Articles: patients.
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A short survey about the different methods available for producing postoperative analgesia is given, the goal being to make it clear to the clinician that there are quite a number of techniques to be used although the everyday clinical practice often sticks to simple and not too effective methods of pain treatment following surgery. Initially presenting short informations about the neurophysiology of pain and the pathogenesis and causes of postoperative pain two main groups of producing analgesia are then discussed. Thefirst group deals with the systemic use of analgesics be it nonnarcotic analgesic antipyretics or narcotic analgesics (opioids). ⋯ They present clear advantages over the local anesthetic methods as there are the long lasting analgesia and the selective blockade of pain not touching motor and sympathetic nerve fibers. A delayed respiratory depression however might be a serious danger showing an incidence of 0,3% in the epidural and some 10% in the subarachnoid route. Aiming to inform the clinician once again about the vast field of possibilities available to make the postoperative course painfree it is hoped that this important task in the postoperative period will be handled with more consequence and effectivity in the future.
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This article reviews the methods currently in use for the measurement of chronic pain. The most important items for inclusion in questionnaires about the history and in pain diaries to elicit data on the time-course of pain are presented, and both the aims and the advantages and disadvantages of various strategies are discussed. The documentation of chronic pain in outpatients would allow answers to some questions concerned with medical epidemiology if practiced in a large number of therapeutic institutions, especially if the data were processed and evaluated by microcomputer.
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As a result of changing public attitudes non-orthodox methods of pain therapy have become widely accepted within everyday health care. The view that non-orthodox methods, even if not overly successful are at least harmless is widely held. ⋯ Patients should be questioned about the use of alternative methods of treatment and physicians should be aware of unwanted effects of acupuncture, cell therapy, Ajurvedic medicines and herbal therapies. In addition, they should know that some drugs sold as herbal products with "no side-effects" are enriched with e.g. phenylbutazone and/or corticoids, for example.
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This study examined the accuracy of patient estimates of time spent in the waiting room, examining room, and with the physician. In addition, the impact of physician touch (such as a handshake in greeting) upon those estimates was determined. Patients were noted to be quite accurate in estimates of waiting room time. ⋯ The overestimation of physician contact time was positively related to the number of interruptions requiring the physician to leave the examining room. Minimal touch in greeting had no effect on estimates of waiting room time but did significantly magnify the underestimation of examining room waiting time. Patients who were touched did, on an average, overestimate physician contact time to a greater extent than those who were not touched; however, this difference did not reach statistical significance.
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Journal of anesthesia · Mar 1987
Spread of epidural analgesia following a constant pressure injection--an investigation of relationships between locus of injection, epidural pressure and spread of analgesia.
(1) The spread of epidural analgesia following injection of 15 ml of 2% mepivacaine was 17.3 +/- 0.6, 14.3 +/- 0.4, and 13.3 +/- 0.7 spinal segments in cervical, thoracic, and lumbar epidural analgesia, respectively. The patient's age showed significant correlation with the spread of epidural analgesia in cervical (r = 0.5776, p < 0.001), thoracic (r = 0.3758, p < 0.01), and lumbar area (r = 0.8195, p < 0.001). ⋯ The lower epidural pressure associated with higher age, the wider spread of analgesia. There was no significant correlation between the residual pressure at 60 seconds and the age or the spread of analgesia.