Articles: function.
-
Spinal opioids are effective analgesics for surgical and non-surgical pain. Central and systemic side effects are less frequent than with epidural local anaesthetics or parenteral opioids. This review focuses on the analgesic efficacy of spinal opioids and their combination with local anaesthetics for postoperative analgesia, including patient-controlled epidural analgesia. ⋯ However, evidence suggesting that effective postoperative analgesia can significantly improve postoperative morbidity in patients at risk is accumulating. In such patients, combined use of epidural local anaesthetics and opioids may become the technique of choice for postoperative analgesia. However, there is no evidence that this would have any clinically relevant benefit in low-risk patients.
-
Low back pain ist frequently associated with malposition of the pelvis due to an imbalance of the postural muscles. In these patients functional malposition of both the sacrum and the ileum can be observed, resulting in differences in the length of the legs. We investigated whether the return to a normal position correlated with pain relief. ⋯ Differences in the length of the legs can be successfully treated by manual therapy at C0/C1 or C2/C3 in the majority of patients with pelvic malposition. However, infiltration of the iliosacral joints is often required as additional therapy for short-term and long-term pain relief. Treatment with NSAIDs alone is only seldom effective in cases of pelvic malposition and rarely affords long-term pain relief.
-
Appl Neuropsychol Adult · May 1996
Rey complex figure: memory error patterns and functional abilities.
The functional abilities of brain injured persons to live independently, were assessed using the Rancho Los Amigos Scale ratings of functional levels which were compared with memory error patterns on the Rey Complex Figure (Rey 1941) and the Recognition Trial developed by Meyers & Meyers (1995) Memory error patterns were described by Sohlberg & Mateer (1989), the least impaired memory error pattern was Retrieval, while Storage, Encoding and Attention patterns indicated greater defect Spearman rank order correlation revealed the strong association (r(S) = 86) of memory error pattern with Rancho Scale functional ratings In independent subjects 96 % achieved a Retrieval memory error pattern whereas 93% of subjects whose memory error pattern was poorer than a Retrieval pattern were unable to function independently Results indicate that patients obtaining a Retrieval (or better) memory error pattern may be expected to possess adequate cognitive resources for independent functioning.
-
Journal of anesthesia · Mar 1996
Alterations in the myocardial β-adrenergic system during experimental endotoxemia.
In this study to investigate whether β-adrenergic receptor systems in the heart are impaired during endotoxemia, we examined two models of septic shock in rats, each of which has a different time course for the shock state. Male Wistar rats were divided into two groups: (1) the LPS (lipopolysaccharide) iv group (Escherichia coli endotoxin 1.0 mg·kg(-1) iv bolus administration), and (2) the CLP (cecal ligation and puncture model) group. As a control group for each model, a 0.9% saline injection group and a sham-operated group were also prepared. ⋯ The alteration in hemodynamics of septic-shock rats observed in this study was linked to the change in heart β-receptor density rather than the change in plasma CA. These observations suggested that the alterations which occur in the β-receptor system during endotoxemia depend upon the model of animal sepsis that is employed, and the time course of the septic-shock state. These alterations in the β-adrenergic system are thought to cause myocardial dysfunction during endotoxemia.
-
We compared the effects of normothermic cardiopulmonary bypass (CPB) with those of hypothermic CPB in patients who underwent coronary artery bypass grafting (CABG) with respect to hemodynamics and oxygen balance. The patients in our study were divided into two groups according to temperature during CPB: systemic normothermia combined with warm blood cardioplegia (group W,n=36) and systemic hypothermia combined with cold crystalloid cardioplegia (group C,n=26). In group W, the use of directcurrent (DC) defibrillators was less frequent after release of the cross clamp, and the duration of CPB and of reperfusion was shorter. ⋯ Mixed venous oxygen saturation ([Formula: see text]) was maintained above 65% during and after CPB in group W and group C. Our results showed that normothermia may be superior to hypothermia during CPB with respect to recovery of cardiac function and avoidance of hyperglycemia. The whole-body oxygen demand-supply balance may be preserved during normothermic as well as hypothermic CPB.