Articles: analgesics.
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Clinical neurosurgery · Jan 1983
Treatment of chronic pain of malignant origin with intrathecal opiates.
The acute administration of intrathecal morphine in man results in analgesia mediated by an opiate receptor. Chronically infused intraspinal opiates have an analgetic action mediated by opiate receptors. ⋯ There appear to be at least two classes of opiate receptors in the human and animal spinal cords which mediate analgesia. Our preliminary data suggest that, as in the animal model, DADL, a delta-ligand, shows significant activity in a morphine-tolerant spinal cord.
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In 30 patients undergoing cardiac surgery, anaesthesia was induced with alfentanil 125 micrograms kg-1 and maintained with an infusion of alfentanil 0.5 mg kg-1 h-1 until the start of cardiopulmonary bypass, and alfentanil 0.25 mg kg-1 h-1 thereafter until the end of surgery. Pancuronium was given and the lungs ventilated with air in oxygen. ⋯ Twenty-six patients required alfentanil supplementation before bypass. These results indicate that anaesthesia with an alfentanil infusion provides satisfactory cardiovascular stability for cardiac surgery.