Multimodal pain management combines analgesics to improve analgesia and reduce side effects. This study investigates the fixed combination of diclophenac and orphenadrin (Neodolpasse(®) Infusion Solution) in patients after unilateral total hip arthroplasty (THA). This prospective, randomized, double-blind, placebo-controlled, multi-centre clinical study enrolled 120 patients receiving patient-controlled analgesia (PCA). Isotonic saline was infused as placebo. The primary efficacy goal was defined as reduction of PCA analgesics used over the first 24 h post-surgery. The study used a three-stage group sequential test design with two interim analyses. Analgesia was monitored by visual analogue scale and verbal rating. Infusion of the Neodolpasse(®) Infusion Solution resulted in a significant reduction in the PCA analgesic requirements by approximately 30% (38.7 ± 21.3 mg vs. 55.9 ± 31.1 mg; p = 0.0004) while maintaining adequate analgesia and patient safety. This study demonstrates that Neodolpasse(®) Infusion Solution significantly reduces PCA analgesic requirements without compromising analgesic effectiveness and safety in THA patients.
The value of echo-cardiography, CT and magnetic resonance tomography was evaluated in 10 patients with hypertrophic cardiomyopathy. Echocardiography made the diagnosis in most cases. The diagnostic criteria depended on functional and morphological changes. CT and magnetic resonance can show thickening in the myocardium, either symmetrical or asymmetrical. Magnetic resonance tomography provides excellent demonstration of the myocardium and accurate delineation of the degree of hypertrophy. It is well suited for measuring cardiac wall thickness.
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