No abstract

No abstract

The study showed that pain intensity during 24 hours after the lumbar disk surgery was significantly lowered by dexketoprofen, but not with paracetamol, as a supplemental analgesic to morphine patient-controlled analgesia when compared with controls.

No abstract

No abstract

Purpose The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1–3) days vs. 3 (Q1-Q3, 1–6) days) and hospital length of stay (median 14 (Q1-Q3, 9–24) days vs. 10 (Q1-Q3, 7–17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-023-07169-7.

Patient controlled analgesia with 0.5 mg morphine may be safe and effective for pain management following supratentorial craniotomies. Integrated pulmonary index can be used for detecting opioid-induced respiratory depression. Clinical Trials registration number: NCT02929147.

Objective: Aneurysmal subarachnoid haemorrhage (SAH) may have devastating effects on patients. Motor and neurocognitive impairments may arise depending on the location and grade of the SAH. Although the effects of amantadine on neurocognitive function after traumatic brain injury have been widely studied to the best of our knowledge, their effects on recovery from SAH in humans have not been studied. The present study aimed to evaluate how amantadine influences improvement in neurocognitive function in patients with aneurysmal SAH over a period of six months. Methods: This preliminary study included 12 patients with aneurysmal SAH who were admitted to the neurointensive care unit of Cerrahpasa Faculty of Medicine. Patients in Group A (n=5) received the standard treatment for SAH and amantadine for 30 days after admission, and those in Group C (n=7) received only the standard treatment. Neurocognitive function was evaluated using the Coma Recovery Scale-Revised and Disability Rating Scale on the first and fifth days and at the third and sixth months after admission. The primary endpoint of the present study was to compare the effects of amantadine in combination with the standard treatment to those of the standard treatment alone on the neurocognitive function of patients with SAH for over 6 months. Results: Compared to the standard treatment alone, amantadine administration with the standard treatment during the early period of SAH may improve recovery. Conclusion: Amantadine along with the standard treatment can ameliorate neurocognitive function after SAH. Keywords: Amantadine, subarachnoid haemorrhage, neurocognitive functions Amaç: Anevrizmalara bağlı subaraknoid kanamalarda, kanamanın yeri ve derecesine göre motor ve nörokognitif fonksiyonlar değişik derecelerde etkilenebilmektedir. Travmatik beyin hasarı sonrası amantadinin nörokognitif fonksiyonlar üzerine etkisi geniş olarak çalışılmış olsa da, bildiğimiz kadarıyla insanlarda sunaraknoid kanama sonrası iyileşmeye etkisi çalışılmamıştır. Bu çalışmanın amacı, amantadinin anevrizmaya bağlı subaraknoid kanamalarda kanamadan sonraki 6 ay süresince nörokognitif fonksiyonları nasıl etkilediğini değerlendirmektir. Yöntemler: Bu ön çalışma anevrizmal sunaraknoid kanama tanısıyla Cerrahpaşa Tıp Fakültesi nöroyoğun bakım ünitesine kabul edilen 12 hastayı içermektedir. Grup A'da (n=5) standart subaraknoid kanama tedavisinin yanında 30 gün boyunca amantadin verilirken, Grup C'de sadece standart tedavi uygulandı (n=7). Nörokognitif fonksiyonlar; amantadin başlandığında, beşinci günde, üçüncü ve altıncı ayda "coma recovery scale-revisited" ve "disability rating scale" ile değerlendirildi. Bu çalışmanın primer sonlanım noktası, anevrizmaya bağlı subaraknoid kanaması olan hastalarda, standart tedaviye amantadin eklenmesinin kanama sonrası 6 ay süresince nörokognitif fonksiyonlardaki iyileşme üzerine olan etkilerini standart tedaviyle karşılaştırmaktır. Bulgular: Bu çalışma, anevrizmaya bağlı subaraknoid kanaması olan hastalarda, standart tedaviye amantadin eklendiğinde, ...