative hours. Besides not significant decreasing of the pH-value no changing of the bloodgases was observed. The incidence of nausea, vomiting and headache were not increased. Considering the not in all cases avoidable development of a respiration insufficiency even after a little dosis of morphine this method seems to be a suitable treatment of postoperative pain which enables the early mobilisation of the patients.
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PMID:[Intrathecal morphine administration in pain therapy following extensive gynecologic operations. Clinical study]. 383 60

Delirium is a debilitating form of brain dysfunction frequently encountered in the intensive care unit (ICU). It is associated with increased morbidity and mortality, longer lengths of stay, higher hospital costs, and cognitive impairment that persists long after hospital discharge. Predisposing factors include smoking, hypertension, cardiac disease, sepsis, and premorbid dementia. Precipitating factors include respiratory failure and shock, metabolic disturbances, prolonged mechanical ventilation, pain, immobility, and sedatives and adverse environmental conditions impairing vision, hearing, and sleep. Historically, antipsychotic medications were the mainstay of delirium treatment in the critically ill. Based on more recent literature, the current Society of Critical Care Medicine (SCCM) guidelines suggest against routine use of antipsychotics for delirium in critically ill adults. Other pharmacologic interventions (e.g., dexmedetomidine) are under investigation and their impact is not yet clear. Nonpharmacologic interventions thus remain the cornerstone of delirium management. This approach is summarized in the ABCDEF bundle (Assess, prevent, and manage pain; Both SAT and SBT; Choice of analgesia and sedation; Delirium: assess, prevent, and manage; Early mobility and exercise; Family engagement and empowerment). The implementation of this bundle reduces the odds of developing delirium and the chances of needing mechanical ventilation, yet there are challenges to its implementation. There is an urgent need for ongoing studies to more effectively mitigate risk factors and to better understand the pathobiology underlying ICU delirium so as to identify additional potential treatments. Further refinements of therapeutic options, from drugs to rehabilitation, are current areas ripe for study to improve the short- and long-term outcomes of critically ill patients with delirium.
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PMID:Prevention and Management of Delirium in the Intensive Care Unit. 3274 69