Articles: pain.
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Five patients who underwent thoracic operations had an extradural catheter placed in the paravertebral space. X-ray contrast was injected through the catheters. ⋯ In one patient, contrast appears to have entered the extradural space and, in another who had no detectable analgesia, the contrast was probably dispersed intrapleurally. The significance of these findings is discussed.
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Clin. Orthop. Relat. Res. · Feb 1987
Patient-controlled analgesia in the total joint arthroplasty patient.
In a prospective study of 30 total hip or knee joint arthroplasty patients, the use of the patient-controlled analgesia (PCA) pump was evaluated for patient acceptance and relief of pain. In 30 patients, (average age, 72.5 years) excellent analgesia was obtained with the PCA machine without the side effects of conventional intramuscular dosing. PCA was enthusiastically received by nurses, physicians, and patients, and it has become the method of choice in the author's hospital.
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The effect of stimulus area and adaptation temperature on warm and heat pain threshold were studied in healthy human subjects using a contact thermal stimulator. The stimulus area was varied in the range of 1.3 to 11.8 cm. Both the warm and heat pain thresholds decreased with increasing stimulus surface. ⋯ The adapting temperature was varied in the range 25-35 degrees C, and warm thresholds were elevated with increasing adaptation temperature. The change of heat pain thresholds with increasing adapting temperature was not significant. Thus, there are both differences and similarities concerning how the different stimulus conditions affect heat pain and warm thresholds.
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From the historical viewpoint, a change of attitude towards pain and the possibilities opened up by general anesthesia from 1846 onwards were needed to bring about the advent of a surgery specialized in the cure of pain. The individual stages in this development, up to Leriche's "Chirurgie de la douleur", are illustrated by reference to the relevant sources.