Articles: pain.
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We report the extradural administration of low-dose morphine in 10 ml of 10% dextrose (2-3 mg) to 98 adult patients with various types of acute and chronic pain. Extradural morphine injections were given either via a Tuohy needle (single or repeat injection) or via an extradural catheter. Pain relief was evaluated by subjective scoring and by the subsequent need for systemic analgesics. ⋯ The analgesia of each dose of extradural morphine lasted for 8 h (mean range 4-36 h). There was no motor, sensory or sympathetic blockade and no respiratory or haemodynamic complications. Dizziness and vomiting occurred in two patients, and urinary retention for about 12 h in three.
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The human intercostal space has been studied by excision of the posterior part of the rib cage at autopsy, followed by fixation, decalcification, section and staining. Injection of India ink was used to simulate local anaesthetic. At a point 7 cm from the midline, the distance from the posterior aspect of the rib to the pleura averaged 8 mm. ⋯ An injection of 3 ml will also spread medially to enter the paravertebral space and surround the sympathetic chain. A small clinical study gave excellent analgesia after operation for a mean duration of 12.3 h following unilateral intercostal block with 3 ml of bupivacaine 0.5% (with adrenaline) into each of the intercostal spaces T5-11, before cholecystectomy through a subcostal incision. There were no complications in the series.
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Journal of neurosurgery · Mar 1980
Pain reduction in amputees by long-term spinal cord stimulation. Long-term follow-up study over 5 years.
This follow-up study analyzes the results of dorsal column stimulation instituted between 1972 and 1974 for the relief of pain in 84 patients, including 64 amputees. Good results decreased from 52.4% after 2 years of stimulation to 39% after 5 years. Special therapeutic problems in amputees are discussed.
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Southern medical journal · Mar 1980
Case ReportsBrompton's mixture in alleviating pain of terminal neoplastic disease: preliminary results.
We conducted a one-year preliminary study on 107 patients in a hospice for incurable cancer to assess the efficacy of a modified Brompton's Mixture (an oral analgesic solution) in alleviating intractable pain. The results presented indicate that in patients who can tolerate oral medication, the present formulation can be used in lieu of parenteral narcotics, often with superior results and always with cost effectiveness. ⋯ As documented by four representative case reports, the patient is pain-free, ambulatory, communicating with his environment, and experiencing an improved nutritional status, thereby improving the quality of life. Brompton's Mixture appears to be a valuable adjunct to conventional therapy, giving the patient an effective alternative to parenteral medication for control of pain.