Articles: analgesia.
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Anaesth Intensive Care · Dec 1994
Randomized Controlled Trial Clinical TrialPeritonsillar infiltration with bupivacaine for paediatric tonsillectomy.
In a double-blind study forty-two children scheduled for elective adenotonsillectomy were randomized to receive peritonsillar infiltration, following induction of anaesthesia, with either 0.25% plain bupivacaine or 0.9% saline, 0.5 ml/kg to a maximum of 10 ml. The children were assessed on awakening, and then 10 minutes, 1 hour, 4 hours and 24 hours later. ⋯ Thereafter there was no difference between the groups. The authors conclude that peritonsillar infiltration with bupivacaine is only moderately useful as analgesia for children having tonsillectomy.
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We describe a miniature electrochemically driven, wrist-worn infusion pump. Generation of gas by an electrolytic reaction compresses a reservoir containing medication and provides a predictable and controllable infusion rate. ⋯ This portable system, using a novel motive force, has advantages of convenience over larger systems and has sophisticated features not present in existing small systems. It has potential as a routine PCA device and it may have uses in other situations requiring convenient infusion or intermittent injection in an ambulatory setting.
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(+)Pentazocine antagonizes morphine analgesia as potently as its (-)-isomer, ruling out an opioid receptor mechanism of action and suggesting, which suggests a role for sigma 1 receptors. Systemic (+) pentazocine also reverses supraspinal or spinal morphine analgesia. 1,3-Di(2-tolyl)guanidine, a sigma ligand with no appreciable opioid receptor affinity, antagonizes morphine analgesia. The actions of both (+)pentazocine and 1,3-di(2-tolyl)guanidine are reversed by haloperidol, which has high affinity for both sigma and D2 receptors, but not by the D2-selective antagonist (-)sulpiride, which lacks activity at sigma sites. ⋯ Blockade of the sigma system with haloperidol eliminates these strain differences. In conclusion, sigma 1 systems functionally antagonize opioid analgesia without affecting morphine's effects on gastrointestinal transit or lethality. The antiopioid sigma system is tonically active and is more active against kappa analgesia than mu.(ABSTRACT TRUNCATED AT 250 WORDS)
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Gan To Kagaku Ryoho · Dec 1994
Case Reports[Bathing a patient with cancer pain treated with continuous epidural blockade--subcutaneous catheter track and Lapack method].
Continuous epidural blockade is considered to be the most useful device for the management of cancer pain. However, it has the disadvantage to compel the patients to restrict their daily activities. We report a unique "Subcutaneous catheter track & Lapack-method" that enabled a patient with epidural catheter to safely bath at home. ⋯ Since his wishing was to bath, we made a long subcutaneous catheter track with Tuohy-needle to prevent infection, and let him bath with transparent film dressings (Bioclusive) and Lapack to tightly cover and seal up the catheter. Although subcutaneous pustule occurred 7 days after the beginning of bathing, it was easily cured by local disinfection. He was able to enjoy bathing without any infection with this method at home for about 2 months after discharge, until he returned to the hospital. "Subcutaneous catheter track & Lapack-method" offers a safe and comfortable bathing to patients with epidural catheter, and contributes to the improvement of their quality of life.
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Anaesth Intensive Care · Dec 1994
Tunnelled epidural catheters for routine use: description of a technique.
A simple technique for routine tunnelling of epidural catheters is described. It represents a simplified version of subcutaneous tunnelling as commonly performed in chronic pain patients. In 200 obstetric and gynaecological patients to date, only two catheters have become dislodged prematurely.