Bibliography: leaves 216-251. / 251 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Bile returning to the intestinal lumen of rats with obstructive jaundice did not alter bowel-wall permeability to endotoxin or ethylenediaminetetraacetic acid. Urobilinogen was toxic to in vitro cultured renal cells in concentrations that may be expected to occur in disease. A previously-described assay for urobilinogen was found not to be useful for assaying specimens from jaundiced subjects. / Thesis (M.D.)--University of Adelaide, Dept. of Surgery, 1998?

<p><em>Syfte: </em>Syftet med uppsatsen var att studera förekomst av postoperativt illamående (dag 0-3) hos patienter som genomgått en ortopedisk operation i narkos. Syftet var också att studera om kända riskfaktorer och typ av anestesiform kan relateras till uppkomsten av postoperativt illamående (dag 0-3).<em></em></p><p><em>Metod</em>: Studiens design var en prospektiv kvantitativ icke experimentell studie. Data samlades in genom en enkätundersökning bland ortopedpatienter som opererats under narkos och som uppfyllde inklusionskriterierna. Antalet svarande var 18 av 34 tillfrågade. Resultatet analyserades och sammanställdes deskriptivt i statistikprogrammet SPSS.</p><p><em>Resultat</em>: Resultatet visar att alla patienter som deltog i studien sövdes med en kombination av inhalationsanestesi och intravenös anestesi. Ca en tredjedel av dessa var illamående under studiens gång. Illamåendet uppstod främst under operationsdagen och första dagen efter operation. Inget samband mellan illamående och riskfaktorerna kön, ålder, åksjuka, eller fastetid kunde ses. Dock fanns en tendens till samband mellan illamående och tidigare postoperativt illamående. <em></em></p><p><em>Slutsats:</em><em> </em>Då undersökningsgruppen var för liten och inga säkra slutsatser kunde dras på grund av detta, krävs mer forskning inom detta område.</p> / <p><em>Aim: </em>The aim of this study was to investigate the instance of postoperative nausea in orthopedic patients that has performed an operation in narcosis. The aim was also to examine if well-known risk factors and type of anesthesia could relate to postoperative nausea (day 0-3).</p><p><em>Method:</em> The study design was prospective quantitative non experimental. Data were collected through six week on a ward for traumaortopedic patients. The response rate was 18 out of 34 approached. The results were analyzed and compiled in the descriptive statistics program SPSS.</p><p><em>Findings:</em> The findings show that all the patients that participates anaesthetizes with a combination of inhalation- and intravenous anesthesia. About one-third were nauseous in the process of the study. Nausea was most common in the first two days after operation. There was no correlation between nausea and sex, age, travel-sickness, or fast. A tendency could been seen between nausea and earlier postoperative nausea.</p><p><em>Conclusion:</em> More research requires since the research-group was to tiny, and no certain conclusions could be done on that account.</p>

ABSTRACT Purpose: Dexamethasone provides potent analgesic and antiemetic effects. Sevoflurane are associated with an increased incidence of postoperative nausea and vomiting (PONV) and delayed patient discharge compared to propofol. This study was designed to evaluate whether the prophylatic use of dexamethasone with sevoflurane could minimize the incidence of PONV and facilitate early recovery after outpatient anorectal surgery. Methods: Forty outpatients undergoing anorectal surgery were randomly assigned to receive either dexamethasone (5 mg IV; n=20) or an equal volume of saline (n=20) before the induction of anesthesia. Anesthesia was induced with sevoflurane 8% and N2O 67% in oxygen (at 6 L/min) followed by placement of laryngeal mask. Anesthesia was maintained with sevoflurane 2-4% end-tidal in combination with N2O 50% in oxygen 3 L/min. All patients were allowed to breathe spontaneously during the operation. The postoperative nausea and vomiting (PONV), VAS pain score and patient satisfaction were recorded. Results: The incidence of PONV and VAS pain score were significant lower in dexamethasone-treated patients compared with saline-treated ones. The time required for discharge was significantly shorter in dexamethasone-treated patients. Above all, the dexamethasone-treated patients expressed higher satisfaction index. There was no significant difference in recovery time for eye opening, response to commands, orientation, and ambulatory. Conclusions: The prophylactic administration of dexamethasone reduces the incidence of PONV andVAS pain score, promotes recovery to home readiness, and improves the satisfaction after the anesthesia with spontaneously breathing of sevoflurane through laryngeal mask in outpatients undergoing anorectal surgery.

Syfte: Syftet med uppsatsen var att studera förekomst av postoperativt illamående (dag 0-3) hos patienter som genomgått en ortopedisk operation i narkos. Syftet var också att studera om kända riskfaktorer och typ av anestesiform kan relateras till uppkomsten av postoperativt illamående (dag 0-3). Metod: Studiens design var en prospektiv kvantitativ icke experimentell studie. Data samlades in genom en enkätundersökning bland ortopedpatienter som opererats under narkos och som uppfyllde inklusionskriterierna. Antalet svarande var 18 av 34 tillfrågade. Resultatet analyserades och sammanställdes deskriptivt i statistikprogrammet SPSS. Resultat: Resultatet visar att alla patienter som deltog i studien sövdes med en kombination av inhalationsanestesi och intravenös anestesi. Ca en tredjedel av dessa var illamående under studiens gång. Illamåendet uppstod främst under operationsdagen och första dagen efter operation. Inget samband mellan illamående och riskfaktorerna kön, ålder, åksjuka, eller fastetid kunde ses. Dock fanns en tendens till samband mellan illamående och tidigare postoperativt illamående. Slutsats: Då undersökningsgruppen var för liten och inga säkra slutsatser kunde dras på grund av detta, krävs mer forskning inom detta område. / Aim: The aim of this study was to investigate the instance of postoperative nausea in orthopedic patients that has performed an operation in narcosis. The aim was also to examine if well-known risk factors and type of anesthesia could relate to postoperative nausea (day 0-3). Method: The study design was prospective quantitative non experimental. Data were collected through six week on a ward for traumaortopedic patients. The response rate was 18 out of 34 approached. The results were analyzed and compiled in the descriptive statistics program SPSS. Findings: The findings show that all the patients that participates anaesthetizes with a combination of inhalation- and intravenous anesthesia. About one-third were nauseous in the process of the study. Nausea was most common in the first two days after operation. There was no correlation between nausea and sex, age, travel-sickness, or fast. A tendency could been seen between nausea and earlier postoperative nausea. Conclusion: More research requires since the research-group was to tiny, and no certain conclusions could be done on that account.

As some references suggested that tobacco smoking behavior increases the risk of persistent pain and poorer recovery, but some demonstrated that nicotine decreased pain sensitivity. Both contrary conclusions make clinicians confused on how to manage the patients with tobacco smoking habit. This study conducted a retrospective way to evaluate the relationship between acute postoperative pain management and tobacco smoking behavior. This study included 511 Patients underwent general surgery were assigned to smokers or non-smokers. Site of surgery, type and duration of anesthesia were extracted from the anesthetic record. Information regarded each patient's gender, age, preoperative weight, past medical history, postoperative course, all non-opiate sedatives and opiate analgesics used in the first 72 hours were collected and recorded. Morphine administered via a patient-controlled analgesia (PCA) device was the preferred method of analgesia for these patients. Anesthesia was standardized. Exclusion criteria included the patients underwent major thoracic cardiovascular surgery, the patients with significant lung lesion, the patients with conscious disturbance, and the patients with allergic history to morphine. The results showed that of the sense of pain, the smoking group in the second day the pain scores significantly higher than non-smoking group (p<0.001), indicated that smoking patients were had more pain than non-smoking patients after surgery. And of the analgesic drug effects, the smoking group in the second and third day analgesic doses and the total analgesic doses were significantly higher than non-smoking group (p<0.023), showed that smoking patients significantly used more analgesic than non-smoking group after surgery. Smoking was associated with pain indeed existence.

Thesis (doctoral)--Technische Hochschule, Aachen, 2001.

Zugl.: Leipzig, Univ., Habil.-Schrift, 2009

Background Various analgesics are available for post-operative pain after third molar surgery. Combinations of different classes of analgesics may improve the overall efficacy of pain control as they covers different pain pathways. A great variation of combinations and dosages of analgesics have been suggested in the literature, yet it was still unclear what combination(s) and dosages were the most effective for acute post-operative dental pain. A systematic review of randomized clinical trials would help clinicians to make clinical judgment of which analgesic combination(s) would be the best for their patients for acute post-operative dental pain in terms of efficacy and safety. Aim To conduct a systematic review of randomized clinical trials to answer the clinical question “which analgesic combination and dosage is potentially the most effective and safe for acute post-operative dental pain control?” Methods A structured systematic literature search, with predefined inclusion and exclusion criteria, of the relevant computer databases and journals was performed. The search and the evaluations of articles were done by 2 independent reviewers in 3 rounds. Studies that fulfilled the pre-set criteria were included to enter the final review. The analgesic efficacy of the analgesic combinations reported in the included studies were presented by the objective pain measurements, sum of pain intensity at 6 hours (SPID6) and total pain relief at 6 hours (TOTPAR6). The SPID6 and TOTPAR6 of various combinations were adjusted after deducting from the effect of placebos of the respective studies. The adverse effects of the different analgesic combinations were also presented. Results There were 13 studies with 2843 subjects included in the final review. Eight groups of drug combinations with 13 different dosages were reported. The efficacies of the reported analgesic combinations have SPID6 scores ranged from 1.46 to 6.44 and TOTPAR6 scores ranged from 3.24 – 10.3. Among the analgesic combinations, ibuprofen 400mg + oxycodone HCL 5mg had the highest adjusted SPID6 (6.44), and a very higher adjusted TOTPAR6 (9.31), representing its efficacy could be superior to the other different analgesic combinations reported in this study. Nausea was the most common adverse effect of the analgesic combinations, with prevalence ranged from 0-55%. Most of the common adverse effects were related to the use of opioids in the combination. Three combinations of different dosages containing ibuprofen and caffeine were reported with the lowest prevalence of adverse effect. Conclusions This systematic review of randomized clinical trials has presented the efficacy and adverse effects of the various analgesic combinations for acute post-operative dental pain control. We have identified ibuprofen 400mg with oxycodone 5mg was more effective when compared to the other 12 combinations. Nausea was the most common adverse effects in an analgesic combination containing an opioid. Ibuprofen 200mg with caffeine 100mg or 200mg has a reasonable analgesic effect with fewer side effects when compared to the other analgesic combinations. / published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

No description available.

In the homeotherm, core body temperature (T(bc)) is considered one of the vital signs by which physiologic normality can be assessed. In persons who are unable to self-regulate T(bc), hypothermia (HT) can result. Recognition of HT as a potential physiologic problem especially in the adult postsurgical patient who is recovering from anesthesia has been acknowledged. Recovery room (RR) nurses daily manage the shivering patient who not only experiences increased oxygen demand, but who may also exhibit airway obstruction and increased somnolence as a result of HT. Thus, a primary nursing activity in the RR is to assist the patient in recovery from anesthesia and to facilitate his return toward normothermia. No study has delineated the frequency, temperature range, or duration of HT in adult RR postsurgical patients. Additionally, no data exist to support the effectiveness of current nursing heat treatments directed against mild to moderate degrees of HT. The present study addresses both of these issues. Hypothermia is defined as T(bc) of less than 36.0 degrees centigrade (°C). One hundred ninety-eight patients were randomly assigned to one of four treatment groups. Three groups received a form of external heat while the final group did not. Heat was applied with radiant heat lamps, thermal with bath blanket (warmed), and bath blankets (warmed) with change. The control group had one bath blanket at room temperature. The purposive, nonrandom sample consisted of consenting adults scheduled for various operative procedures. Previous approval for the protocol had been received from the Human Subjects Committee. In all patients requiring RR care, identifying and descriptive characteristics were recorded. Disposable tympanic membrane probes were used to assess T(bc) with measurements taken on RR admission and every 15 minutes thereafter until discharge. Descriptive statistical analyses demonstrated that 60 percent of the subjects (n = 118) were hypothermic on RR admission. Mean RR admission T(bc) and discharge T(bc) (mean ± standard error [range]) were 35.6°C ± 0.06 [32.5-37.5°C] and 36.3 ± 0.05 [33.5-38.0°C] respectively. Duration of HT averaged 47 ± 4 minutes. Eighteen percent of all subjects were discharged from the RR with T(bc) of less than 36.0°C. Among heat transfer treatment groups, one-way analysis of variance or group t-tests demonstrated no significant difference in the rate of T(bc) rise in the first hour of RR stay, T(bc) change every 15 minutes, change in T(bc) divided by RR time, or discharge T(bc). Statistical significance was set at p < .05). Aged subjects (≥ 60 years) compared to nonaged subjects (< 60 years) demonstrated significantly lower T(bc)'s on admission and throughout the mean RR stay (admission to +90 minutes; p < .05). Rate of T(bc) rise for aged subjects was not significantly different from nonaged subjects. In conclusion, RR nurses should be alert for HT in a significant number of adult postsurgical patients. Accurate monitoring of T(bc) is necessary particularly early during the RR stay. Application of the heat transfer treatments does not significantly affect T(bc). However, anesthetic type and age can significantly affect T(bc) and therefore prescribe alterations in nursing activities.