European journal of anaesthesiology
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Historical Article
Early forms of local anaesthesia: A historical review.
The direct application of volatile anaesthetic and the application of intense cold to traumatic injuries and surgical sites were important steps in 18th and 19th century anaesthesia. Local tissue temperature could be brought down by the application of ice and salt by the surgeon. Techniques used topical applications of chloroform, Dutch Oil, amyl hydrate, the vaporisation of nebulised ether, methylene and ethylene chloride applied by spray or fumigation and vaginal douche with carbonic acid gas. ⋯ To improve the precision of the jet, a different system of nozzles had to be invented. Nineteenth century medical practitioners were able to call on general anaesthesia, but some individuals and specific indications such as minor surgery called for an alternative approach. The introduction of cocaine in 1884 completely changed common practice.
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Randomized Controlled Trial
Intravenous nonopioid analgesic drugs in chronic low back pain patients on chronic opioid treatment: A crossover, randomised, double-blinded, placebo-controlled study.
Addition of nonopioid analgesic drugs reduces pain and opioid requirements in acute low back pain. In noncancer chronic low back pain (CLBP), the efficacy of a combined regimen to reduce breakthrough pain has not been proven so far. ⋯ The present data show that the anticipation of an i.v. infusion of nonopioid analgesic drug improves VAS significantly, probably through expectation-related mechanisms. However, single dose i.v. infusions of nonopioid analgesic drugs fail to improve pain intensity and spinal mobility in CLBP patients on chronic opioid treatment, even immediately after the infusion.