Articles: patients.
-
A total of 97 patients with an acute monoradicular lumbosacral compression syndrome and a herniated disc at the same level were reinvestigated an average of 25 months after the acute event. Assessment was based on CT investigation and "root score", which was compiled from reports of subjective complaints and neurological deficits. All patients had initially undergone conservative treatment as inpatients. ⋯ In the majority of cases, during the further course of the disease the herniated disc causes no pain. It appears, therefore, that the course of disease following a disc herniation can be influenced very favourably by non-operative treatment and that in more than 50% of cases the condition becomes clinically silent. It follows that in neuroradicular compression syndromes a neurological deficit associated with the acute event does not mean operative intervention is indicated.
-
Journal of anesthesia · Sep 1994
RETRACTED ARTICLE: Airway occlusion pressure is an indicator of respiratory depression with isoflurane.
The purpose of this study was to elucidate the respiratory depressant effects of isoflurane (0%-1.0%) using airway occlusion pressure (P0.1), a known index of the output of the respiratory centers, in ten anesthetized patients. P0.1 was measured as the pressure change obtained after the first 0.1 sec of spontaneous inspiration against the occluded airway. A significant decrease in minute volume ([Formula: see text]) and a significant increase in PaCO 2 were not observed during the periods of isoflurane 1.0% at the end-tidal concentration compared with those of control period (0% isoflurane) (P<0.05), whereas a significant decrease in P0.1 was observed during the period of isoflurane 0.5%. Our results suggested that P0.1 was a more sensitive indicator of respiratory depression than PaCO 2 or[Formula: see text], and the respiratory center was depressed with a considerably lower concentration (0.5%) of isoflurane.
-
In rheumatology, all of the more than 400 specified syndromes are associated with pain. In the conceptual discussion on the multidimensional influences postulated to explain the development of chronic pain, fibromyalgia has gained increasing interest. Fibromyalgia (fibrositis) is an unspecific soft-tissue disorder with chronic wide-spread musculoskeletal pain and palpable hypersensitivity at fibrositic tender points. ⋯ Histochemical investigations on muscle biopsy and biochemical tests have revealed unspecific changes but no characteristic muscle abnormality. It is supposed that the clinical features may result from central neurohumoral dysfunction combining with peripheral mechanisms to result in hyperalgesia. An integrated therapeutic concept with a reassuring and positive doctor-patient relationship can be helpful in achieving satisfactory treatment results.
-
The article describes the interdisciplinary treatment of chronic pain at the Center of Pain Studies (CPS). The CPS is an intergral part of the Rehabilitation Institute in Chicago. An essential part of the program is a 1-day outpatient evaluation in which members of all disciplines take part. ⋯ General aims of the treatment are to return to productive life, improve emplopyability, increase activity level, improve mobility, apply pain management techniques, and improve coping. The program is monitored by an evaluation/follow-up system. Success criteria of the 6-month follow-up for the years 1987-91, such as less daily downtime in 58-78% of the patients, more time out on weekends in 40-68%, return to work in 50-67% and reduced depression in 37-70%, give an impression of the effectiveness of the pain management program.
-
Journal of anesthesia · Sep 1994
The effect of pH adjustment of 1% lidocaine on the onset of sensory and motor blockade of epidural anesthesia in nonpregnant gynecological patients.
Using a double-blind randominzed study protocol, we examined the distribution of sensory blockade and the quality of motor blockade after epidural anesthesia with 1% lidocaine with or without bicarbonate in nonpregnant gynecological patients. Alkalinization significantly decreased the time to onset of sensory blockade. However, there were no statistically significant differences between the low-pH and high-pH groups with respect to motor blockade or the distribution of sensory blockade. We conclude that pH-adjusted 1% lidocaine offers the advantage of a more rapid onset of sensory blockade, while motor blockade and the distribution of anesthesia are unaffected by pH change in epidural anesthesia.