„Acute Pain Management Service“ — ein Dienst zur Behandlung akuter Schmerzen

  • F. P. Buckley


Studien über die Effektivität konventioneller Analgesieverfahren (hauptsächlich mittels intramuskulärer Injektion von Opioiden) zeigen, daß ein großei Anteil von Patienten, ungefähr 30–40%, postoperativ unter mittleren bis starken Schmerzen leidet, was bereits in Editorials in angesehenen Zeitschriften angeklagt wurde [16, 17]. Diese Inzidenz scheint sich in den letzten 30 Jahren nur wenig geändert zu haben [13, 23, 30, 38].


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  1. 1.
    Austin KL, Stapleton JV, Mather LE (1980) Multiple intramuscular injections: a major source of variability in response to meperidine. Pain 8: 47–62PubMedCrossRefGoogle Scholar
  2. 2.
    Austin KL, Stapleton JV, Mather LE (1980) Relationship between blood meperidine concentrations and analgesic response: a preliminary report. Anesthesiology 53: 460–466PubMedCrossRefGoogle Scholar
  3. 3.
    Bacon AK (1977) An alternative nerve block for post circumcision analgesia. Anaesth Intensive Care 5: 63–64PubMedGoogle Scholar
  4. 4.
    Berkowitz BA, Ngai SH, Yang JC, Hempstead J, Spector S (1975) The disposition of morphine in surgical patients. Clin Pharmacol Ther 17: 629–635PubMedGoogle Scholar
  5. 5.
    Bond MR (1980) Personality and pain. The influence of psychological and environmental factors upon the experience of pain in hospital patients. In: Lipton S (ed) Persistent Pain, Vol. 2. Academic Press, Grune and Stratton, London New York, pp 1–25Google Scholar
  6. 6.
    Brands E, Callanan VL (1978) Continuous lumbar plexus block–analgesia for femoral neck fractures. Anaesth Intensive Care 6: 256–258PubMedGoogle Scholar
  7. 7.
    Bromage PR (1954) Spinal Epidural Analgesia. Livingstone, Edinburgh LondonGoogle Scholar
  8. 8.
    Bridenbaugh PO, DuPen SL, Moore DC, Bridenbaugh LD, Thompson GE (1973) Postoperative intercostal nerve block vs. narcotic analgesia. Anesth Analg 52: 81–85PubMedGoogle Scholar
  9. 9.
    Buckley FP, Robinson NB, Simonowitz DA, Dellinger EP (1983) Anesthesia in the morbidly obese: a comparison of anesthetic and analgesic regimens for upper abdominal surgery. Anaesthesia 38: 840–851PubMedCrossRefGoogle Scholar
  10. 10.
    Buckley FP, Sizemore WA, Charlton JE (1986) Medication management in patients with chronic non-malignant pain: a review of the use of a drug withdrawal protocol. Pain 26: 153–165PubMedCrossRefGoogle Scholar
  11. 11.
    Chapman CR (1985) Psychological factors in postoperative pain. In: Smith G, Covino BG (eds) Acute Pain. Butterworths, London, pp 22–41Google Scholar
  12. 12.
    Delilkan AE, Lee CH, Yong NK, Ong SC, Ganendran A (1973) Post-operative local analgesia for thoracotomy with direct bupivacaine intercostal blocks. Anaesthesia 28: 561–567PubMedCrossRefGoogle Scholar
  13. 13.
    Donovan BD (1983) Patient attitudes to postoperative pain relief. Anaesth Intensive Care 11: 125–129PubMedGoogle Scholar
  14. 14.
    Eason MJ, Wyatt R (1979) Paravertebral thoracic block–a reappraisal. Anaesthesia 34: 638–642PubMedCrossRefGoogle Scholar
  15. 15.
    Egbert LD, Batit GE, Welch CE, Bartlett MK (1964) Reduction of post-operative pain by encouragement and instruction of patients. A study of doctor-patient rapport. N Engl J Med 280: 825–827Google Scholar
  16. 16.
    Editorial (1976) Post-operative pain. Anaesth Intensive Care 4: 95–96Google Scholar
  17. 17.
    Editorial (1978) Postoperative pain. Br Med J 1: 517–518Google Scholar
  18. 18.
    Engberg G (1985) Respiratory performance after upper abdominal surgery. A comparison of pain relief with intercostal blocks and centrally acting analgesics. Acta Anaesthesiol Scand 29: 427–435PubMedCrossRefGoogle Scholar
  19. 19.
    Gourlay GK, Willis RJ, Wilson PJ (1984) Postoperative pain control with methadone: influence of supplementary methadone dose and blood concentration relationships. Anesthesiology 61: 19–26PubMedGoogle Scholar
  20. 20.
    Hashimi K, Middleton MD (1983) Subcutaneous bupivacaine for post-operative analgesia after herniorraphy. Ann R Coll Surg Engl 65: 38–39Google Scholar
  21. 21.
    Humphreys CF, Kay h (1976) The control of postoperative pain with the use of bupivacaine injections. J Urol 116: 618–619Google Scholar
  22. 22.
    Kirya C, Werthmann MW (1978) Neonatal circumcision and penile dorsal nerve block–a painless procedure. J Pediatr 92: 998–1000PubMedCrossRefGoogle Scholar
  23. 23.
    Lasagna L, Beecher HK (1954) The optimal dose of morphine. JAMA 156: 230–236CrossRefGoogle Scholar
  24. 24.
    Lehmann KA, Heinrich C, van Heiss R (1988) Balanced anaesthesia and patient-controlled postoperative analgesia with fentanyl• minimum effective concentrations, accumulation and acute tolerance. Acta Anaesthesiol Be1g 39: 11–23Google Scholar
  25. 25.
    Lehmann KA, Reichling U, Wirtz R (1988) Influence of naloxone on the postoperative analgesic and respiratory effects of buprenorphine. Eur J Clin Pharmacol 34: 343–352PubMedCrossRefGoogle Scholar
  26. 26.
    Levack SP, Holmes JD, Robertson JS (1986) Abdominal wound perfusion for the relief of postoperative pain. Br J Anaesth 58: 615–619PubMedCrossRefGoogle Scholar
  27. 27.
    Middaugh RE, Menk EJ, Reynolds WJ, Bauman JM, Cawthon MA, Hartshorne MF (1985) Epidural block using large volumes of local anesthetic for intercostal block. Anesthesiology 63: 216–218CrossRefGoogle Scholar
  28. 28.
    Moore DC (1975) Intercostal nerve block for postoperative somatic pain following surgery of the thorax and upper abdomen. Br J Anaesth 47: 284–286PubMedGoogle Scholar
  29. 29.
    Owen M, Galloway DJ, Mitchell KA (1985) Analgesia by wound infiltration after surgical excision of benign breast lumps. Ann R Coll Surg Engl 67: 114–115PubMedGoogle Scholar
  30. 30.
    Papper EM, Brodie BB, Rovenstein EA (1952) Postoperative pain; its use in the comparative evaluation of analgesics. Surgery 32: 107–109PubMedGoogle Scholar
  31. 31.
    Porter KM, Davies J (1985) The control of pain after Keller’s procedure–a controlled double blind prospective trial with local anaesthetic and placebo. Ann R Coll Surg Engl 67: 293–294PubMedGoogle Scholar
  32. 32.
    Rawal N, Sjostrand U, Christoffersson E, Dahlström B, Arvill A, Rydman h (1984) Comparison of intramuscular and epidural morphine for postoperative analgesia in the grossly obese: influence on postoperative ambulation and pulmonary function. Anesth Analg 63: 583–592Google Scholar
  33. 33.
    Reading AE (1979) The short term effects of psychological preparation for surgery. Soc Sci Med 13 (A): 641–654Google Scholar
  34. 34.
    Reiestad F, Stomskag KE, Holmquist E (1986) Intrapleural administration of bupivacaine in the postoperative management of pain. Anesthesiology 65: A204CrossRefGoogle Scholar
  35. 35.
    Rosenblatt RM (1980) Continuous femoral anesthesia for lower extremity surgery. Anesth Analg 59: 631–632PubMedGoogle Scholar
  36. 36.
    Selander D (1977) Catheter technique in axillary plexus block. Acta Anaesthesiol Scand 21: 324–329PubMedCrossRefGoogle Scholar
  37. 37.
    Smith BE (1984) Continuous sciatic nerve blocks. Anaesthesia 39: 155–157PubMedCrossRefGoogle Scholar
  38. 38.
    Sriwatanakul K, Weis OF, Alloza BA, Kelvie W, Weintraub M, Lasagna L (1983) Analysis of narcotic usage in the treatment of postoperative pain. JAMA 250: 926–927PubMedCrossRefGoogle Scholar
  39. 39.
    Stenseth R, Sellevold O, Breivik h (1985) Epidural morphine for postoperative pain: experience with 10$5 patients. Acta Anaesthesiol Scand 29: 148–156CrossRefGoogle Scholar
  40. 40.
    Tuominen M, Rosenberg PM, Kaslo E (1983) Blood levels of bupivacaine after single dose, supplementary dose and continuous infusion in axillary plexus block. Acta Anaesthesiol Scand 27: 303–306PubMedCrossRefGoogle Scholar
  41. 41.
    Vatashsky E, Aranson HB (1980) Continuous interscalene brachial plexus block for surgical operations on the hand. Anesthesiology 53: 356PubMedCrossRefGoogle Scholar
  42. 42.
    Wilson JF, Moore RW, Randolph S, Hanson BJ (1982) Behavioral preparation of patients for gastrointestinal endoscopy: information, relaxation, and coping style. J Human Stress 8: 13–23PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1990

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  • F. P. Buckley

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