Articles: analgesia.
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To determine the efficacy and safety of administering low-dose analgesic infusions through cervical epidural catheters. ⋯ Patients with chronic persistent cervical radiculopathy pain were effectively treated with infusion of analgesics through epidural catheters for 2 to 17 days while they were at home.
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Cahiers d'anesthésiologie · Jan 1994
[Mechanisms of the analgesic effect of alpha 2 adrenergic agonists].
Alpha 2 adrenergic agonists stimulate specific receptors in the dorsal horn of the spinal cord leading to blockade of potassium and calcium channels. Presynaptic alpha 2 receptors inhibit the release of substance P and other neuropeptides which stimulate transmission of nociceptive stimulations. Post-synaptic alpha 2 receptors hyperpolarize neurons membranes and decrease the activity of nociceptive neurons. In addition, alpha 2 adrenergic agonists have a synergistic action with opioid and cholinergic agonists.
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Cahiers d'anesthésiologie · Jan 1994
Comparative Study[Effect of epidural analgesia on obstetrical mechanics].
Epidural analgesia is the most effective technique of pain relief during labour. However, there is an old suspicion that it modifies the course of labour. ⋯ The deleterious effect on the second stage is primarily due to motor blockade of the pelvic floor muscles which normally exert an important influence on fetal accommodation. It is possible to limit the negative effect of motor blockade by using either a combination of low-dose bupivacaine and opioid, or injection of a lipophilic opioid through a subarachnoid catheter, or by using the new amide local anaesthetic, ropivacaine, which is claimed to possess less motor blocking action.
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Anesthesia and analgesia · Jan 1994
Comparative StudyA comparison of epidural catheters with or without subcutaneous injection ports for treatment of cancer pain.
The aim of this study was to compare the incidence of technical complications of epidural catheters with subcutaneous injection ports to percutaneous epidural catheters without ports, fixed only by adhesive dressing. We reviewed 149 patients who received 250 epidural catheters for treatment of cancer pain during a 3 1/2-yr period from January 1, 1989, to June 30, 1992. Of the 250 catheters, 52 were provided with subcutaneous injection ports and 198 were percutaneous catheters. ⋯ No injection port became infected during the first 70 days of treatment, whereas in the percutaneous group infections occurred as early as the first week. Within the percutaneous group the complication rate in the tunneled epidural catheters was as high as in the nontunneled. We conclude that injection ports reduce the complication rate of epidural catheters, particularly catheter dislodgement and early infections.