Articles: analgesia.
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The effect of immersion in a jacuzzi in relieving labor pains, and on cervical dilatation was examined in 40 parturients. They were immersed in the jacuzzi during labor for an average of 25.5 minutes. ⋯ The cervical opening increased during immersion by an average of 1.5 cm in the test group, compared with 0.3 cm in the controls (p < 0.01). Immersion in a jacuzzi during labor is apparently associated with analgesia and accelerated cervical dilatation.
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In the pain treatment of patients with incurable head and neck tumors it may be difficult to provide adequate oral drug therapy in the advanced stages. In these cases continuous subcutaneous application of morphine by means of external infusors is an alternative. An example of the method of continuous subcutaneous application of analgesics in pain therapy is shown in a patient suffering from a chondrosarcoma of the maxilla. ⋯ Because of growing tumor infiltration, we progressively increased the morphine dosage. Nevertheless, continous subcutaneous application of droperidol, dexamethasone and clonidine was also needed to achieve much better analgesia. The technical simplicity of this safe and effective treatment make it suitable for outpatient care in tumor clinics.
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Epidural analgesia remains the mainstay for providing pain relief during labor. The search continues to find the ideal combination of analgesic agents and administration techniques that will provide excellent pain relief for the mother yet minimize side effects to the mother and fetus. This article reviews recent studies of epidural analgesia, including the increased use of epidural opioids, patient-controlled epidural analgesia, and the complications of epidural analgesia (including effects on gastric emptying, maternal temperature control, and hemodynamic changes to the mother and fetus). Intrathecal (spinal) analgesia, especially using opioids, is also discussed.