Articles: analgesia.
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Although during the past few years more knowledge on pain and analgesia in the neonate has been acquired, adequate treatment is not always given. To achieve better understanding and treatment of pain in newborn infants, a review of pain perception and pain assessment is given as well as guidelines regarding its prevention and treatment. A proper assessment and an adequate relief of pain contributes to the quality of care for the newborn infant.
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The severity of postoperative pain after thoracotomy means that total analgesia cannot be achieved with a single method or agent without significant side-effects. Recent advances in our understanding of the mechanism of pain generation and maintenance mean that measures prior to surgery greatly affect the requirement for postoperative analgesia. We review the methods available for post-thoracotomy analgesia in the light of our knowledge of peripheral and central mechanisms of neuronal hypersensitivity. The combination of opiate premedication, preoperative non-steroidal anti-inflammatory drugs (NSAIDs), preincisional regional block and postoperative continuous paravertebral block together with NSAIDs may be the ideal combination for near total analgesia following thoracotomy.
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Review Comparative Study
The value of pre-emptive analgesia in the treatment of postoperative pain.
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We reviewed the out-patient consultation notes of 136 pregnant women seen at the Ottawa Civic Hospital from 1985 to 1991 to evaluate the efficacy of an Obstetric Anaesthesia Assessment Clinic (OAC). In addition, their anaesthetic records from labour and delivery were reviewed. For each patient the reason for referral was recorded according to the involved organ system. ⋯ The OAC gave an opportunity for patient education regarding anaesthetic options for labour and delivery. The attending anaesthetist was provided with a risk assessment and anaesthetic management plan which was adhered to with only two exceptions. Finally, the obstetrician was given consistent advice regarding anaesthesia management that may affect obstetrical decisions.
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An epidural catheter can be chosen for domiciliary oncological pain relief when relief is not achieved with oral drugs. The patient/relatives put in the central nervous systems the analgesic solution, through this peridural catheter. This article discusses how pain relief occurs, the infusion systems of opioids in the peridural space, the complications and side effects of this therapy.