RESUMEN
Analgesia with nonsteroid antiinflammatory drugs (NSAID) becomes a pressing problem today. One such drug is ketorolak tromethamine (KT), characterized by expressed analgesic activity comparable with that of opioid analgesics morphine or promedol. Our purpose was to assess KT efficacy in analgesia performed by different methods, including analgesia controlled by the patient (ACP) after surgery. In medium severe and strong pain KT was used in group I (n = 60) "as needed" in a dose of 30 mg up to 3-4 times a day, in group 2 (n = 12) by the ACP method, in group 3 (n = 16) KT was incessantly infused in a daily dose of up to 120 mg, and in group 4 (n = 11) KT was injected 3-4 times a day in a dose of 30 mg in combination with morphine ACP. The results indicate a high efficacy of KT: 83% after a single injection. Combined use of KT and promedol decreased the dose by 40-50%. Side effects were observed in 15% of patients: most often it was a sense of fever and sweating (in 4% of patients), nausea and vomiting (in 2%), insomnia (in 2%). ACP and planned injections in a daily dose of 90-120 mg is the optimal method of analgesia in patients after extensive surgical interventions.
Asunto(s)
Analgésicos no Narcóticos/administración & dosificación , Dolor Postoperatorio/tratamiento farmacológico , Tolmetina/análogos & derivados , Trometamina/análogos & derivados , Adolescente , Adulto , Anciano , Analgesia Controlada por el Paciente , Analgésicos no Narcóticos/efectos adversos , Analgésicos Opioides/administración & dosificación , Quimioterapia Combinada , Estudios de Evaluación como Asunto , Femenino , Humanos , Inyecciones Intramusculares , Inyecciones Subcutáneas , Ketorolaco Trometamina , Masculino , Persona de Mediana Edad , Morfina/administración & dosificación , Dolor/tratamiento farmacológico , Periodo Posoperatorio , Promedol/administración & dosificación , Tolmetina/administración & dosificación , Tolmetina/efectos adversos , Trometamina/administración & dosificación , Trometamina/efectos adversosAsunto(s)
Enfermedades Cardiovasculares/cirugía , Puente de Arteria Coronaria , Dobutamina/uso terapéutico , Hemodinámica/efectos de los fármacos , Transporte Biológico , Hemodinámica/fisiología , Humanos , Oxígeno/fisiología , Periodo Posoperatorio , Intercambio Gaseoso Pulmonar/efectos de los fármacos , Intercambio Gaseoso Pulmonar/fisiología , Respiración/efectos de los fármacos , Respiración/fisiologíaAsunto(s)
Dobutamina/administración & dosificación , Dopamina/administración & dosificación , Cuidados Posoperatorios , Gasto Cardíaco Bajo/tratamiento farmacológico , Gasto Cardíaco Bajo/fisiopatología , Gasto Cardíaco Bajo/cirugía , Evaluación de Medicamentos , Hemodinámica/efectos de los fármacos , Humanos , Oxígeno/sangre , Intercambio Gaseoso Pulmonar/efectos de los fármacosRESUMEN
Basic changes in receptor-controlled platelet calcium metabolism that occur in the early postoperative period under the effect of aggregation-inducing hormones--platelet activation factor (PAF), adenosine phosphate (ADP) and vasopressin--are reviewed. Patients after lung surgery and patients with ischemic heart disease after aortocoronary bypass surgery have been examined. Patients operated on for malignant lung tumours developed increased postoperative sensitivity to ADP, while in patients after aortocoronary bypass surgery the early postoperative period was characterized by decreased sensitivity to PAF and vasopressin.