Articles: patients.
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Migraine is a syndrome and not a nosological entity. It is therefore relatively improbable that a uniform etiology can be defined, and it must be assumed that there are different multifactorial etiological conditions for each individual. It is probable that a therapy concept that is equally valid and promising for all patients can therefore never be developed. ⋯ The intrinsic action of a therapy method should be compared to the placebo effect on a randomized doubleblind basis. If this preconditions is fulfilled, appraisals of the real chances of success in the practice can be made more accurately on the basis of large-scale open studies comprising a representative cross-section of migraine patients. Further topics for therapy studies should include the analysis of responders and nonresponders and the development of differential indications for certain methods of therapy.
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Journal of anesthesia · Sep 1987
Tracheal tube cuff pressure--study on tube size and inflating gases.
The effect of nitrous oxide on the cuff pressure was studied from the following points of view. One was the size of tubes and the type of cuff. The other was the effects of different gas mixture in the cuff. ⋯ In the group of air, the cuff pressure increased as well as experiment I. However in the group of mixtured gas, there were almost no changes in the cuff pressure. This means that if the cuff is inflated with a mixtured gas in which nitrous oxide is under the equivalent condition, the cuff pressure would not change.
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Journal of anesthesia · Sep 1987
Epidural pressure and its relation to spread of epidural analgesia.
The relationships between the epidural pressures following the injection of local anesthetic solution and the spread of epidural analgesia were investigated. In 46 patients, 15 ml of 2% mepivacaine was injected into the lumbar epidural space at a constant rate (1 ml/sec) using an electropowered syringe pump. Injection pressures and residual pressures were recorded and the spread of analgesia to pinprick was assessed. ⋯ The spread of analgesia closely correlated with the epidural pressures during and following the injection of local anesthetic solution. The most close correlation was found between the epidural pressure immediately after the completion of injection and the spread of analgesia (r = -0.5659, P < 0.001). In conclusion, the lower the terminal injection pressure and the residual pressures associated with higher age, the wider the spread of epidural analgesia.
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Acute postoperative pain has an important psychological component. This psychological element could be registered by observing or measuring interindividual differences in pain experience, expressions of pain, and pain-coping behavior. Emotions such as anxiety, anger, and helplessness accompany postoperative pain, and postoperative pain can also be elicited by very intense preoperative anxiety. ⋯ Psychological factors also influence pain reduction. Postoperative aggression and its underlying metabolism facilitates recovery if the physicians or nurses can cope with the anger of the patient. Providing sensory descriptions of the pain during the preoperative visit and careful attention to both the pain-experiencing and the pain-free patient help to reduce pain or prevent its escalation.
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This article reviews the methods currently in use for the measurement of chronic pain. The most important items for inclusion in questionnaires about the history and in pain diaries to elicit data on the time-course of pain are presented, and both the aims and the advantages and disadvantages of various strategies are discussed. The documentation of chronic pain in outpatients would allow answers to some questions concerned with medical epidemiology if practiced in a large number of therapeutic institutions, especially if the data were processed and evaluated by microcomputer.