Papers by Ulf E Kongsgaard
![Research paper thumbnail of [Palliative sedation to the dying]](https://a.academia-assets.com/images/blank-paper.jpg)
BACKGROUND Guidelines for palliative sedation to dying patients were issued by the Council for Me... more BACKGROUND Guidelines for palliative sedation to dying patients were issued by the Council for Medical Ethics of the Norwegian Medical Association in 2001. This study is a follow up of these guidelines. MATERIAL AND METHODS In 2002 an anonymous questionnaire was sent to 400 hospital departments. After two years, only 12 questionnaires had been returned. In addition to this survey we present data from a survey among a random sample of 1539 doctors. RESULTS Ten of the 12 treatments which were registered in detail concerned patients with advanced cancer and in great discomfort. Average age was 49. Pain, nausea, convulsions and dyspnoea were the most common symptoms. Nine out of the 12 patients were in pain. In no case the sedation was assessed to have been avoidable with more health care resources. Relatively few patients had been examined psychologically. The decisions were taken by several caregivers, always in accordance with the family's wish. Six of the patients whose conscien...
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2016
BACKGROUND There has been a steady increase in cases reported to the Norwegian System of Patient ... more BACKGROUND There has been a steady increase in cases reported to the Norwegian System of Patient Injury Compensation (NPE). We wished to look into what might characterise those cases of central and peripheral nerve blockade for anaesthesia that led to compensation claims. MATERIAL AND METHOD Cases with codes for central and peripheral blockade within the field of anaesthesiology were retrieved from the NPE database for the period 2001 – 14. The cases were evaluated on the basis of variables including sex, age, type of anaesthesia, diagnosis, type of injury, site of injury, damages received, and written descriptions of treatment and injury. The expert reports were anonymised and reviewed in detail. RESULTS A total of 339 patient compensation claims relating to nerve blockade were identified, of which 149 concerned spinal anaesthesia, 142 epidural anaesthesia, 21 combined spinal and epidural anaesthesia and 27 peripheral nerve blockade. The group consisted of 236 women and 103 men, an...
Acta Anaesthesiologica Scandinavica
Scandinavian Journal of Pain
Background and aims Pupil size and reaction are influenced by opioids, an effect that is not cons... more Background and aims Pupil size and reaction are influenced by opioids, an effect that is not considered to be affected by opioid tolerance. As clinicians have observed patients on high-dose opioids who exhibited seemingly normal pupil sizes, we wanted to dynamically assess the pupillary reflex in cancer patients on high-dose opioids. Methods We performed a dynamic assessment of the pupillary reflex in cancer patients on high-dose opioids and a control group of healthy volunteers using a portable, monocular, infrared pupillometer. We also performed a clinical examination and measured blood concentrations of opioids and their active metabolites. Results Sixty three patients who were on opioids for 2 months (median time) and on an oral morphine equivalent dose of 250 mg (median dose) were investigated. Most patients used more than one opioid. When correcting for age, pupil size in the group that had received no increase of opioid dose over the last 14 days was not significantly differe...
Scandinavian Journal of Pain
Nursing in critical care, 2018
There is growing interest in potential long-term outcomes following intensive care, but few resea... more There is growing interest in potential long-term outcomes following intensive care, but few researchers have studied the prevalence of multiple symptoms or the association between pain and other symptoms. To investigate the prevalence of anxiety, depression, fatigue, sleep disturbance and post-traumatic stress symptoms (PTSS) among intensive care survivors 3 months and 1 year after being discharged from an intensive care unit (ICU) and to determine whether pain is associated with higher prevalence of these symptoms 3 months and 1 year after ICU stay. Exploratory, longitudinal cohort of intensive care survivors from two mixed ICUs in a tertiary referral hospital in Norway. Intensive care survivors completed surveys at 3 months (n = 118) and 1 year (n = 89) after ICU discharge. Clinical Trials: NCT02279212. Prevalence rates of intensive care survivors' symptoms were pain 58 (49·2%), anxiety/depression 24/118 (20·8%), fatigue 18/118(15·3%), PTSS 15 (12·8%) and sleep disturbance 58/...
Pain management nursing : official journal of the American Society of Pain Management Nurses, 2018
A growing number of studies have addressed the long-term consequences of intensive care unit (ICU... more A growing number of studies have addressed the long-term consequences of intensive care unit (ICU) treatment, but few have studied the prevalence of chronic pain and pain characteristics longitudinally. The goal of the work described here was to investigate the prevalence and characteristics of chronic pain in ICU survivors 3 months and 1 year after ICU discharge and to identify risk factors for chronic pain 1 year after ICU discharge. The design used was an explorative and longitudinal study. The patients in this work had stayed >48 hours in two mixed ICUs in Oslo University Hospital, a tertiary referral hospital. Patients completed a survey questionnaire 3 months and 1 year after ICU discharge. Pain was assessed using the Brief Pain Inventory-Short Form. At 3 months after discharge, 58 of 118 ICU survivors (49.2%) reported pain, and at 1 year after discharge, 34 of 89 survivors (38.2%) reported pain. The most common sites of pain at 3 months were the shoulder and abdomen; the s...
PloS one, 2018
Experiences during a stay in the intensive care unit (ICU), including pain, delirium, physical de... more Experiences during a stay in the intensive care unit (ICU), including pain, delirium, physical deterioration, and the critical illness itself, may all influence survivors' health-related quality of life (HRQOL). However, few studies have examined the influence of social support, comorbidity, and pain interference on ICU survivors' HRQOL. To investigate possible associations between social support, number of comorbidities, and pain interference on HRQOL in ICU survivors. ICU survivors responded to a survey 3 months (n = 118) and 1 year (n = 89) after ICU discharge. HRQOL was measured using the Short Form Health Survey-12 (v1), social support using the revised Social Provision Scale, pain interference using the Brief Pain Inventory-Short Form, and comorbidities using the Self-Administered Comorbidity Questionnaire. Physical and mental HRQOL were reduced at both 3 months and 1 year in ICU survivors compared with the general population. This reduction was more pronounced at 3 mo...
Journal of Pain Research, 2017
Background: Persistent pain affects a large proportion of patients after thoracotomy and is assoc... more Background: Persistent pain affects a large proportion of patients after thoracotomy and is associated with sensory disturbances. The objective of this prospective study was to investigate the time course of pain and sensory disturbances over a 12-month period. Methods: Patients scheduled for thoracotomy were recruited. Data were collected on the day before surgery, including baseline characteristics and the presence of any preoperative pain. At 6-and 12-month follow-ups, data on pain were collected using the Brief Pain Inventory-Short Form, and perceived sensory disturbances around the thoracotomy scar were recorded from a self-exploration test. Results: At 12 months after surgery, 97 patients had complete data including baseline and 6and 12-month measurements. Almost half of the patients reported post-thoracotomy pain at the follow-ups. However, 20% of the patients not reporting post-thoracotomy pain at 6 months did report it at 12 months. Between 40% and 60% of patients experienced some kind of sensory disturbance at 6 months. A small decline in some kind of sensory disturbance was reported by 20%-50% of patients at 12 months. Conclusion: A proportion of patients experienced either resolved or delayed onset of pain. Sensory changes were strongly associated with post-thoracotomy pain syndrome, but were also present in a large proportion of patients without it.
Tidsskrift For Den Norske Laegeforening, Mar 1, 2004
Tidsskrift For Den Norske Laegeforening, Mar 1, 2004
Patients with advanced cancer may present complex sets of symptoms, of which pain is the most pre... more Patients with advanced cancer may present complex sets of symptoms, of which pain is the most prevalent. In addition to systemic pharmacological therapy for pain management, neurolytic blocks are also effective in controlling cancer pain in selected patients. Various neurolytic blocks used in the treatment of cancer pain are reviewed. Several studies have documented the efficacy of neurolytic blocks in reducing pain intensity and opioid consumption, although good prospective, randomized controlled trials are scarce. The narrow risk-benefit ratio associated with neurolysis techniques requires knowledge of the complications associated with the different neurolytic blocks in order to minimise undesirable effects. Interventional techniques continue to play an important role in the management of cancer pain. The quality of the neurolytic blocks improves when they are performed image-guided in collaboration with an interventional radiologist. These blocks should never be considered an isolated treatment, but as a component of a comprehensive therapeutic strategy.
Tidsskrift for Den norske legeforening
High frequency jet ventilation gives adequate alveolar ventilation with very small tidal volumes,... more High frequency jet ventilation gives adequate alveolar ventilation with very small tidal volumes, gas exchange at lower airway pressure, reduced risk of pulmonary barotrauma, and less cardiovascular impairment. Use of small insufflation catheters facilitates surgery when access is restricted, as in laryngeal surgery, and makes it possible to ventilate a patient through a cricithyroid membrane puncture in an emergency situation. In intensive care medicine, jet ventilation can have some advantage over conventional ventilation in patients with bronchopleural fistulas, and when it is difficult to wean patients from a respirator. The article describes experience using an Acutronic AMS-1000 Universal Jet Ventilator.
Tidsskrift for Den norske legeforening
Tidsskrift for Den norske legeforening
Tidsskrift for Den norske legeforening
Tidsskrift for Den norske legeforening
Tidsskrift for Den norske legeforening
ABSTRACT
Tidsskrift for den Norske laegeforening
ABSTRACT
Clinical Intensive Care, 1996
Tidsskrift for Den norske legeforening
Bakgrunn. Legemidler som inneholder cannabinoider brukes til symptomlindring hos palliative pasie... more Bakgrunn. Legemidler som inneholder cannabinoider brukes til symptomlindring hos palliative pasienter i flere land. Metode. Vi foretok et litteratursøk etter randomiserte studier som undersøkte bruk av cannabinoider ved kreftrelaterte symptomer.
Uploads
Papers by Ulf E Kongsgaard