Pain Clinical Trial
Official title:
Influence of Physostigmine on Patient-Controlled Analgesia (PCA) in Postoperative Intensive Care Patients, Considering Pain Score, Opioid Consumption, Hemodynamics and Cognitive Function
The study is to evaluate the influence of physostigmine in the postoperative period in intensive care patients considering pain quality, opioid consumption, hemodynamics and mobilisation.
Pain management is of major concern in the postoperative period, mostly based on opioids. In
numerous experimental and clinical trials cholinergic mechanisms have been demonstrated to
play an important antinociceptive role. Physostigmine, a central cholineresterase inhibitor,
has been shown to produce analgesia and enhance opiate analgesia after systemic injection.
This action is not based on µ-receptor (opioid) activity, but can be mostly explained by
stimulation of serotonine (5-HT-3) receptors. The major withdrawal of utilizating
physostigmine in postoperative care, is due to its short duration of action.
In the present study, we examined the effect of a continuous intavenous physostigmine
application during a patient-controlled analgesia with piritramide for 48 hours compared to
a placebo infusion with NaCl.
Major concern was set for consumption of analgesics, VAS-pain scale, hemodynamics,
mobilisation and side effects.
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Time Perspective: Prospective
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