The results suggest clinically relevant interactions of propofol and remifentanil in humans, since propofol led to a delay and a weakening of remifentanil-induced postinfusion anti-analgesia in humans. Nevertheless, pronociceptive effects were not completely antagonized by propofol, which may account for the increased demand for analgesics after remifentanil-based anesthesia in clinical practice.

The results confirm clinically relevant interaction of mu opioids and prostaglandins in humans. Adequate timing seems to be of particular importance for the antihyperalgesic effect of cyclooxygenase-2 inhibitors.

: For the doses administered in this study, buprenorphine and fentanyl showed an additive interaction.

No abstract

Background:The proportions of older adults with major trauma is increasing. Highquality care for this population requires accurate and effective prehospital trauma triage decisions.Objectives: Anatomicalal and physiologicalal changes with age, comorbidities, and medications use for older adults may affect the accuracy of prehospital trauma triage. Materials and methods:This narrative review focuses on age-related anatomicalal and physiologicalal changes, comorbidities, and medications use for older adults with an emphasis on their impact on the accuracy of prehospital trauma triage tools. It also addresses efforts to develop alternative triage criteria to reduce under-triage.Results: These factors were shown to affect physiological responses to injury and mechanism of injury for older people. Current triage tools poorly predicted injury severity. Geriatric-specific physiologicalal measures and comorbidities significantly improved sensitivity with much lower specificity. Assessing anticoagulant or antiplatelet use in head injury notably improved sensitivity to identify traumatic intracranial haemorrhage, neurosurgery or death with modest decrease in specificity.Conclusions: Improving paramedics' knowledge about the challenges when assessing older people with silver trauma may reduce under-triage. Assessing frailty could help in predict injury severity. Future research is needed to improve triage decisions for this population.