Articles: patients.
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This epidemiological questionnaire-study of 362 patients suffering from chronic pain related to musculoskeletal disorders showed the following results: Most musculoskeletal pain syndromes are located in the head and back areas (57.3%). Patients who seek treatment in an orthopedic pain clinic suffer from at least moderate pain according to the verbal rating scale and from pain equal too or more than 50 on to the numeric rating scale. For most patients (51.9%) the duration of the pain has been between 1 and 10 years. ⋯ Most patients with chronic pain consult 2 to 6 doctors. For typical orthopedic pain syndromes most patients consult an orthopedist. Patients with chronic headaches consult an orthopedic specialist about as frequently as neurologist or internist specialist.
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J Neurosurg Anesthesiol · Mar 1989
Sufentanil, alfentanil, and fentanyl: impact on cerebrospinal fluid pressure in patients with brain tumors.
In order to evaluate the safety of the new synthetic opioids, alfentanil and sufentanil, in neurosurgical patients, we administered sufentanil 1 microg/kg i.v., alfentanil 50 microg/kg i.v. followed by an infusion of 1 microg/kg/min, or fentanyl 5 microg/kg i.v. to 30 patients with supratentorial tumors anesthetized with nitrous oxide (N2O), 60% in O2. Lumbar cerebrospinal fluid pressure (CSFP) and mean arterial pressure (MAP) responses were recorded for 10 min thereafter, while ventilation was held constant [mean PaCO2 = 36.1 +/- 1.0 mm Hg (SEM)]. There was no change in CSFP after fentanyl. ⋯ It is concluded that because sufentanil increased CSFP in patients who have brain tumors, it also may be contraindicated in other neurosurgical patients at risk for intracranial hypertension. Alfentanil may share this propensity, since CSFP increased despite a profound reduction in MAP. Among the three opioids evaluated, only fentanyl appears to be appropriate for supplementing N2O-2 anesthesia in patients who have compromised intracranial compliance.
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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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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.