Articles: pain.
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In the light of hypotheses related to the evolution of pain-carrying systems in mammals, terminal projection fields in brainstem and diencephalon of efferents of nucleus caudalis (NC) of the spinal trigeminal complex and spinal cord were determined in hedgehog by using Nauta-Gygax and Fink-Heimer silver techniques for degeneration. Unilateral NC lesions resulted in medullary degeneration in the ventral portion of NC contralaterally and bilaterally in cuneate nucleus (CU) and reticular formation. Pontine degeneration was noted ipsilaterally in medial (PBM) and lateral (PBL) parabrachial, facial motor (VII), and interpolar, oral, and main sensory trigeminal nuclei; degeneration in reticular formation was bilateral. ⋯ These results are consistent with the thesis that specific sensory thalamic nuclei evolved from a diffuse sensory region. Response properties of neurons in the dorsomedial portion of the ventral nuclear field, an area which are also received NC efferents, are not known. Last, NC projections to MD and LH implicate the role of "limbic" aspects of nociception.
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Morphine sulphate 5 mg and placebo administered epidurally after caesarean section under epidural analgesia were compared in a double-blind fashion. Morphine was significantly superior to placebo for pain relief, duration of pain relief, and reduction of parenteral narcotic requirements. ⋯ There was no statistical difference between morphine and placebo in the incidence of urinary catheterisation, vomiting, nausea, dizziness or drowsiness. No serious respiratory depression requiring treatment was observed.
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Previous to October 1st, 1981, 8 major Danish anaesthesiological departments registered 105 patients treated with extradural opiates for a period of more than 7 days, partially or completely on outpatient basis. Ninety-four suffered from painful malignant diseases and 11 patients from various painful benign diseases. The mean period of treatment was 65 days (range: 7-283 days) and of these 49 days (2-266 days) as outpatients. ⋯ Eleven patients managed injections without assistance. District nurses took care of medication for 46 patients, aided by a general practitioner in 5 cases. Three patients were supplied with continuous extradural infusion by means of a Mill Hill microinfusion pump.
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Randomized Controlled Trial Clinical Trial
Analgesic effect of graded doses of flurbiprofen in post-episiotomy pain.
Our purpose was to evaluate the analgesic efficacy and safety of single oral doses of flurbiprofen 25, 50 and 100 mg, aspirin 600 mg, and placebo in the relief of moderate to severe post-episiotomy pain. One hundred and fifty-two evaluable patients completed a randomized, double-blind, stratified, parallel groups study. They were observed over a six hour period by one nurse-observer. ⋯ Flurbiprofen 25 mg appeared to be slightly less effective than aspirin 600 mg, but the differences were not statistically significant. Flurbiprofen 50 and 100 mg were quite similar and were significantly more effective than aspirin 600 mg and flurbiprofen 25 mg. There were no observed or reported adverse effects.
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Randomized Controlled Trial Comparative Study Clinical Trial
Single injection spinal anaesthesia with amethocaine and morphine for transurethral prostatectomy.
The intrathecal administration of amethocaine plus morphine as an anaesthetic technique for providing surgical anaesthesia and postoperative analgesia was evaluated in 24 patients undergoing transurethral resection of the prostate. The efficacy of the technique was compared with that observed following spinal anaesthesia with amethocaine alone. ⋯ In group II the addition of morphine 1 mg to the amethocaine produced excellent surgical anaesthesia and postoperative analgesia and these patients had significantly less postoperative pain than the patients who received amethocaine alone. There was a high frequency of side-effects associated with intrathecal morphine in group II, for example, subtle respiratory depression, nausea, vomiting and pruritus.