Agressologie: revue internationale de physio-biologie et de pharmacologie appliquées aux effets de l'agression
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Narcotics are used in neuro-anesthesiology according to their pharmacology and their effects on cerebral physiology. New narcotics (fentanyl, sufentanil, alfentanil) fulfill the requirements of modern neurosurgical anesthesiology looking for quick awakening.
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The effect of pentobarbital was evaluated in 12 comatose brain injured patients (Glasgow coma scale < 7 at admission). Mean hemispheric cerebral blood flow (CBF) was studied following intravenous administration of 133Xenon. ⋯ The increase in cerebral perfusion pressure (PP) was found only in patients with diffuse brain injury. The results supports the hypothesis that barbiturate therapy is more effective at reducing ICP while preserving CPP when the cause is a diffuse lesion.
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Each class (mu, delta kappa and epsilon) of opioid receptors has a characteristic pattern of distribution in the nervous system, which may, however, exhibit species differences. The effects of opioid receptor stimulation depend on the class of receptor involved, the localization of these specific receptors and the animal species under investigation. Endogenous ligands of opioid receptors, which include more than twenty peptides, derive from three precursors:proopiomelanocortin (beta-endorphin), proenkephalin A (enkephalins) and prodynorphin (dynorphins, neo-endorphins). ⋯ At this level, opioids reduce the activity of spinal neurones that convey the nociceptive messages. The classes of opioid receptors (certainly mu [mu 2?] and a, perhaps kappa) involved in this effect, and their pre- or postsynaptic location are not firmly established to date. Further developments on these points can be expected from the use of new ligands which are highly selective of the various classes of opioid receptors.(ABSTRACT TRUNCATED AT 250 WORDS)
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Psychiatric disorders are observable in Intensive Care Unit. They belong to all the psychiatric field. Their genesis depend on various factors that often work together and are interdependent: organic, demographic, psychological, environmental, procedural, hypnic. They can be considered as risk factors influencing the development of responses to stress (theory of stress).
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A number of chronic pain syndromes in the perineal area can be related to pudental nerves suffering. The constancy of symptoms among various patients, and in duration for a particular one, alterations revealed by electrophysiologic studies, pain relief by diagnostic blocks, data from anatomic studies, preliminary results of medical and surgical applied therapies, give consistent arguments for possible organic lesions of pudental nerves.