Spinal Opiate Analgesia
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Spinal Opiate Analgesia
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Author : T. L. Yaksh
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-12-06
Spinal Opiate Analgesia written by T. L. Yaksh and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-12-06 with Medical categories.
The recent development of the use of spinal opiates as a rational therapy for pain rests on clear and certain experimental data. We have long known the spinal cord to be a highly complex structure. Anatomical studies of the substantia gelatinosa have repeatedly demonstrated signs of massive synaptic interaction between primary afferents, descending pathways and intrinsic neurons. Yet, to date that knowledge, insofar as clinical therapy is concerned, has permitted us only to destroy certain connections within the spinal cord in the hopes that the substrate mediating pain could be anatomically differentiated from those which mediate other function. Though cordotomies are clearly effective under certain circumstances, they suffer from the fact the spinal cord is not organized in such an anatomically discrete fashion as is often times drawn in basic medical text. Rather, functions intertwine exquisitely and specific physical interventions are no more likely to produce a specific effect than smashing of the fmgertip with a hammer will produce just a loss of the fingernail. The development of specific therapies of the spinal cord has come about by our growing aware ness of the intricate organization of the pharmacological substrates associated with specific neural function.
Spinal Narcotics
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Author : Narinder Rawal
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-12-06
Spinal Narcotics written by Narinder Rawal and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-12-06 with Medical categories.
One of the most exciting developments in medicine in this century has been the discovery of opioid receptors and their pharmacology. The breadth of know- edge derived from such discovery has truly changed the practice of medicine today. The acceptance by the clinicians of the research data obtained by the basic scientist on spinal opioids is truly amazing. The clinical sequelae of the discovery of opioid receptors has been the development of the technique of intraspinal administration of opioids. In the last decade much has been written about indications, effects, and side effects of intraspinal opioids. The technique has become commonplace for cancer and postoperative pain. However, no standards of care and management of patients with spinally administered opioids have been developed. We need these standards to be developed and universally followed. The monograph was conceived to update clinicians on the applied pharma cology of spinal opioids. We were fortunate to have Drs. N. Rawal and D. Coombs agree to edit this monograph. They have been able to assemble world-renowned experts as contributing authors. It is our hope that the con tents of this book will be stimulating, informative, and useful to the reader. PREFACE Much has been written about the subject of spinal opioid analgesia, includ ing several notable reviews. We were stimulated to assemble this particular volume in this important series on pain management initiated by Dr. Raj for a number of reasons.
Regional Opioid Analgesia
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Author : J. de Castro
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-12-06
Regional Opioid Analgesia written by J. de Castro and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-12-06 with Medical categories.
by E.K. ZSIGMOND, M.D. Department of Anesthesiology University of Illinois Chicago U.S.A. It is, indeed, a distinct honor and privilege to be invited by the authors to write a preface to this monumental monograph, Regional Opioid Analgesia. Regional Opioid Analgesia is a colossal undertaking by Drs. De Castro, Meynadier and Zenz shortly after the introduction of this revolutionary approach to pain relief which opened a new epoch in analgesiology. This is, indeed, the first authentic and comprehensive textbook encompassing the current knowl edge on this novel approach to pain relief. We are indebted to the authors for introducing the new opioids to regional analgesia with the scientists, who de veloped the potent short and ultrashort acting opioids with high therapeutic indices, which many researchers dreamt about but never before materialized. The side effect liabilities of these new opioids are minute as compared to morphine and meperidine. Regional Opioid Analgesia could not have been more authentically written than by Drs. De Castro,Zenz and Meynadier,who have conducted daily clinical investigations on all known opioids for regional analgesia as well as for neurolept analgesia. Therein lies the great value of this monograph: it is the most authentic work on this topic.
Opioids In Pain Control
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Author : Christoph Stein
language : en
Publisher: Cambridge University Press
Release Date : 1999
Opioids In Pain Control written by Christoph Stein and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Medical categories.
This book offers a comprehensive overview of scientific developments and clinical implications surrounding the use of opioids in pain control.
Thesis Spinal Opiate Analgesia
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Author : Lars L Gustafsson
language : en
Publisher:
Release Date : 1985
Thesis Spinal Opiate Analgesia written by Lars L Gustafsson and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1985 with categories.
Opioids In Cancer Pain
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Author : Mellar P. Davis
language : en
Publisher: Oxford University Press, USA
Release Date : 2009-05-28
Opioids In Cancer Pain written by Mellar P. Davis and has been published by Oxford University Press, USA this book supported file pdf, txt, epub, kindle and other format this book has been release on 2009-05-28 with Medical categories.
Opioids can be effective in relieving pain in more than 90% of cancer patients. However, often irrational fears from both patients and clinicians persist about the potential for addiction, meaning treatable pain continues to be tolerated. This book offers clear guidelines on the use of opioids when managing cancer pain.
Anesthesiology And Pain Management
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Author : T.H. Stanley
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-12-06
Anesthesiology And Pain Management written by T.H. Stanley and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-12-06 with Medical categories.
Anesthesiology and Pain Management contains the edited presentations of the 39th Annual Postgraduate Course in Anesthesiology, February 1994. The chapters reflect new data concepts within the general framework of `pain research and basic science', and `clinical topics in pain management'. The purpose of the textbook is to serve as a vehicle to bring many of the latest concepts in anesthesiology to those who did not attend the conference, within a short time of the formal presentation. Each chapter is a brief but sharply focused glimpse of the current interests in anesthesia. This volume, as well as past and future volumes, reflects the rapid and continuing evolution of anesthesiology in the late twentieth century.
Low Dose Of Spinal Opioids Vs Local Peridural Anesthesia For Postoperative Pain Management In Cesarea Controlled Clinical Trial
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Author : Andrea Valencia Echavarri
language : en
Publisher:
Release Date : 2017
Low Dose Of Spinal Opioids Vs Local Peridural Anesthesia For Postoperative Pain Management In Cesarea Controlled Clinical Trial written by Andrea Valencia Echavarri and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017 with categories.
Introduction caesarean section is the most common, so the management of the obstetric patient in anesthesiology is usual. Opioids have been an option in regional anesthesia to improve the antinociceptive effect of local anesthetics.Objective To compare the efficacy and safety of the spinal administration of fentanyl 25 micrograms and morphine 50 micrograms vs the administration of ropivacaine to 1.2% peridural for pain control in post-operative cesarean patients.Methodology A randomized, controlled clinical trial was conducted in patients undergoing caesarean section from January-December 2017; in the HCC.Results A sample of 68 patients was obtained, distributed in Control Group (34) and Experimental (34). With the scale used to assess pain (VAS) in its different measurements over time, a mean was obtained. At 8 hours, Spinal Opioid Group of 1.5 with an SD of u00b1 1.5; while the Continuous Epidural Analgesia Group had an average of 2.5 with an SD of u00b1 2.3 (p = .026). At 16 Opioid Groups of 1.5 with an SD of u00b1 0.9 while the Continuous Epidural Analgesia Group had a mean of 2.7 with an SD of u00b1 2.3 (p = .001).Conclusions The practical application of the results of this study could be the use of a combination of lipophilic and hydrophilic spinal opioids with a local anesthetic in cesarean anesthesia to increase the comfort level of the patient.
Analgesia Or Addiction
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Author : Sarah A. Woller
language : en
Publisher:
Release Date : 2012
Analgesia Or Addiction written by Sarah A. Woller and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012 with categories.
Up to 65% of individuals with a spinal cord injury (SCI) experience neuropathic pain, and cite this as one of the most significant consequences of injury. Opiate analgesics are one of the most effective, but also most concerning, treatments for neuropathic pain. In fact, the use of morphine after SCI can potentiate the development of paradoxical pain symptoms, and continuous administration can lead to dependence, tolerance, and addiction. Empirical evidence suggests that the addictive potential of morphine decreases when used to treat neuropathic pain, but this has not been studied in an SCI model. These studies, therefore, aimed to investigate the addictive potential of morphine in a rodent model of spinal contusion injury. These experiments used a conditioned place preference (CPP) paradigm to examine whether subjects with SCI would develop a preference in the acute phase of injury, and whether a place preference would be expressed after the development of neuropathic pain symptoms in the chronic phase of injury. Results suggest that the time of treatment did affect the development of a preference for the morphine-paired context; subjects displayed a CPP in the acute, but not the chronic phase of SCI. In addition, the findings indicate that spinal neurons are sufficient, but not necessary, for producing a morphine-induced place preference. Overall, the results suggest that morphine could be used for the clinical treatment of neuropathic pain without concerns of addiction. Although SCI alone did not reduce the addictive potential of morphine in the acute phase of injury, the lack of preference in the chronic phase suggests that addiction may be reduced by molecular changes that accompany the development of neuropathic pain. Moreover, we hypothesize that the analgesic effects of morphine acting on spinal and peripheral mu-opioid receptors (MOR's) underlies the development of CPP in the acute phase of injury. This hypothesis is supported by the CPP established with intrathecal morphine administration. Nonetheless, the current studies cannot discount the role of supraspinally-mediated reward in the development of place preference after injury. Further work is needed to distinguish between the addictive and analgesic properties of morphine.
Spinal Opiate Analgesia
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Author : Lars L. Gustafsson
language : en
Publisher:
Release Date : 1985
Spinal Opiate Analgesia written by Lars L. Gustafsson and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1985 with categories.