Harefuah
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[The benefit of combining spinal morphine and intravenous buprenorphine for perioperative pain].
Concurrent administration of opioids with different affinity produces synergistic antinociceptive effect in rats. We tested the perioperative antinociceptive effects of the simultaneous double blind administration of morphine, a pure agonist and buprenorphine, a partial agonist, in 30 patients undergoing hysterectomy under general anesthesia. Pre- and post-operatively regimens consisted of random patient assignment to intrathecal 0.3 mg morphine plus intravenous saline (group 1), intravenous 0.09 mg buprenorphine plus intrathecal saline (group 2) or intrathecal morphine 0.3 mg plus intravenous buprenorphine 0.09 mg (group 3). ⋯ Buprenorphine-induced analgesia in group 3 lasted significantly (P < 0.05) longer than in group 2. Side effects in groups 2 and 3 were by 44% and 42% fewer than in group 1, respectively, with no withdrawal symptoms. Thus, concomitant administration of intrathecal morphine and low dose intravenous buprenorphine produces better and longer pain relief than intravenous buprenorphine alone in women after hysterectomy.
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Historical Article
[Chapters in the history of psychiatry in Israel and its surroundings: B). The Asfouriyeh hospital for the insane in Lebanon].
This is the second of a series of articles dealing with the history of psychiatry in Eretz-Israel and its surroundings. After a brief survey of the Ottoman medicine and Islamic hospitals, this article presents a short description of the treatment for mentally ill patients in the Ottoman Empire. We describe the historical background and the establishment of the Asfouriyeh hospital for the insane in Lebanon towards the end of 19th century, as well as other mental hospitals in this land. We outline some similarities in initiative and administration during the foundation of Ezrath-Nashim hospital in Jerusalem at that time.