Articles: analgesia.
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Anesthesia and analgesia · Jan 1989
Paravertebral somatic nerve block: a clinical, radiographic, and computed tomographic study in chronic pain patients.
The spread of solution after a standardized paravertebral injection was studied to determine the precision and predictability of paravertebral spread. The spread of 5 ml of a solution of radiological contrast medium (sodium iothalamate) and local anesthetic mixture after 45 (34 thoracic, 11 lumbar) paravertebral injections was studied in 31 patients by radiography and computed tomography and correlated with the clinical effects. Spread confined to the paravertebral area occurred after only eight (18%) injections. ⋯ The distance from bony landmarks to pleura frequently fell outside the limits recommended by many standard texts. We conclude that the spread of a small volume of solution after paravertebral injection is imprecise and unpredictable. Neurolytic and diagnostic paravertebral injections performed without the aid of radiological imaging and contrast media should be regarded as hazardous and interpreted with extreme caution.
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Pediatric neuroscience · Jan 1989
Use of epidural morphine for control of postoperative pain in selective dorsal rhizotomy for spasticity.
Postoperative pain control can be a major problem after selective dorsal rhizotomy for the treatment of spasticity. We report the use of epidural morphine delivered via a catheter placed at surgery for postoperative analgesia in 28 consecutive patients undergoing this procedure. ⋯ There were no instances of respiratory depression, wound infection, or central nervous system depression, and the patients were easily mobilized in the early postoperative period. Epidural morphine is concluded to be a safe and very efficacious method of analgesia after selective dorsal rhizotomy.
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Anaesthesiol Reanim · Jan 1989
[Experiences with sacral anesthesia in combination with morphine analgesia].
Sacral anaesthesia is an anaesthetic method which is easy to learn, has a low complication rate and can be used also in elderly patients. The application of long-lasting local anaesthetics like bupivacaine in combination with morphine provides good conditions for postoperative pain relief following proctological operations. ⋯ The mean value of postoperative pain relief amounts to 53 +/- 23.4 hours in patients given sacral anaesthesia with 2 mg/kg bupivacaine with adrenaline 0.005% and 5 mg morphine. Our results are based on 513 patients of whom 105 were given sacral anaesthesia without morphine and 308 with morphine.