[Clonidine can reduce opioid medication during post-operative pain]. / Clonidin kan reducere opioidforbrug ved postoperative smerter.

Post-operative pain management can be a challenge, and one of the first choices seems to be opioids. However, opioids have undesirable side effects, and attention may lead to a multimodal analgesia. The use of clonidine is a part of this strategy. We present a study with assessment of routes of administration of clonidine. Overall, there is a good effect of post-operative pain management. Side effects as hypotension and sedation are mentioned but not as a limitation. Many anaesthesiologists do already use clonidine in the management of post-operative pain, but more research about intravenous administration of clonidine is needed.

[Antidigitalis Fab-fragment for treating poisoning from a foxglove plant]. / Antidigitalis Fab-fragment til behandling af forgiftning med fingerbølplanten.

Plant poisonings are rare in Denmark, but can have fatal consequences. We present a case in which a woman went into cardiac arrest after having ingested leaves from the foxglove plant. Sinus rhythm was not restored until Digibind was administered. Literature in this field is sparse, but we conclude that the following advice can be given: 1) assessment of the degree of poisoning should be based on clinical features and changes of the electrocardiogram; 2) activated charcoal should be given; 3) in case of malignant arrhythmia or cardiac arrest, the use of Digibind should be considered.

[A possible analgesic effect of nicotine on postoperative pain]. / Mulig analgetisk effekt ved postoperativ behandling med nikotinsubstitution.

Since postoperative pain often is undermanaged, and opioids, although being efficient analgesics, have undesirable side effects, attention has turned towards adjuvant therapies, among them nicotine. We present seven studies of which six show an effect of nicotine on postoperative pain when given in a low dose, with short time of exposure and to non-smokers. Other possible confounders are gender and type of anaesthesia. Nicotine seems to increase the occurrence of nausea and vomiting. More research is needed, and nicotine cannot currently be recommended as part of a multimodal pain management regime.

[Who are the users of emergency contraception?]. / Hvem anvender nødpraevention?

INTRODUCTION: A user profile is necessary in order to direct future campaigns for emergency contraception (EC). MATERIAL AND METHODS: Over a three-month period, 423 women with prescriptions for EC were consecutively entered in the study, which was carried out in four inner-city pharmacies in Copenhagen, Denmark. RESULTS: The median age was 24 years (range 13-50 years). Most women (73%) were first-time users of EC. The reason for the current need for EC was most often condom failure (54%) or non-use of any contraceptive method (41%). Only six women (1.4%) reported non-use of contraception because of their knowledge of EC and only four women (0.9%) reported EC as the usual method of contraception. Knowledge about EC more often came from family or friends (51%) and advertising (47%), than from general practitioners (26%) or through sex education in schools (3%). Altogether 282 women (69%) received EC from a doctor in the medical emergency service or a casualty ward. DISCUSSION: Overall, EC is used as recommended. Its availability does not seem to reduce the use of safer contraceptive methods. The mandatory sex education in school should include information on EC.