Articles: pain.
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The results of treatment of 164 out-patients with far advanced malignancies for chronic pain syndrome are discussed. It was found that subarachnoid, peridural and sacral blocks with alcohol, phenol glycerine and carbolic acid can relieve pain for a long time, improve general condition and save narcotic analgetics. The most effective proved to be peridural block by phenolglycerine which induced analgesia in 67% of cases and maintained it for 45 days.
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Antidepressant drugs have been used successfully in the treatment of chronic pain syndromes. Clinical trials have supported the use of these drugs for pain and the depression that often accompanies pain syndromes. ⋯ Studies presented in this paper support the clinical efficacy of antidepressant medications in the treatment of patients suffering from headaches (migraine, tension, and mixed types), diabetic neuropathy, arthritis, and facial pain. These data also suggest that antidepressant drugs may be effective in the treatment of postherpetic neuralgia, back pain, and pain from mixed etiologies; however, data for these pain syndromes are less clear, and, thus, further testing is required.
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Brief radiant heat pulses, generated by a CO2 laser, were used to activate slowly conducting afferents in the hairy skin in man. In order to isolate C-fibre responses a preferential A-fibre block was applied by pressure to the radial nerve at the wrist. Stimulus estimation and evoked cerebral potentials (EP), as well as reaction times, motor and sudomotor activity were recorded in response to each stimulus. ⋯ Latency corrected averaging with a modified Woody filter yielded a grand mean ultralate EP (N1050/P1250), the shape of which was surprisingly similar to the late EP (N240/P370). The similarity of these components indicates that both EPs may be secondary responses to afferent input into neural centers, onto which myelinated and unmyelinated fibres converge. Such convergence may also explain through the known mechanisms of short term habituation and selective attention, why ultralate EPs are not reliably present without peripheral nerve block.
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Peridural injections of morphine were given to 180 incurable cancer patients suffering chronic pain. The effectiveness of the said procedure as well as its side-effects were assessed. A relationship between the external respiration parameters, on the one hand, and drug dosage and time postinjection, on the other, was studied. The data obtained point to the effectiveness of the said method and suggest that it be used as a universal procedure for the treatment of intractable pain in incurable patients.