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.
Continue readingOpioid 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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The feasibility of laparoscopic general surgery under regional anaesthesia
Pharmacology of the critically ill (Part ΙI). Pharmacodynamic principles and their significance in critical illness
Anaesthesia management during cardiologic interventions
Non invasive methods of postoperative analgesia
Damage control surgery and intensive care
Apneic oxygenation; pulmonary and cardiovascular effects
Postconditioning or manipulating the re-perfusion injury
Extubation in the operating room immediately after orthotopic liver trans-plantation. Case report and review of the literature
In general, laparoscopic procedures of the abdominal cavity necessitate endotracheal intubation and mechanical ventilation due to the induction of pneumoperitoneum.
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The study of mechanisms by which drugs can modify cellular and ultimately whole animal and human performance is still one of the most exciting branches of science. However and despite the fact that many physicians are frequently using some times more than 20 drugs simultaneously in critically ill patients, very few of them are able to understand the enormous complexity and variability of different therapeutic responses within patients and/or between patients suffering from critical illness.
Continue readingThe management of cardiologic patients who are presenting for diagnostic and theurapeutic cardiac interventions has become a significant topic of interest and concern among anesthesiologists. This review will update recent reports and also will provide practical advice on delivering anesthesia in cardiac catheterization laboratory. During recent years cardiac procedures are more complex, take longer, and involve high risk patients.
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Despite of great interest in understanding the pain mechanisms and pain management, and the foundation of acute pain services; numbers of patients still suffer unacceptable pain even today. Surveys show that there are not many improvements in this area. So, it is quite clear that the solution to post operative pain is not just developing a single technique.
Continue readingDamage control surgery is defined as rapid termination of an operation after control of life threatening bleeding and contamination in severely injured and unstable patients, followed by correction of physiologic abnormalities and de-finitive management. Emphasis then shifts from the operating theater to the intensive care unit, where the patient’s physiologic deficits are corrected.
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