Articles: surgery.
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The possible association of brain tumour with headache was investigated in 100 patients seen for brain surgery. Preoperatively, 43 patients suffered from headache. These patients were thoroughly questioned about the nature of their pain. Investigation included the McGill Pain Questionnaire. ⋯ Our investigations yielded new information concerning the epidemology of headache accompanying brain tumours. Headache is not an early cardinal symptom of brain tumours, as was generally believed earlier. With the help of the McGill Pain Questionnaire a fine quantitative and qualitative characterization of headache of different origins could be made. The connection between tumour localization and pain lateralization, as well as the possible mechanisms of intracranial pain projection was extensively analysed. The interpretations of the results are at best hypotheses and they do not help determine why more than half of the patients with brain tumour did not experience headache.
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There have been major advances in knowledge and efficient techniques for pain relief have been developed during recent years. Nevertheless, many patients on surgical wards still suffer from severe pain following surgery or trauma. Therefore, in the University hospital of Kiel (Germany) an anaesthesiology-based acute pain service (APS) was established in 1985 to improve this situation.
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Norplant implants were removed from fifty (50) patients using a modified approach to Norplant implant removal (Emory Method). Eighty-eight percent (88%) of the removals were accomplished in less than 10 minutes using this technique. The average time for removal of Norplant implants from 50 women included in the current study was 8 minutes. ⋯ More anesthesia, a slightly longer incision and vigorous disruption of the tissue encapsulation surrounding the implants are recommended. The Emory Method is fast, safe and easy to perform. It has been successfully taught to over twenty-five clinicians.