[Ultrasound-guided central venous catheterization]. / Centrális véna kanülálása ultrahangvezérléssel.

Central venous cannulation is frequently used in patients with serious diseases, although it may be unsuccessful and known to have complications in many cases. It is especially true in more complicated cases e.g. after unsuccessful punctures or cervical operations. With the use of ultrasound control success rate increases, while the chance of the complications decreases. In this prospective study, authors used ultrasound control during jugular vein punction in complicated cases. 56 successful central venous cannulation controlled by ultrasound has been performed since year 2000. This report overviews these cases and the related literature.

[Diclofenac/orphenadrine as a combined analgetic in post-operative relief of pain]. / Diclofenac/orphenadrin kombinált analgetikum a posztoperatív fájdalomcsillapításban.

The authors compared the potency, safety and tolerability of combined infusion containing non-steroid anti-inflammation diclofenac and central muscle relaxant orphenadrine, and those of tramadol HCl, during postoperative pain relief after low and middle category operations. The test was an open, group- and self-controlled, prospective, randomised, IV. phase clinical test. The involved 60 patients were given analgesics for 74 days. The patients were divided into three groups: those in group A ( n = 19) were given diclofenac-orphenadrine, those in group B ( n = 30) tramadol, while those in group C ( n = 11) both diclofenac-orphenadrine and tramadol. The received data were statistically analysed. For the assessment of the analgesics' potency, the visual analogue scale (VAS) was used. As a result of the treatment, VAS values in all three groups decreased significantly ( p < 0.001) both in inactive (-2.5, -3.7, -3.0) and active (-3.0, -3.8, -3.4) state, so pain relief was successful. This was also supported by the analysis of cardiovascular parameters. At the end of the treatment, both the patients and the physicians considered potency significantly ( p < 0.05 and p < 0.01) better in group A which received only diclofenac-orphenadrine infusion. Analysing the quantity of used analgesics, the quantity of tramadol administered as a complement in group C was significantly smaller than in group B receiving only tramadol ( B: 87.5 mg, C: 61.5 mg, p < 0.01), which means that diclofenac-orphenadrine infusion increased the analgesic effect of tramadol. Laboratory parameters measured at the beginning and at the end of treatment were inside physiological limits, as side effects nausea and vomiting were observed in 3 cases. Based on all this, diclofenac-orphenadrine infusion is considered an effective and safe analgesic which is easy to administer and to combine in pain relief after small and middle category operations.