Articles: analgesia.
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In the operating room, anaesthetist must provide unconsciousness, analgesia and muscular relaxation. In intensive therapy (IT), the rules are different and not every patient requires sedation, but almost every patient needs analgesia. The patient who is alert, calm and comfortable despite the presence of tubes and cannulas in the nose, mouth, radial artery, central vein, urethra, surgical wounds, pleural space etc. does not need any sedation. However, sedation and analgesia are clinically inseparable. If mechanical ventilation is not well controlled, muscular relaxants must be prescribed. There are a lot of trials in formulating an ideal sedative/analgesic regimen for each individual patient. ⋯ There are two barbiturates in use: thiopentone and pentobarbital. Although the main effect is hypnosis, the most important is anticonvulsant effect. Thiopentone is an agent for cerebral protection. Barbiturates have not achieved popularity in IT because of prolonged elimination and slow recov
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Arch Phys Med Rehabil · Nov 1998
Fluoroscopic transforaminal lumbar epidural steroids: an outcome study.
To determine the therapeutic value and long-term effects of fluoroscopic transforaminal epidural steroid injections in patients with refractory radicular leg pain. ⋯ Fluoroscopic transforminal epidural steroids are an effective nonsurgical treatment option for patients with lumbar herniated nucleus pulposus and radiculopathy in whom more conservative treatments are not effective and should be considered before surgical intervention.
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Postoperative pain therapy in modern clinical practice still has significant deficits. Establishing acute pain services is reported to be a method of improving pain therapy. ⋯ The results showed that pain control was insufficient in 29 patients, and that side effects developed in 45 patients, included one patient with late respiratory depression. We conclude that acute pain service is essential in order to improve postoperative analgesia.