Articles: pain.
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After a brief review of the supraspinal and spinal effects of morphine, the reference substance for studies on analgesia, the authors expose a synthesis of the recent literature regarding neurotransmitter involvement in pain perception and transmission. From these data, some future prospects for pain treatment research are identified.
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Acta Anaesthesiol Scand Suppl · Jan 1987
Intraventricular morphine for intractable cancer pain: rationale, methods, clinical results.
The experience with the administration of intraventricular morphine for the control of malignant pain in 197 patients is analyzed. Small doses of morphine injected via a ventricular reservoir provided satisfactory control of otherwise intractable pain in terminal cancer-patients. ⋯ Chronic intraventricular therapy can be safely performed on an outpatient basis by injecting the opiate once or twice a day. The method may be improved by using refillable continuous-infusion devices and new drugs, able to retain the analgesic effects of morphine while eliminating the unwanted ones.
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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.