Comparison of two methods of continuous femoral nerve block with elastomeric pump after total knee arthroplasty.

Background: The best method of continuous femoral nerve block (CFNB) after total knee arthroplasty (TKA) has not been determined. The study aimed to assess the effectiveness of CFNB based on patient-controlled regional analgesia (PCRA) with basal infusion of local anesthetic in decreasing pain and providing functional restoration after TKA and to compare it with the method of basal infusion only.

Methods: The prospective randomized controlled trial included 90 patients who were divided into three groups.

Levosimendan in the modern treatment of patients with acute heart failure of various aetiologies.

Acute decompensated heart failure (ADHF) is a common clinical problem associated with a high mortality rate. Because ADHF has various aetiologies, there are a range of therapeutic options, among others, positive inotropes (inotropic drugs). As an inotropic agent whose mechanism is different than that of "classical" medicines, levosimendan (LSM) is one of the most common therapeutic options.

Psychometric Assessment of Physiologic and Behavioral Pain Indicators in Polish Versions of the Pain Assessment Scales.

Background: There is an urgent need to prepare a reliable and accurate tool for pain assessment in patients who are unable to self-report. Translating pain assessment scales into foreign languages requires further validation testing.

Aim: The aim of the study was to carry out psychometric assessment of behavioral and physiological indicators of pain included in two Polish versions of pain assessment scales, the Behavioral Pain Scale (BPS) and the original Adult Non-Verbal Pain Scale (NVPS).

Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section - a controlled clinical study.

Objectives: Quadratus Lumborum Block in contrast to Transversus Abdominis Plane Block contains a unique component which not only stops somatic pain but also inhibits visceral pain by spreading the local anesthetic to the paravertebral space. This study was designed to determine whether performing the Quadratus Lumborum Block type I in patients un-dergoing cesarean section would be associated with both decreased morphine consumption and decreased pain levels in the postoperative 48-hour period.

Material And Methods: Sixty patients undergoing caesarean section under spinal anesthesia were randomly and equally assigned to one or other of two groups: QLB I (who received Bilateral Quadratus Lumborum Block type I with the use of 24 mL 0.

Practical issues of nutrition during continuous renal replacement therapy.

Continuous renal replacement therapy (CRRT) in critically ill patients has significant impact on one's ability to provide efficient nutritional therapy. CRRT may help in the prevention of intestinal oedema and the maintenance of the proper function of the gastrointestinal tract by enabling strict control of the fluid balance. It facilitates early introduction of nutrition via the enteral route, as well as allowing for the composition of high-volume feeding mixtures.

Results of the severe sepsis registry in intensive care units in Poland from 2003-2009.

Background: Severe sepsis remains the most common cause of death in intensive care units (ICUs) according to many epidemiological studies. There are no data in Poland on the extent of severe sepsis cases treated in ICUs. The aim of the study was to analyse the course and outcome of severe sepsis patients treated in Polish ICUs.

[Polish guidelines for the prevention and treatment of venous thromboembolism. 2012 update].

The overall objective of the Polish guidelines for the prevention and treatment of venous thromboembolism is to increase patient benefit and safety by appropriate prevention and treatment of deep vein thrombosis and pulmonary embolism as well as proper management of the complications associated with antithrombotic and thrombolytic therapy. These guidelines apply to adult trauma, cancer, surgical, and medical patients as well as those at increased risk of venous thromboembolism. Specific recommendations have been formulated for pregnant women, patients requiring surgery while receiving long-term oral anticoagulant treatment, and patients undergoing regional anesthesia and/or analgesia.

Multiwavelength time-resolved detection of fluorescence during the inflow of indocyanine green into the adult's brain.

Optical technique based on diffuse reflectance measurement combined with indocyanine green (ICG) bolus tracking is extensively tested as a method for clinical assessment of brain perfusion in adults at the bedside. Methodology of multiwavelength and time-resolved detection of fluorescence light excited in the ICG is presented and advantages of measurements at multiple wavelengths are discussed. Measurements were carried out: 1.

Time-resolved detection of fluorescent light during inflow of ICG to the brain-a methodological study.

It was reported that time-resolved reflectance measurements carried out during inflow and washout of an optical contrast agent may provide information on the blood supply to the brain cortex of human adults. It was also shown that a measurement of fluorescence excited in the dye circulating in the brain is feasible. Unfortunately, patterns of time-resolved fluorescence signals observed during in vivo measurements are difficult to interpret.

Assessment of inflow and washout of indocyanine green in the adult human brain by monitoring of diffuse reflectance at large source-detector separation.

Recently, it was shown in measurements carried out on humans that time-resolved near-infrared reflectometry and fluorescence spectroscopy may allow for discrimination of information originating directly from the brain avoiding influence of contaminating signals related to the perfusion of extracerebral tissues. We report on continuation of these studies, showing that the near-infrared light can be detected noninvasively on the surface of the tissue at large interoptode distance. A multichannel time-resolved optical monitoring system was constructed for measurements of diffuse reflectance in optically turbid medium at very large source-detector separation up to 9 cm.

[The influence of epidural analgesia on the course of labor].

Objective: The aim of the study was to analyze the influence of epidural analgesia (EA) on the course of labor.

Material And Methods: The study group consisted of 191 women with EA ("walking anesthesia"). 209 women without EA were chosen for controls.

[Polish guidelines for the prevention and treatment of venous thromboembolism: 2009 update].

The overall objective of the Polish guidelines for the prevention and treatment of venous thromboembolism is to increase patient benefit and safety by appropriate prevention and treatment of deep vein thrombosis and pulmonary embolism as well as proper management of the complications associated with antithrombotic and thrombolytic therapy. These guidelines apply to adult trauma, cancer, surgical, and medical patients as well as those at increased risk of venous thromboembolism. Specific recommendations have been formulated for pregnant women, patients requiring surgery while receiving long-term oral anticoagulant treatment, and patients undergoing regional anesthesia and/or analgesia.

[Comparative study of postoperative analgesia after intrathecal administration of bupivacaine with fentanyl or morphine for elective Caesarean section].

Background: Various opioids have been recommended for spinal anaesthesia during Caesarean section. The aim of this prospective randomized, double-blind study was to compare the quality of postoperative analgesia and adverse effects after intrathecal administration of 0.5% hyperbaric bupivacaine (HB) combined with either morphine or fentanyl.

[Tobacco smoking and the perioperative period].

In this review we present the pathophysiology of tobacco smoking and its effect on respiration, circulation and the digestive tract. Smokers have a higher risk of postoperative respiratory complications. Smoking approximately 20 cigarettes a day over twenty years significantly influences the development of pulmonary events, particularly hypoxemia and bronchospasm.

[Peripartum cardiomyopathy and preeclampsia complicated with HELLP syndrome--a case report].

Peripartum cardiomyopathy (PC) and preeclampsia with HELLP syndrome are serious complications of pregnancy, but the coincidence of both in one pregnancy is extremely rare. Here, we report a case of 32-year-old primipara who in 35th Hbd presented for the first time in her life symptoms of severe heart failure (HF) in NYHA class III/IV. In 37th Hbd the diagnosis of PC was established based on clinical status and echocardiographic examination, which demonstrated a dilatation of heart chambers and impaired left ventricular systolic function with decreased ejection fraction (EF) 17%.

Intrathecal antinociceptive interaction between the NMDA antagonist ketamine and the opioids, morphine and biphalin.

Biphalin is an opioid peptide analogue that currently is under clinical development as a new type of site-directed analgesic. In rats, the intrathecal (i.t.

[Anesthetic complications in spinal surgery].

Background. The frequency of occurrence of anesthesiological complications is closely associated with the type of operation being performed and the chosen method of inducing anesthesia. The present study described complications encountered during anesthesia for various types of surgery to correct scoliosis.

Results of severe sepsis treatment program using recombinant human activated protein C in Poland.

Background: Recombinant human activated protein C (drotrecogin alfa [activated]--DAA) demonstrated in Phase III controlled clinical studies significant reduction of mortality in patients with severe sepsis and high risk of death. The aim of the study was to assess the therapeutic efficacy of DAA in patients included in the National Severe Sepsis Register in Poland.

Material/methods: The analysis included 3233 cases of severe sepsis reported between 04.

[HELLP syndrome in the postpartum period].

The HELLP syndrome was described by Weinstein as a complication of pregnancy induced hypertension (PIH). There are few clinical reports about HELLP during postpartum period. We present the history of 31 years old pregnant patient, who developed in 36 week of her first pregnancy PIH, pregnancy was terminated in 39 week by cesarean section and postpartum period was complicated with HELLP syndrome (class I).