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001-es BibID:	BIBFORM063308
Első szerző:	Molnár Csilla (aneszteziológus)
Cím:	A single preoperative dose of diclofenac reduces the intensity of acute postcraniotomy headache and decreases analgesic requirements over five postoperative days in adults: A single center, randomized, blinded trial / Molnár Csilla, Simon Éva, Kazup Ágota, Gál Judit, Molnár Levente, Novák László, Bereczki Dániel, Sessler Daniel I., Fülesdi Béla
Dátum:	2015
ISSN:	0022-510X
Megjegyzések:	OBJECTIVE:Postcraniotomy headache causes considerable pain and can be difficult to treat. We therefore tested the hypothesis that a single 100-mg preoperative dose of diclofenac reduces the intensity of postcraniotomy headache, and reduces analgesic requirements.METHODS:200 patients having elective craniotomies were randomly assigned to diclofenac (n = 100) or control (n = 100). Pain severity was assessed by an independent observer using a 10-cm-long visual analog scale the evening of surgery, and on the 1st and 5th postoperative days. Analgesics given during the first five postoperative days were converted to intramuscular morphine equivalents. Results were compared using Mann-Whitney-tests; P < 0.05 was considered statistically significant.RESULTS:Baseline and surgical characteristics were comparable in the diclofenac and control groups. Visual analog pain scores were slightly, but significantly lower with diclofenac at all times (means and 95% confidence intervals): the evening of surgery, 2.47 (1.8-3.1) vs. 4. 37 (5.0-3.7), (P < 0.001); first postoperative day, 3.98 (3.4-4.6) vs. 5.6 (4.9-6.2) cm (P < 0.001) and 5th postoperative day: 2.8 (2.2-3.4) vs. 4.0 ? (3.3-4.7) cm (P = 0.013). Diclofenac reduced systemic analgesic requirements over the initial five postoperative days (mean and 95% CI): 3.3 (2.6-3.9) vs. 4.3 (3.5-5.1) mg morphine equivalents (P < 0.05).CONCLUSIONS:Preoperative diclofenac administration reduces postcraniotomy headache and postoperative analgesic requirements - a benefit that persisted throughout five postoperative days.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Craniotomy Preventive analgesia Postcraniotomy headache
Megjelenés:	Journal Of The Neurological Sciences. - 353 : 1-2 (2015), p. 70-73. -
További szerzők:	Simon Éva (1963-) (aneszteziológus) Kazup Ágota Gál Judit (1977-) (aneszteziológiai és ITO szakorvos) Molnár Levente Novák László (1964-) (idegsebész) Bereczki Dániel (1960-) (neurológus) Sessler, Daniel I. Fülesdi Béla (1961-) (aneszteziológus)
Pályázati támogatás:	KTIA_13_NAP-A-II/5 Egyéb
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM053066
Első szerző:	Molnár Levente
Cím:	Postcraniotomy headache / Levente Molnár, Éva Simon, Réka Nemes, Béla Fülesdi, Csilla Molnár
Dátum:	2014
ISSN:	0913-8668 1438-8359
Megjegyzések:	Although pain after craniotomy is a clinically significant problem that has a continuously expanding literature, it is still a source of concern and controversy. Postcraniotomy headache (PCH) has been neglected for years. It is assessed regularly by only a few neurosurgical centers, and its frequency and severity tend to be underestimated by medical staff; hence, PCH is often undertreated and poorly managed. Various patient and surgical factors have an impact on the severity and incidence of PCH; thus, effective analgesic protocols are hard to define, which could explain the absence of available therapeutic guidelines. According to recent studies, certain surgical measures and the use of local anesthetics are promising in the prevention of PCH. NSAIDs seem to have inadequate analgesic effects, whereas opioids have a wide range of drawbacks; nevertheless, both types of medicaments are regarded as cornerstones of a balanced and adequate multimodal therapy. The purpose of this review is to collect the currently available knowledge about the incidence, assessment, pathophysiological mechanism, and predictors of acute and chronic PCH. Therefore, a broad search of the literature has been carried out to collect evidence of potential prevention and treatment strategies.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban sepsis-associated encephalopathy
Megjelenés:	Journal of Anesthesia. - 28 : 1 (2014), p. 102-111. -
További szerzők:	Simon Éva (1963-) (aneszteziológus) Nemes Réka (1985-) (aneszteziológus, intenzív terápiás szakorvos) Fülesdi Béla (1961-) (aneszteziológus) Molnár Csilla (1962-) (aneszteziológus)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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