[Strong opioids for treatment of chronic pain: a meta-analysis].

In the following presentation 59 German and English articles on the use of strong opioids in chronic pain syndromes are analysed. Studies concerning the epidural, intrathecal, intracerebroventricular and transdermal application of opioids were excluded. The articles were attributed to different study levels according to their contents.

Poor correlation of mouth-to-mouth ventilation skills after basic life support training and 6 months later.

The purpose of the present study was to evaluate the cardiopulmonary resuscitation (CPR) skills of medical students after a 2-h basic life support class (n = 129) and 6 months later (n = 113). Mean +/- SD written test score decreased from 6.4 +/- 0.

[Intraoperative EEG monitoring using a neural network].

Objective: To introduce a new EEG parameter for monitoring a patient's cerebral status during anaesthesia.

Method: EEG epochs (channel C3 P3, duration 30 see per epoch) yield patterns used as the training input of a self-organising neural network (neural gas algorithm). Each pattern contains spectral components.

[Supply of opioid analgesics to outpatients with cancer pain].

Introduction: Treatment of chronic cancer pain with strong opioids is indicated in about 60-70 % of patients. Surprisingly, these very potent analgesics are prescribed with great reservations in many countries, including Germany. The aim of our investigation was to analyse the supply of opioid analgesics to outpatients with cancer pain in the region of Hannover, which has about 1.

[Age-related correlation between EEG parameters and depth of anesthesia under propofol. Effect of fentanyl].

Unlabelled: This study was designed to determine the relationship between the electroencephalogram (EEG) and clinical signs of depth of anaesthesia during induction of anaesthesia by slow infusion of propofol (18 mg/kg.h).

Methods: Four groups of 12 patients each were studied (groups I and II: 18-50 years; groups III and IV: > 70 years).

[Are special burn scores necessary in intensive care?].

In a retrospective study of 51 severely burned patients specific scores for burn injuries showed no advantages to general intensive scores in respect to the prediction of mortality and sepsis. Monitoring is possible since patients at high risk already differed significantly in the early phase of treatment.

[Channel selection for EEG-monitoring in anesthesia].

The conventional multichannel electroencephalogram is quite inconvenient for long-term monitoring in the operating theatre or intensive care unit. Recording of the EEG would be easier if a small number of channels was sufficient. Aiming at reduction of channels, leads from different regions of the scalp were analysed visually and with regard to their spectral content.

[Changes with age in EEG during anesthesia].

The number of older persons who have to undergo surgical procedures is steadily growing. For these patients the risks of anaesthesia are often increased because of their past medical history and their restricted physiological resources. Apart from parameters of the cardiovascular system, the electroencephalogram (EEG) represents a supplementary method for intraoperative monitoring, because cerebral alterations caused by anaesthetics or narcotics are directly reflected in the EEG.

Preventing intraoperative complications: a new monitoring device for intraoperative EEG recordings.

Alterations of the cerebral function caused by anesthetics or due to potentially harmful situations are reflected in the electroencephalogram (EEG). Nevertheless, the EEG has not become a routine monitoring device so far because of the complicated and time-consuming recording procedure. Furthermore, interpretation of the EEG requires special knowledge.

[Reduction of the number of recorded EEG channels for routine monitoring in the intensive care unit].

Monitoring patients in the intensive care unit with the aid of the conventional electroencephalogram employing a large number of recording channels is rather difficult, and can be laborious. This imposes limits on the routine application of this method. To investigate the possibility of developing a new monitoring device for easier application in the ICU, we aimed to establish whether the relevant information provided by a multi-channel EEG could be found in a subgroup of channels, thus reducing the number of channels required.

Testing the Gaussianity of the human EEG during anesthesia.

The Gaussian properties of human EEGs, which were measured over various stages of general anesthesia, were tested. The basis of the method was to describe the EEG signals by autoregressive models and to test the normality of the regression residuals with the Shapiro-Wilk statistic. The results show that in general the human EEG during anesthesia can be considered as a realization of a Gaussian stochastic process.

[Slowing down of the EEG during hypoventilation in emergence from anesthesia].

Electroencephalographic (EEG) recordings were made using a "Narkograph", which performs an automatic on-line interpretation of electroencephalographic data obtained during anesthesia. The EEG was classified into one of 13 stages from A (awake) to F (very deep narcosis). In 20 of roughly 600 patients EEG changes were observed that could not be explained by the effects of anesthetics.

Identification of EEG patterns occurring in anesthesia by means of autoregressive parameters.

In EEG analysis an automatic pattern recognition is of interest. In this paper the usefulness of autoregressive parameters to classify EEG segments recorded during anesthesia is examined. Assuming that the AR parameters are multivariate normally distributed, parametric methods of discriminant analysis can be applied.

[Opioids in "non-malignant" pain-results of long-term treatment in patients with rheumatic disease.].

The oral administration of strong opioids like morphine is a very effective treatment in cancer pain. However, these analgesics are rarely prescribed for patients suffering from severe "non-malignant" pain. We examined the effects of oral opioids (morphine sulphate tablets, buprenorphine and levomethadone) given to patients with intractable rheumatic pain, which were refractory to other therapeutic measures.

[Fatty emulsions in parenteral feeding following liver transplantation. A study of the neurotropic effect of MCT/LCT emulsions using EEG].

In the early postoperative period after liver transplantation a possible neurotropic side effect of middle-chain triglycerides used for total parenteral nutrition (TPN) was evaluated by EEG and Glasgow Coma Scale. Group I: no fat for TPN; Group II: 0.7 g/kg body weight (BW) and day, of MCT/LCT emulsion; Group III: 1.

[Can ventilation based on the principle of the iron lung act today as a substitute for or an alternative method to conventional forms of ventilation?].

A plastic lung working on the same principles as an iron lung has been developed at the Medical School in Hannover. Functional and practical tests were performed in a representative group of patients. Respirators support following the principles of an iron lung may be provided as a supplement or an alternative to existing artificial respirator therapy.

Fat emulsions in parenteral nutrition after liver transplantation: The recovery of the allografts RES function and histological observations.

Following liver transplantation, the effect of post-operative parenteral nutrition with MCT LCT (Medium Chain Triglycerides/Long Chain Triglycerides) fat emulsions on the recovery of allografts RES function was investigated in a randomised prospective study of three groups of patients (group I, n = 14: 50g MCT LCT fats twice weekly, group II, n = 15: 0.7 g/kg body weight per day MCT LCT fats, group III, n = 17: 1.5 g/kg body weight per day MCT LCT fats).

[Fat emulsions in parenteral feeding following liver transplantation. I. Effect on the recovery of RES function in the transplant].

Following liver transplantation, the effect of postoperative parenteral nutrition with MCT/LCT fatty emulsions on the recovery of RES function in the allograft was investigated in a randomised prospective study of three groups of patients (group I: 50 g MCT/LCT fats twice weekly, group II: 0.7 g/kg body weight per day MCT/LCT fats, group III: 1.5 g/kg body weight per day MCT/LCT fats).

[Postoperative ventilation in non-intubated patients with iron lung versus conventional ventilation].

Postoperative ventilation using a steel lung is an alternative to conventional ventilation through an endotracheal cannula. Both methods were compared in two groups of patients undergoing major abdominal surgery. Group A was ventilated using a Servo Ventilator 900C, whereas group B was ventilated using a newly designed steel lung.

[Long-term therapy of tumor pain using morphine-retard tablets].

We analysed the effect of sustained-release morphine tablets in 174 patients with severe cancer pain. A good relief of pain could be obtained in 65% of the patients within the first week and in 80% of the patients at the end of therapy. The mean daily dose was at 178 mg morphine, six patients needed more than 1000 mg per day.

[The ovarian hyperstimulation syndrome. Anesthesiologic aspects based on a severe case].

Ovarian hyperstimulation syndrome (OHS) is an iatrogenic syndrome in which induction of ovulation results in a wide spectrum of clinical symptoms and signs and laboratory manifestations. Based on the severity of the symptoms and signs, three degrees of hyperstimulation have been described: mild, moderate and severe. The most severe manifestation, presented in this paper with reference to the case of a 27-year-old woman, takes the form of massive ovarian enlargement with multiple cysts, hemoconcentration and third-space accumulation of fluid in the form of ascites, pleural and pericardial effusion.

[Postoperative ventilation in the "iron lung"].

Postoperative artificial ventilation by using an endotracheal tube may cause a pulmonary infection. A possibly necessary permanent sedation and relaxation may result in an additional danger for the patient. The principle of the "iron lung" represents an alternative to endotracheal artificial respiration, which applies especially to endangered patients who are under postoperative artificial respiration.

[The effects of ketamine on the electroencephalogram--typical patterns and spectral representations].

In 40 female patients aged between 17 and 79 years, the pre- and intraoperative EEG was recorded and processed by personal computer. For induction of general anesthesia patients received between 2 and 3 mg/kg ketamine i.v.

[Pain therapy in gynecologic neoplasms].

A great number of patients with gynaecological malignant diseases suffer from severe pain, caused, for example, by bone metastases of breast cancer or tumour infiltration of the pelvis and the lumbar plexus in uterine cancer. Several methods of treatment are available depending upon the origin of pain. It is possible to achieve pain relief by radiotherapy or by cytostatic therapy.