Articles: analgesia.
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Narcotic analgetics administered directly into the spinal subarachnoid space of the rat via a chronically inserted catheter produce a potent analgesia that can be antagonized by naloxone. The narcotics, acting only at the spinal level, changed cord function to block not only spinal reflexes but also the operant response to painful stimuli.
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As part of an agreement between the Governments of the People's Republic of China and Canada, 10 Canadian Anaesthetists visited China for six weeks during April and May 1974. The delegation observed 87 surgical operations and 19 dental procedures conducted under acupuncture analgesia in 17 large hospital in Peking, Schichiachuang, Nanking, Shanghai and Canton. In this report, observations on acupuncture analgesia made during this visit are presented as well as information obtained in group discussions with Chinese physicians. ⋯ Acupuncture analgesia poses considerable limitations on the surgeon and requires careful surgical technique; the patient's co-operation must be assured by a suitable preparation. It appears, that acupuncture analgesia should be seen as an alternative to local anaesthesia rather than general anaesthesia; the latter is only used to a limited extent in China. In our present anaesthetic practice, acupuncture would appear to be of only very limited use, however, a further study of this phenomenon should contribute to our knowledge of the function of the nervous system.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of effect of narcotic and epidural analgesia on postoperative respiratory function.
A prospective, randomized comparison was made of the value of meperidine versus epidural analgesia when used for the relief of pain after cholecystectomy in twenty patients without cardiopulmonary disease. Respiratory function was assessed the day before surgery and at 3 to 4 hours and 24 hours after operation by the bedside measurement of expiratory peak flow, vital capacity, and arterial blood gases. The two groups of patients were comparable as to age, height, weight, smoking habits, preoperative peak flow, vital capacity, and duration of operation. ⋯ However, at 3 to 4 hours postoperatively, vital capacity was significantly greater in the epidural anesthesia group. This might account for the differences in arterial blood gases the following day. These findings suggest that epidural analgesia is valuable in the early postoperative period after upper abdominal surgery.