Pain
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Three double blind, placebo controlled, cross-over studies were conducted to assess the activity of analgesics in healthy volunteers using a modified submaximal effort tourniquet test (SETT). On each study day tests were performed in a silent cubicle at 21 degrees C immediately before and then hourly after drug administration. After exsanguination of the dominant arm trained subjects performed intermittent, isometric hand-grip exercise for 1 min and then rated pain intensity continuously on a visual analogue scale generated and scored by microcomputer. ⋯ Scores on visual analogues scales for alertness and reports of side effects as well as the absence of analgesic activity of diazepam showed that analgesia was not related to sedation. The computerisation of pain ratings and standardisation of experimental conditions probably account for the sensitivity of this model. The difference between responses to opiates and anti-inflammatory drugs is discussed.
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Comparative Study
Relief of cancer pain in man: alcohol-induced neuroadenolysis vs. electrical stimulation of the pituitary gland.
To explore new methods for the control of intractable pain caused by advanced cancer, the analgesic effect of electrical stimulation of the pituitary gland was investigated in 25 patients. The results were compared with a control study and with the effects of alcohol-induced pituitary neuroadenolysis (NALP) in the same patients. The pain score (0: no pain at all, 4: extreme pain) in the control study was 3.88 +/- 0.33. ⋯ Autopsy examinations of 3 patients who expired from their malignancies revealed that the pain relief was unrelated to the degree of necrosis induced in the pituitary by alcohol. Naloxone administration did not inhibit the analgesic effect of either NALP or electrical stimulation. The advantages and disadvantages of electrical stimulation, the pain relief mechanism activated by this method, and potential clinical applications are also discussed.
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The present study is a long-term report on 69 patients undergoing unilateral percutaneous cervical cordotomy for vertebral pain due to neoplastic bone metastases. The pain was unilateral or bilateral and was characterised by a chronic and/or an incident component. ⋯ There was a survival Q(50%) of 5 months (S. E. = 1.6) with no pain and a satisfactory quality of life.