The introduction of the laparoscopic and robotic assisted laparoscopic technique in total hysterectomy patients alleviated significantly their postoperative pain and lowered the opioid consumption rate during their recovery. In the present article, we review the use of the Transversus Abdominis Plane block technique and the probability of further lessening the patients’ pain. Hereby we adduce the different variations of the TAP-block and the results of several clinical trials, after a thorough search in the existing literature. Continue reading
Codes of ethics are considered as indispensable parameters of every aspect of medical care. When performing cardiopulmonary resuscitation (CPR) ethical issues become even more important since cardiac arrest (CA) is directly related to death. The aim of this study was to record personal opinions and everyday clinical practice approaches of healthcare professionals (HCPs) regarding ethical issues related to CPR. HCPs answered a questionnaire consisting of 30 questions related to ethical issues in CPR on a voluntary basis. The study included 195 HCPs (88♂& 107♀). Out of the 195 HCPs, 95 were physicians, 71 nurses and 29 paramedics. 49 HCPs (25.1%) worked in the prehospital setting (EMS or Healthcare Centers) and 147 (74.9%) in hospitals. Continue reading

Despite stable background pain, most cancer patients suffer 3-4 episodes of breakthrough pain daily. Aim of the present study was the evaluation of potential correlation between effective doses of sublingual fentanyl citrate, administered for controlling breakthrough pain, with transdermal fentanyl used for background pain. Fifty-six cancer patients were prospectivelly recruited. All patients were suffering episodes of breakthrough pain and managed with transdermal fentanyl 25-300μg/h for their background pain.

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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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Our study compared the effectiveness between two of the proposed as rescue manoeuvres to overcome difficulty, in advancing a tracheal tube, during railroading over the fibreoptic bronchoscope. A ninety degrees anti-clockwise rotation (90ΑCWR) of the tube or cricoid cartilage pressure application (CCPA) was randomly performed in eighty patients undergoing fibreoptic orotracheal intubation under general anaesthesia, in whom first attempt to railroad the tracheal tube had failed.

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Gabapentin was tested as complementary analgesic in 25 cancer patients in whom pain was not sufficiently controlled by transdermal fentanyl. Neuropathic pain syndrome in these patients consisted of burning pain and allodynia. Gabapentin was administered at a dose of 648±206,4mg, while dosage of transdermal fentanyl was fixed (261±98,1μg/h).

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