Patientenkontrollierte Analgesie

Lehmann, K. A.

doi:10.1007/978-3-662-21762-7_18

Cited by 10 publications

(9 citation statements)

References 198 publications

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“…Im Gegensatz dazu metabolisieren einzelne Patienten das Tramadol sehr rasch ("ul trarapid metabolizer"); dies kann bei Nie reninsuffizienz zu stark ausgeprägten Ne benwirkungen mit Atemdepression füh ren. Die Retardform führt nach eigenen Beobachtungen zu geringeren Nebenwir kungen als die Tropfeneinnahme, und während "i.v.patient controlled analge sia" (i.v.PCA) ist Übelkeit nicht häufiger als durch andere Opioide [17]. Die häufige Einnahme (etwa mehr als 3 bis 4mal/ Tag) erhöht das Missbrauchsrisiko.…”

Section: Tramadolunclassified

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Medikamente zur postoperativen Schmerztherapie: Bewährtes und Neues

Jage

Laufenberg-Feldmann²,

Heid³

2008

Anaesthesist

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In part 1 of this review, perioperative aspects of the use of non-opioids (acetaminophene, dipyrone, traditional NSAR, coxibs) were discussed. In part 2 the perioperative aspects of opioids (weak opioids: tramadol, tilidine with naloxone, strong opioids: morphine, piritramide, oxycodone, hydromorphone, fentanyl, methadone, buprenorphine) and coanalgesics (gabapentinoids; ketamine) will now be presented. The main aim of the review is to describe the use, risks and cost of some substances to facilitate the differential indication. New aspects concerning the use of gabapentinoids and ketamine are discussed.

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Section: Tramadolunclassified

“…Morphin ist nach wie vor das Referenzopioid, denn Metaa nalysen [4,13] und klinische Studien mit der i.v.PCA [17] belegen eine vergleich bare Analgesie aller starker Opioide. Auch hinsichtlich ihrer Nebenwirkungen ergibt sich keine Präferenz, wenn verschiedene Opioide in Studien miteinander und nicht mit Placebo verglichen wurden [13,24] …”

Section: Wirkungsmechanismusunclassified

Medikamente zur postoperativen Schmerztherapie: Bewährtes und Neues

Jage

Laufenberg-Feldmann²,

Heid³

2008

Anaesthesist

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“…Any increase in cerebrospinal fluid pCO 2 or decrease of pH leads to chemoreceptors' activation. Opioids depress this reflex in a dose-dependent manner.…”

Section: Safety Aspects and Mishapsmentioning

confidence: 99%

“…The unit dispenses a preprogrammed amount of analgesic into an intravenous infusion, intramuscularly, subcutaneously or even into the spinal space. Unauthorized modifica- Results as arithmetic means; relative equipotent dose was calculated from the product of consumption and retrospective pain score [2]. 1 Retrospective pain scores (0 = no pain at all; 1 = sometimes moderate pain; 2 = always moderate pain; 3 = sometimes severe pain; 4 = always moderate and sometimes severe pain; 5 = discontinuation due to inefficiency).…”

Section: Pca Devicesmentioning

confidence: 99%

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Patient-Controlled Analgesia: An Efficient Therapeutic Tool in the Postoperative Setting

Lehmann

1999

Eur Surg Res

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Patient-controlled analgesia (PCA) is one of the newer techniques for pain management. It was developed in reaction to the large number of unsatisfied postoperative patients suffering from moderate to severe pain despite the availability of potent analgesic drugs. With PCA, patients are allowed to self-administer small analgesic doses into a running intravenous infusion, intramuscularly, subcutaneously or even into the spinal space. Clinical experience soon demonstrated that individual variability in pain intensity and analgesic needs was extremely large. Psychological factors seem to be as important as the surgical trauma. Opioid consumption is usually higher than with conventional regimens, but without serious side effects. Although patients generally prefer self-control, pain relief is not necessarily better than with well-conducted conventional techniques. In addition to routine clinical pain management, PCA has proven its importance in research, e.g. for pain measurement, to determine predictors of postoperative pain, to evaluate drug interactions and the concept of pre-emptive analgesia, or for pharmacokinetic designs. PCA has been extremely important in order to change the mind of physicians and nursing staff with respect to individual pain management strategies.

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Postoperative Schmerztherapie

Jage

Hartje

1997

Der Anaesthesist Weiterbildung Für Anästhesisten 1997

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Patientenkontrollierte Analgesie

Cited by 10 publications

References 198 publications

Medikamente zur postoperativen Schmerztherapie: Bewährtes und Neues

Medikamente zur postoperativen Schmerztherapie: Bewährtes und Neues

Patient-Controlled Analgesia: An Efficient Therapeutic Tool in the Postoperative Setting

Postoperative Schmerztherapie

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