[Pharmacotherapy of postoperative pain]. / Farmakoterapia bólu pooperacyjnego.

In recent years there has been much progress in the understanding of the pathophysiology of acute pain and analgesic pharmacology. The most important role in postoperative pain management is still played by opioids administered through various modes, including spinal and local ones. However, non-opioid analgesics, i.e. non-steroid anti-inflammatory drugs and paracetamol are more and more frequently used in the management of postoperative pain, which is the result of, among other factors, the appearance on the market of intravenous forms of those drugs. Paracetamol, owing to its safe therapeutical profile, should be the primary postoperative pain management tool in a majority of surgical procedures. A combination of opioids, NSAIDs and paracetamol in order to relieve pain allows both for a significant reduction in the dosage of respective drugs, fewer side effects and an improved pain relief.

[Respiratory infections in the surgical intensive care unit]. / Zakazenia ukladu oddechowego w oddziale chirurgicznej intensywnej terapii.

The purpose of the study was to assess microbiological structure and the influence of the predisposing factors on frequency of lower respiratory tract infections. The study group consisted of 72 patients admitted to the Intensive Care Unit between January and October 1994. We found that 27 pts. (39%) developed respiratory infections. The risk of an infection was much higher in the group with long (over 5 days) stay on ICU, which required artificial ventilation as well as in the group of patients treated due to acute pancreatitis. More than 75% of isolated strains were Gram negative bacteria. Using susceptibility tests we conclude that Pseudomonas aeruginosa, Serratia, and Acinetobacter baumanii are highly resistant to antibiotics. The results suggests that 3rd generation cephalosporins and imipenem are most efficient in vitro.