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Steven Ganzberg Richard A Pape F Michael Beck 《Journal of oral and maxillofacial surgery》2002,60(3):244-50; discussion 250-1
PURPOSE: Remifentanil is a new, short-acting opioid that is similar pharmacodynamically to currently available opioids but differs in its pharmacokinetics. In the present study, we compared the use of remifentanil with the use of meperidine during intravenous conscious sedation for third molar surgery. PATIENTS AND METHODS: Forty patients who were scheduled for the removal of impacted third molars were randomly assigned to undergo 1 of 2 intravenous conscious sedation techniques. For both groups, 50:50 nitrous oxide oxygen were administered via nasal hood, and midazolam was titrated to Verril's sign. Twenty patients each then received either remifentanil 0.05 microgram/kg/min or meperidine 50 mg. Both patients and surgeons were blinded to the narcotic that was used. Blood pressure, heart rate, and oxygen saturation were determined before sedation and every 5 minutes during surgery. Recovery was measured using serial Trieger tests every 5 minutes after surgery. Patient and surgeon satisfaction of the quality of sedation was measured with a visual analog scale. RESULTS: Peak heart rate (91 beats/min for remifentanil vs 107 beats/min for meperidine, P <.01) and peak systolic blood pressure (131 mm Hg for remifentanil vs. 142 mm Hg for meperidine, P <.05) were significantly lower for the remifentanil group. Although there was a trend toward increased surgeon satisfaction with remifentanil (86 of 100 with remifentanil vs. 73 of 100 with meperidine), it was not found to be statistically significant. Likewise, other physiologic parameters were not found to be statistically significant. CONCLUSIONS: The lower peak heart rate and systolic blood pressure levels indicate that remifentanil may allow for less fluctuation in cardiovascular parameters. This could prove beneficial in patients with cardiovascular compromise. 相似文献
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Pape Lars; Mengel Michael; Offner Gisela; Ehrich Jochen H.H. 《Nephrology, dialysis, transplantation》2004,19(12):3207
Sir, A 4-year-old boy presented with oedema and weight gain of 5kg. There had been no preceding infections, vaccinations ormedication. The family history includes the mothers mesangioproliferativeglomerulonephritis. Laboratory results showed decreased albumin (13 g/l) concentration.Calculated glomerular filtration rate was 125 ml/min/1.73 m2and the 相似文献
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Disc replacement using Pro-Disc C versus fusion: a prospective randomised and controlled radiographic and clinical study 总被引:4,自引:0,他引:4
A. Nabhan F. Ahlhelm T. Pitzen W. I. Steudel J. Jung K. Shariat O. Steimer F. Bachelier D. Pape 《European spine journal》2007,16(3):423-430
Anterior cervical discectomy and fusion (ACDF) may be considered to be the gold standard for treatment of symptomatic degenerative
disc disease within the cervical spine. However, fusion of the segment may result in progressive degeneration of the adjacent
segments. Therefore, dynamic stabilization procedures have been introduced. Among these, artificial disc replacement by disc
prosthesis seems to be promising. However, to be so, segmental motion must be preserved. This, again, is very difficult to
judge and has not yet been proven. The aim of the current study was to first analyse the segmental motion following artificial
disc replacement using a disc prosthesis. A second aim was to compare both segmental motion as well as clinical result to
the current gold standard (ACDF). This is a prospective controlled study. Twenty-five patients with cervical disc herniation
were enrolled and assigned to either study group (receiving a disc prosthesis) or control group (receiving ACDF, using a cage
with bone graft and an anterior plate.) Radiostereometric analysis was used to quantify intervertebral motion immediately
as well as 3, 6, 12 and 24 weeks postoperatively. Further, clinical results were judged using visual analogue scale and neuro-examination.
Cervical spine segmental motion decreased over time in the presence of disc prosthesis or ACDF. However, the loss of segmental
motion is significantly higher in the ACDF group, when looked at 3, 6, 12 and 24 weeks after surgery. We observed significant
pain reduction in neck and arm postoperatively, without significant difference between both groups (P > 0.05). Cervical spine disc prosthesis preserves cervical spine segmental motion within the first 6 months after surgery.
The clinical results are the same when compared to the early results following ACDF. 相似文献
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Potential of a Simplified p24 Assay for Early Diagnosis of Infant Human Immunodeficiency Virus Type 1 Infection in Haiti 下载免费PDF全文