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Biomedical subjects

K Hermanns

Publications and source records attributed to K Hermanns.

4 recordsLinked to original sources
PubMed2006

[Pain therapy in addicted patients].

Each individual is entitled to an adequate and sufficient pain therapy. However, only a few studies have examined the peculiarities of pain management in drug-dependent or formerly addicted patients. Any addiction is disadvantageous for a successful pain therapy, since some of the prescribed drugs may themselves cause addiction. Drug-dependent patients are often tolerant to opioids. Additionally, there is a risk of iatrogenic pain becoming chronic due to disregard for already known risk factors and comorbidities. However, a history of addiction should not prevent sufficient pain therapy, especially since there is no risk of addiction when the pain therapy employed is adequate for the pathophysiology involved. There are adequate pain therapies for addicted patients. The best results are achieved by taking into account the physiological and psychological peculiarities of drug-dependent patients. Importantly, this should be combined with a variety of different, optimized, multimodal therapeutic regimes, as well as with an interdisciplinary approach.

Acupuncture Therapy↗
PubMed1993

[Dying and death in a surgical intensive care unit from the viewpoint of close relatives--a questionnaire survey].

No studies are available so far on the way dying and death in the ICU are perceived by relatives of the patients. It is also not clear in how far the current criticism of intensive care medicine stems from these relatives. These problems were investigated by sending a self-developed 48-item questionnaire to relatives of patients who had died in the ICU. The questions centred on the following subjects: Communication and information structures Perception of the ICU and emotional reaction Assessment of treatment Dying and death in the ICU. Of 181 questionnaires distributed, 145 (85.3%) were returned. We present the replies of the 109 persons who visited their relatives in the ICU. The majority regarded themselves as well informed. Initial impressions were a high technical and medical standard. Emotional reactions to ICU treatment of a relative alternated between anxiety and hope with the dominant impression that the patient received the best possible therapy. However, the treatment was not perceived as an artificial prolongation of life. Although death loses dignity in the ICU according to those questioned, dying in peace does seem possible in this situation. The high response rate, the positive general assessment and the critical view of death in the ICU are discussed in the following.

Adolescent↗
PubMed1993

Intranasal meperidine titration for postoperative pain relief.

A prospective, randomized, double-blind study investigating the efficacy of intranasal meperidine as compared with intravenous (i.v.) administration for postoperative pain relief is described. The study was limited to the initial titration of pain relief during a 2-h period immediately after surgery. Sixty women having undergone a hysterectomy were studied. Initially and when complaining of a pain intensity > or = 40 on the 101-point numerical rating scale (NRS), 30 patients received 6 sprays (27 mg) meperidine intranasally and simultaneously 6 mL NaCl 0.9% i.v. (nasal group); another 30 patients received 6 sprays of NaCl 0.9% intranasally and 6 mL of a diluted meperidine solution (27 mg) i.v. (intravenous group). Patients already having a pain reduction < 40 on the 101-point NRS, received half of the above dose. Meperidine was repeated every 5 min until the patients were pain free or refused further analgesic. Before the onset of meperidine titration and at 5- to 10-min intervals for 2 h thereafter, pain was evaluated with a 101-point NRS and a verbal rating scale. Within 20 and 35 min the pain scores evaluated by the NRS and verbal rating scale decreased in the intravenous and nasal group to a median of zero. The total dose of meperidine was 76.5 mg (range, 40.5-135.0) in the intravenous group and 104.4 mg (range, 27-135.0) in the nasal group (P < 0.05). One patient in each group showed a brief decrease in arterial hemoglobin oxygen saturation to < 90%. No patient complained of pain or burning in the nose.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗