[Influence of intraoperative noise protection on postoperative pain: demonstrated exemplified by total knee arthroplasty]. / Einfluss der intraoperativen Schallprotektion auf postoperative Schmerzen : Dargestellt am Beispiel der Knieendoprothetik.

BACKGROUND: It is known that implied memory of intraoperative noise influences postoperative pain. The aim of this study was to evaluate the influence of different intraoperative noise protection methods during total knee arthroplasty on postoperative pain scores. MATERIAL AND METHODS: A total of 83 patients were included in this prospectively designed, double-blind trial and underwent total knee arthroplasty with psoas compartment and sciatic nerve regional anesthesia and additionally propofol sedation. After randomization patients were assigned either to the noise protection group, the music group or the control group. Postoperative pain scores (VAS) were evaluated in each group. RESULTS: In the three different time intervals evaluated there were no significant differences between the groups. Also the pain maxima for each postoperative day showed no significant difference but there was a slight trend to the advantage of the music group. CONCLUSION: Even though there were no significant effects of music or noise protection on postoperative pain scores, it can be concluded, as has been done by many other authors that music should be used in the perioperative setting for general patient comfort.

[Symptoms and signs in cleidocranial dysplasia (CCD)]. / Symptome und Merkmale bei Dysostosis Cleidocranialis (DCC).

AIM: Occurrence of main symptoms and the rate of spontaneous mutations in patients with cleidocranial dysplasia. METHOD: 24 patients with variable phenotypic expression of CCD were examined symptomatically. The main focus was placed on findings in the shoulder girdle, craniofacial symptoms and alterations in radiologic opacity. RESULTS: The average age of the patients was 18.3 years. In our patient cohort, 58.3% were spontaneous mutations. Abnormal apposition of the shoulders were found in 88% of the patients. Craniofacial symptoms were diagnosed in 88%. An increase of the radiologic skull density was apparent in 95%. CONCLUSION: The expression of this rare disorder is variable and its symptomatology not always apparent. Spontaneous mutations occur frequently. Due to the high prevalence of the considered symptoms, the diagnosing physician should focus on the facial appearance and shoulder abnormalities. In cases of ambiguous findings we recommend a consultation of an experienced clinician as well as genetic counseling.