Bailliere's clinical anaesthesiology最新文献_第5页

2a NSAIDs and other non-opioids in chronic pain 非甾体抗炎药和其他非阿片类药物在慢性疼痛中的作用

Bailliere's clinical anaesthesiology Pub Date : 1998-03-01 DOI: 10.1016/S0950-3501(98)80004-4

MD Albrecht Wiebalck (Consultant), MD Roman Dertwinkel (Consultant), MD, PhD Michael Zenz (Professor)

{"title":"2a NSAIDs and other non-opioids in chronic pain","authors":"MD Albrecht Wiebalck (Consultant), MD Roman Dertwinkel (Consultant), MD, PhD Michael Zenz (Professor)","doi":"10.1016/S0950-3501(98)80004-4","DOIUrl":"10.1016/S0950-3501(98)80004-4","url":null,"abstract":"<div><p>Non-opioids are first-line drugs for long-term pain therapy. They are effective and have a low incidence of side-effects. There are differences between non-opioids, allowing for differential indications in order to improve efficacy as well as safety. While patients with low back pain and osteoarthritis are often treated well using pure analgesics, patients with rheumatoid arthritis, and in particular those with ankylosing spondylitis, require the most potent anti-inflammatory drugs. Patients with cancer pain of moderate-to-severe intensity also benefit from them, but this is limited by the progression of the disease and the ceiling effect of non-steroidal anti-inflammatory drugs (NSAIDs). Regular endoscopic investigation of the upper gastro-intestinal tract should be considered for the prevention of fatal side-effects in patients at risk. The choice of drugs for treatment must be based on outcome studies of high quality. According to the selection of studies presented, a few drugs can be ranked, those with highest safety first: ibuprofen, tenidap, fenbufen, aceclofenac, indomethacin, ketorolac, diclofenac, tenoxicam, piroxicam and ASA.</p></div>","PeriodicalId":80610,"journal":{"name":"Bailliere's clinical anaesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3501(98)80004-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127158543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

6 Prevention of chronic pain syndromes by anaesthetic measures: fact or fiction? 麻醉措施预防慢性疼痛综合征:事实还是虚构?

Bailliere's clinical anaesthesiology Pub Date : 1998-03-01 DOI: 10.1016/S0950-3501(98)80011-1

MD Michael Tryba (Professor of Anesthesiology)

引用次数: 4

4 Efficacy of multidisciplinary pain centres: an antidote to anecdotes 多学科疼痛中心的疗效:轶事的解毒剂

Bailliere's clinical anaesthesiology Pub Date : 1998-03-01 DOI: 10.1016/S0950-3501(98)80009-3

PhD Dennis C. Turk (John and Emma Bonica Professor of Anesthesiology and Pain Research), PhD Akiko Okifuji (Research Assistant Professor)

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引用次数: 21

2d The place of nerve blocks and invasive methods in pain therapy: evidence-based results in chronic pain relief 神经阻滞和侵入性方法在疼痛治疗中的地位:慢性疼痛缓解的循证结果

Bailliere's clinical anaesthesiology Pub Date : 1998-03-01 DOI: 10.1016/S0950-3501(98)80007-X

MD, PhD Hugo Adriaensen (Head of the Department of Anaesthesiology and Pain Therapy), MD Jan Maeyaert (Anaesthesiologist), MD Jean Pierre van Buyten (Anaesthesiologist), MD Erik Vanduynhoven (Anaesthesiologist), MD, PhD Marcel Vercauteren (Anaesthesiologist), MD Gery Vermaut (Anaesthesiologist), MD Kris Vissers (Anaesthesiologist)

{"title":"2d The place of nerve blocks and invasive methods in pain therapy: evidence-based results in chronic pain relief","authors":"MD, PhD Hugo Adriaensen (Head of the Department of Anaesthesiology and Pain Therapy), MD Jan Maeyaert (Anaesthesiologist), MD Jean Pierre van Buyten (Anaesthesiologist), MD Erik Vanduynhoven (Anaesthesiologist), MD, PhD Marcel Vercauteren (Anaesthesiologist), MD Gery Vermaut (Anaesthesiologist), MD Kris Vissers (Anaesthesiologist)","doi":"10.1016/S0950-3501(98)80007-X","DOIUrl":"10.1016/S0950-3501(98)80007-X","url":null,"abstract":"<div><p>Since the emergence of locoregional anaesthesia, nerve blocks with local anaesthetic or neurolytic agents have been used in chronic pain patients for diagnostic and therapeutic purposes.</p><p>A critical evaluation of this type of intervention has only begun during the past 10 years. In the literature, few clinical reports on nerve blockade have withstood criticism. A scientific basis for legitimating the daily use of nerve blocks in our clinical practice is missing.</p><p>This has led not only to controversy and discussion, but also to a renewed interest and a more scientific approach towards nerve blockade. Other invasive techniques have also emerged, such as radiofrequency lesioning and dorsal column stimulation; they have partially replaced the older neurolytic or destructive techniques.</p><p>With the help of several co-authors, this chapter outlines the points of this evolution.</p></div>","PeriodicalId":80610,"journal":{"name":"Bailliere's clinical anaesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3501(98)80007-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116889043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

2b Opioids in chronic pain 慢性疼痛中的阿片类药物

Bailliere's clinical anaesthesiology Pub Date : 1998-03-01 DOI: 10.1016/S0950-3501(98)80005-6

MD Roman Dertwinkel (Consultant), MD Barbara Donner (Consultant), MD, PhD Michael Zenz (Professor), MD Stefan Schulz (Resident), MD Birgit Bading (Resident)

引用次数: 9

1 Outcome measures in pain therapy 疼痛治疗的结局指标

Bailliere's clinical anaesthesiology Pub Date : 1998-03-01 DOI: 10.1016/S0950-3501(98)80003-2

Paul Nilges (Psychologist, Head of the Psychological Section)

引用次数: 7

Coronary circulation and left ventricular function in hypertension 高血压患者的冠状动脉循环和左心室功能

Bailliere's clinical anaesthesiology Pub Date : 1997-12-01 DOI: 10.1016/S0950-3501(97)80046-3

B. Schwartzkopff MD (Assistant Professor), B.E. Strauer MD (Director of the Clinic)

{"title":"Coronary circulation and left ventricular function in hypertension","authors":"B. Schwartzkopff MD (Assistant Professor), B.E. Strauer MD (Director of the Clinic)","doi":"10.1016/S0950-3501(97)80046-3","DOIUrl":"https://doi.org/10.1016/S0950-3501(97)80046-3","url":null,"abstract":"<div><p>In hypertensive heart disease, coronary vasodilatory capacity can be reduced owing to vascular, myocardial, extravascular compressive and metabolic factors, all of which may predispose to myocardial ischaemia and consequently ventricular dysfunction. Vascular alterations at the level of the intramural arterioles are characterized by medial hypertrophy and perivascular fibrosis, as well as by an endothelial dysfunction leading to an inappropriate vasodilator function and an increased vasoconstrictor response. Functional and structural alterations of the intramyocardial vasculature may even precede the development of left ventricular hypertrophy, which may further reduce coronary microcirculation by scar formation and increased end-diastolic pressure. In dilated hearts, coronary reserve is further reduced by an increased metabolic demand. Anti-hypertensive therapy in acute hypertensive situations should aim to reduce afterload, lower metabolic demand and increase myocardial coronary blood flow. Long-term anti-hypertensive therapy aims to achieve reparation of the vasculature and regression of myocardial hypertrophy and fibrosis, consequently improving systolic and diastolic function.</p></div>","PeriodicalId":80610,"journal":{"name":"Bailliere's clinical anaesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3501(97)80046-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91691688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

24-hour ambulatory blood pressure monitoring 24小时动态血压监测

Bailliere's clinical anaesthesiology Pub Date : 1997-12-01 DOI: 10.1016/S0950-3501(97)80044-X

Hartmut Schächinger MD (Consultant), Wolf Langewitz MD (Senior Consultant)

引用次数: 9

Hypertension, cardiac hypertrophy and the effects of anaesthesia 高血压、心肌肥厚及麻醉的影响

Bailliere's clinical anaesthesiology Pub Date : 1997-12-01 DOI: 10.1016/S0950-3501(97)80048-7

Tamanna Nahar MD (Fellow, Division of Cardiology), Richard B. Devereux MD (Professor of Medicine Director, Echocardiography Laboratory)

{"title":"Hypertension, cardiac hypertrophy and the effects of anaesthesia","authors":"Tamanna Nahar MD (Fellow, Division of Cardiology), Richard B. Devereux MD (Professor of Medicine Director, Echocardiography Laboratory)","doi":"10.1016/S0950-3501(97)80048-7","DOIUrl":"10.1016/S0950-3501(97)80048-7","url":null,"abstract":"<div><p>Hypertension predisposes to a heightened risk of cardiovascular events over years of follow-up of ambulatory adults and especially during the relatively brief peri-and intra-operative periods of heightened stress resulting from surgery and anaesthetic effects. Structural changes in the circulation, including left ventricular and resistance vessel hypertrophy, and systemic and coronary atherosclerosis, play an even more important role in the development of these morbid events than does the actual level of blood pressure elevation. However, chronic anti-hypertensive therapy stabilizes blood pressure and heart rate responses to stress and therapy, thereby decreasing the incidence of ischaemia, congestive heart failure, arrhythmia and cerebrovascular accident. Although optimal evidence is not yet available, it appears that continued anti-hypertensive therapy is as beneficial in the operative setting as it is chronically. Excluding diuretics and angiotensin-converting enzyme inhitors, most other anti-hypertensive medications should be continued during anaesthesia.</p><p>For intra-operative hypertension, many drugs are used, but the most evidence of cardioprotective effects has been obtained for the beta-blockers. It is important to mention that calcium-channel blockers may potentiate myocardial depression and bradycardia especially when beta-blockers are already being used.</p></div>","PeriodicalId":80610,"journal":{"name":"Bailliere's clinical anaesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3501(97)80048-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124591065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Introduction to arterial hypertension and anaesthesia: a look beyond the numbers 介绍动脉高血压和麻醉:超越数字

Bailliere's clinical anaesthesiology Pub Date : 1997-12-01 DOI: 10.1016/S0950-3501(97)80040-2

Karl Skarvan MD, FMH (Professor of Anaesthesia)

{"title":"Introduction to arterial hypertension and anaesthesia: a look beyond the numbers","authors":"Karl Skarvan MD, FMH (Professor of Anaesthesia)","doi":"10.1016/S0950-3501(97)80040-2","DOIUrl":"10.1016/S0950-3501(97)80040-2","url":null,"abstract":"<div><p>Arterial hypertension represents the most frequent cardiovascular abnormality encountered by an anaesthetist during the peri-operative period. The diagnosis of arterial hypertension prompts anaesthetists to make far-reaching clinical decisions regarding the pre-operative evaluations of the possible risks for their patients during anaesthesia and surgery, cancellation of surgery in patients with poorly controlled hypertension, adjustment of anti-hypertensive drug therapy, optimal anaesthetic management and safe use of intravenous agents for blood pressure control, to name only a few. Over the past few years, the understanding of the pathophysiology of hypertension has increased considerably, and many new anti-hypertensive drugs have been introduced that may produce significant interactions with anaesthesia. This introductory chapter shows how the new knowledge that is presented in this book may be used for all of the clinical decisions mentioned above, and it attempts to convince the readers that arterial hypertension means much more than just the ‘number of millimetres of mercury’.</p></div>","PeriodicalId":80610,"journal":{"name":"Bailliere's clinical anaesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3501(97)80040-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130908710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1