Articles: analgesics.
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Intravenous demand analgesia is introduced as a possible way to optimize the treatment of acute pain. Within certain limits patients are allowed to self-administer small doses of analgesics as often as they need; microprocessors are used to control safe operation and to document individual drug consumption. ⋯ Demand analgesia is described not only as an effective therapeutic concept but also as an interesting tool for pain research (influences on pain perception, comparison of analgesic potencies etc.). It is strongly suggested from the results that treatment of acute pain ought to be more individualized than it is now in routine practice.
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The spinal nociceptive system is the target of various pain depressing agents. It is capable to function without control from the brain. It is activated by tissue damage which, by excitation of nociceptive afferents, evokes activity in axons ascending to the brain (sensory nociceptive response) and in spinal reflex pathways (motor and autonomic responses). ⋯ Ceruletide and cholecystokinin octapeptide depress nociceptive motor responses but do not affect the nociceptive sensory response. This indicates that motor and sensory responses of the spinal nociceptive system are not rigidly linked together. With the help of appropriate drugs, it is possible to manipulate them separately.