Letter from the Editors

Epilepsy and Anaesthesia

Comparison of systemic hemodynamics after subarachnoid administration of either levobupivacaine or ropivacaine to elderly hypertensive patients

Emerging issues on opioid treatment of chronic pain

Known and unknown problems after prolonged use of opioids

How to balance efficacy versus side effects of chronic opioid use

When to start and when to terminate an opioid treatment

Αγαπητοί συνάδελφοι,

Στα τέλη του 2010, το διοικητικό συμβούλιο της Ε.Α.Ε.Ι.Β.Ε. μου ανέθεσε την ευθύνη της σύνταξης του περιοδικού “ΗΛΕΚΤΡΟΝΙΚΟ ΠΕΡΙΟΔΙΚΟ ΠΕΡΙΕΓΧΕΙΡΗΤΙΚΗΣ ΙΑΤΡΙΚΗΣ” - ejournal. Με μεγάλη χαρά αποδέχθηκα την τιμή και με την ευκαιρία αυτής της επιστολής σας ευχαριστώ όλους (διοικητικό συμβούλιο, μέλη και αναγνώστες του περιοδικού) θερμά.

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Management of epileptic patients in the perioperative period is an anesthetic challenge. New drugs and surgical procedures are being used to treat epilepsy. Various anaesthetics exhibit both proconvulsant and anticonvulsant properties at different doses and under different physiologic conditions. Continue reading

This study compares the cardiovascular effects of spinal levobubivacaine or ropivacaine, in equipotent doses, for endoscopic urologic surgery. Eighty elderly, hypertensive patients, with physical status ASA I-III, scheduled to undergo transurethral procedures, were randomly allocated to receive spinal anesthesia with either 15 mg of levobupivacaine or 22.5mg of ropivacaine, in hyperbaric solutions.

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Patient’s rights mandate that every patient in chronic pain has the right to receive proper and effective treatment. It is widely acceptable that opioids can significantly improve the patient’s quality of life, irrespectable of the etiology of pain, either cancer or non-cancer.

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Opioid analgesics are widely accepted as first-line treatment for moderate to severe cancer pain: while their use in patients with non-cancer pain syndromes has increased substantially over the last years. However, opioid analgesia produces numerous adverse effects. These effects have a negative impact on patient’s quality of life, may impair adherence to treatment and finally limitate opioid use.

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Opioid analgesics have finally joined the treatment of chronic non-cancer pain. In many cases, the problems that emerge from long-term use of opioids, can outweigh the benefits from its use. These problems usually refer to somatic disturbances but quite often they affect the psychological milieu.

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Opioid use for cancer pain is well established in medical literature. Recommended by the european guidelines (European Society for Medical Oncology - ESMO, European Association for Palliative Care – EAPC), the World Health Organization (WHO) analgesic ladder remains the gold standard in cancer pain management.

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