Der Schmerz
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In Western industrial countries, low back pain is one of the most frequent causes of illness. Between the 4th and 5th decades of life approximately 80% of adults complain of low back pain, lasting for fairly long periods. About 10% of this population must undergo disc surgery once during life. ⋯ CT control examinations showed clear regression in the extent of disc herniation in 15 patients, in 18 a moderate decrease, and in 9 cases the CT findings had not changed. A favorable tendency towards regression was observed in disc herniations at the level of L5-S1 and in cases showing sequestration of the disc. Herniations of the disc at higher levels between L4-5 and L3-4 or a lateral herniation, reaching the intervertebral foramen, showed on unfavorable prognosis.
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Systemic application of analgesics is still the most frequently used method of postoperative relief of pain. However, neither intermittent intramuscular nor intermittent intravenous application can provide the patient with a continuous level of analgesia. Lipid-soluble analgesics or those with polar binding that are rapidly metabolized demonstrate an rapid effectiveness. ⋯ After an initial bolus injection, the continuous infusion of an analgesic is guaranteed and may be completed by the patient with several bolus injections. PCA requires careful monitoring. We suggest that a special analgesia team to take care of the patient in special analgesia units might be appropriate in the future.