The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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An acute spinal cord injury has been described as one of the most devastating traumatic types of neurological impairment. Twelve years ago I had the misfortune of experiencing this first hand. From the day of my brother's initial injury I began keeping a diary of what this experience was like. The concept of entitlement and indebtedness has been applied to my family's experience.
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Continuous epidural analgesic infusion is widely recognized to be helpful for pain relief in the patient with cancer pain, but it can be as beneficial for the patient with non-cancer pain. Cancer pain patients have been offered long-term epidural infusion for relief of chronic pain, but non-cancer pain patients have less frequently been provided the same opportunities for pain relief. Both patient outcome and cost-effectiveness must dictate treatments offered as alternatives to long-term use of oral or injectables, nonsteroidal anti-inflammatories and muscle relaxants. ⋯ Epidural infusion is a safe and effective route of pain relief if the medical criteria as been met for choosing the patients receiving the treatment, and if the caregivers understand the treatment and expected outcomes. This article discusses anatomic considerations in drug selection, physiology, patient selection, neuropharmacology and patient care for epidural infusion. This article is designed to assist the nurse in accomplishing the patient and physician goals in this treatment modality for chronic non-cancer pain.