[Cave canulam et dilatationem. Cardiopulmonary resuscitation and surgical repair of a vessel perforation following central venous catheterization].

A 58-year-old female patient was scheduled for minimally invasive cardiac surgery. For drainage of venous blood to the heart-lung machine insertion of a central venous large diameter catheter was a prerequisite. During insertion into the right internal jugular vein by the anesthesiologist a life-threatening perforation of the subclavian artery occurred.

Intravenous versus subcutaneous morphine titration in patients with persisting exacerbation of cancer pain.

Background: Patients with cancer pain with initially adequate analgesia under oral sustained-release opioid medication may suffer from persisting pain exacerbations. Sometimes even fast help is needed and then optimally performed by intravenous application (IVA) of immediate-release (IR) opioids. This IVA, however, may only be performed by physicians in Germany.

[MIDOS--an electronic database for the palliative care unit].

Introduction: A minimal documentation system (MIDOS) has been developed for self-assessment of pain and other symptoms by the patients on palliative care units. To decrease the administrative burden and thereby increase the acceptance of the system an electronic database was developed to facilitate data entry and documentation.

System: The database is based on Microsoft Access.

[MIDOS--validation of a minimal documentation system for palliative medicine].

Introduction: Repeated assessment of pain and other symptoms is required for quality assurance in palliative care. However, physical and cognitive impairment of the patients may impede the use of standardized questionnaires and documentation systems in palliative care setting. We developed a minimal documentation system (MIDOS) for the specific requirements in this setting.

[Switching opioids to transdermal fentanyl in a clinical setting].

Introduction: The use of transdermal fentanyl is gaining in importance in the management of cancer pain. We describe the reasons for switching opioid medication to transdermal fentanyl in a pain management unit.

Methods: Case records of patients treated with transdermal fentanyl in our pain clinic were evaluated retrospectively.