Articles: patients.
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Journal of anesthesia · Mar 1989
A new technique of identifying the epidural space "dripping infusion method".
We developed a new visual technique o identifying the epidural space, using the hydrostatic pressure produced by a suspended micro-drip intravenous apparatus. When the needle pierces the ligamentum flavum, the resistance to positive pressure disappears and the saline in the apparatus flows freely into the epidural space. Thus, the entry of the needle point into the epidural space is visually confirmed by the appearance of dripping flow in the drip bulb (dripping infusion sign). ⋯ In the remaining 11 patients (2.2%), a false dripping infusion sign appeared at the more superficial site than expected. If the pressure waveform in the epidural space is analyzed, the correct positioning of the needle can be easily confirmed. We believe that this method is one of the most accurate visual methods of identifying the epidural space and useful for teaching the epidural blockade to students and residents.
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Journal of anesthesia · Mar 1989
Effects of anesthetic and related agents on calcium-induced calcium release from sarcoplasmic reticulum isolated from rabbit skeletal muscle.
We have investigated the effects of anesthetic and related agents on Ca(2+)-induced Ca2+ release (CICR) in heavy sarcoplasmic reticulum isolated from rabbit skeletal muscle. The purpose of this study is to elucidate their possible role as triggering agents in malignant hyperthermia (MH). ⋯ It is unlikely that lidocaine is a potent facilitator of CICR at any concentrations. We conclude that procaine, lidocaine, non-depolarizing muscle relaxants and opiate can be used safely for MH susceptible patients and that ketamine and succinylcholine are not recommended.
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An outpatient treatment programme for pain control was applied in 25 chronic pain patients in three general medical practices, supervised by a medical psychologist as a group therapist. The patients has been suffering from headaches, migraines, cervical pain, shoulder and arm pain, and low back pain for at least 6 months. A sample of 20 patients with the same disorders served as a control group which waiting for treatment. ⋯ Nonetheless, all the subjects treated showed improvements in their average scores for trait anxiety, depression and symptoms complaints compared with the untreated controls. Our results indicate a long-term improvement in well-being as a result of the treatment. Treatment adherence seems to be the most important factor in the maintenance of long-term reduction of pain intensity.
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Tursky's pain perception profile [16] has been revised and adapted for use in German-speaking conditions, and this new modification is presented. It integrates six different methods of clinical and experimental methods of clinical and experimental pain measurement, which are intended to meet the enhanced demands put forward in pain research for multivariate measurement of pain by a variety of methods. ⋯ The results document the many aspects of chronic pain and the necessity for multimodal measurement. In addition, they supply a means of achieving a better pain-related classification of pain patients on an experimental basis.
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J Neurosurg Anesthesiol · Mar 1989
Hypocapnia prevents the decrease in regional cerebral metabolism during isoflurane-induced hypotension.
In neurologic surgery, induced hypotension is often used while the patient is hypocapnic. We investigated, by tissue biopsy methods and scintillation counting, the regional cerebral glucose utilization (rCMRglc) and blood flow (rCBF) in rats subjected to hypocapnia alone and in combination with hypotension. Anesthesia was maintained with 1.0% isoflurane in nitrous oxide/oxygen. ⋯ During hypocapnia/hypotension, rCBF was unaltered in cortical areas, while increases were seen in all subcortical areas compared to hypocapnia. Regional values of the ratio of rCBF/rCMRglc indicated that during hypocapnia and hypotension induced by isoflurane in nitrous oxide/oxygen, the individual brain areas were perfused according to their metabolic needs. It is suggested that hypocapnia may prevent the decrease in rCMRglc, which is usually observed during deep isoflurane anesthesia.