Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1988
Case ReportsIntrathecal morphine and clonidine for control of intractable cancer pain. A case report.
The use of intrathecal clonidine, in combination with intrathecal morphine, for the treatment of a patient with intractable cancer pain is reported. The addition of clonidine overcame the problem of tolerance to the analgesic effects of morphine alone. The patient was maintained pain free for three months, without complications, until his death. At autopsy, no evidence of neurotoxicity associated with the prolonged intrathecal administration of clonidine and morphine was found.
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The De Hemptinne ether inhaler was presented to the Royal Academy of Medicine of Belgium in February, 1847 by Auguste De Hemptinne, a pharmacist. This article outlines the details of construction and use of this device. A comparison to contemporary inhalers is also made.
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The toxicity of local anesthetic agents can be divided into two categories: (1) systemic toxic reactions due usually to an accidental intravascular injection and (2) local tissue toxicity. The systemic toxicity of local anesthetic agents is primarily characterized by CNS excitation and convulsive activity. The cardiovascular system is more resistant to the toxic actions of local anesthetics. ⋯ However, large doses of chloroprocaine solutions administered intrathecally have been associated with prolonged sensory-motor deficits in a few patients due probably to the low pH and presence of sodium bisulfite in the chloroprocaine solutions. In general, local anesthetic agents are relatively safe if administered properly. However, as with any pharmacological agents, local anesthetics may cause severe toxic reactions due to the improper use of these drugs.