Articles: pain-management.
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Int J Obstet Anesth · Apr 1995
Successful subdural anesthesia for cesarean section and postoperative pain management.
Subdural catheterization is a well described, but uncommon complication of attempted epidural block. Aspiration of blood or cerebrospinal fluid and use of a test dose can help identify venous or subarachnoid catheter placement but do not rule out subdural catheter placement. ⋯ This report describes the early identification of subdural placement of a catheter intended for the epidural space. We present radiologic confirmation of the catheter's location, and describe its use to provide successful anesthesia for cesarean section and postoperative analgesia.
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Consecutive obese (n = 53) and non-obese parturients (n = 609) were prospectively evaluated during labour to analyse the influence of maternal obesity on labour pain and outcome. Excessive pre-pregnancy weight was classified as a body mass index of 30 kg.m-2 or more. Pain intensity was measured using an 11 point visual scoring scale. ⋯ After delivery, obese women were significantly more content with the pain relief received; only 12% vs 23% in the control group complained of poor pain control (p = 0.03). In this study, obesity and increased fetal size did not complicate labour or its outcome. Critical patient assessment should be emphasised, however, due to the physiological and medical problems present in obese parturients.
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This is a review of the systematic studies conducted since 1980 in the area of hypnotic interventions for anxiety, pain, and emesis control in child and adolescent cancer patients. The focus of the present paper is on how the problems encountered in studying the use of hypnosis with this population influence the results. The review is divided between studies focused on controlling anxiety and pain and those focused on controlling nausea and vomiting. Consistent findings are identified, and suggestions for future research are made.
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A woman from Hamilton, Ont., is suing a local hospital an three physicians, alleging that she suffered excessive pain while giving birth. The first-time mother alleges that she experienced excessive pain during delivery despite her repeated requests for pain relief.
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In 1985 there were almost 5 million deaths from cancer, and it is estimated that in 2015 there will be over 9 million, of which almost three-quarters will be in developing countries. Seventy to eighty per cent of these patients will experience moderate or severe pain at some stage of their illness and at present most of these will die in pain. This is true in spite of the fact that there is substantial evidence which shows that in as many as 80% of patients with cancer pain it is possible to obtain complete relief with orally administered analgesics, either alone or supplemented with co-analgesic (adjuvant) drugs. ⋯ The most important advances in management have been the simplification and refinement of analgesic treatment which have made relief of cancer pain more widely accessible to patients. The introduction of controlled-release oral formulations of morphine has had a considerable impact because they are convenient and simple to use. The recent development of a long-acting non-invasive transdermal delivery system for strong opioid administration promises a further step forward in terms of flexibility and convenience for cancer patients.