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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient is described who, despite severe pre-operative respiratory disability, had her persistent pneumothorax successfully managed by thoracoscopic pleurectomy. The technique causes considerably less pain and interference with respiratory function postoperatively than does conventional thoracotomy. Potential anaesthetic problems arise because of the necessity of insufflating carbon dioxide at pressures of up to 1 kPa to maintain a pneumothorax during surgery.
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PMID:Anaesthesia for thoracoscopic pleurectomy and ligation of bullae. 148 32

Dimetindene maleate (DMM, Fenistil, CAS 3614-69-5) a specific H1-receptor antagonist, is therapeutically used for the treatment of respiratory allergies, urticaria, itching dermatoses and generally pruritic sensations occurring with various diseases. As it exhibits local anaesthetic activity in the rabbit cornea and the local anaesthetic activity of a couple of H1-antagonists was found to be linearly correlated to the H1-potency represented by the pA2-values--and dimethindene maleate demonstrates a high pA2-value--it seemed worth investigating the local anaesthetic potency in man making use of an objective and well validated pain model, the Laser algesimetry. The study was carried out with 24 healthy volunteers in a double-blind placebo- and reference-controlled, randomized, cross-over design. Three different medications were applied with occlusive dressing: DMM, lidocaine, and placebo. Selective thermo-noxious stimulation of A-delta- and C-fibers was induced by a CO2-laser. Somato-sensory evoked vertex potentials (SEPs) were simultaneously recorded. Both verum treatments showed a remarkable analgesic potency compared to placebo. Effects were preferably concentrated on the peripheral N1-component of the SEPs. The overall means of the N1-amplitudes were suppressed compared to placebo by both active drugs, with the effects being more pronounced for DMM.
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PMID:Evaluation of the local anaesthetic activity of dimetindene maleate by means of laser algesimetry in healthy volunteers. 149 45

Seventy-two women underwent laparoscopic hysterectomy, some concomitant with other laparoscopic procedures. The surgery was performed with a combination of Kleppinger bipolar forceps for hemostasis, a scissors and/or CO2 laser for tissue division, CO2 laser for vaporization and excision of endometrial implants, and CO2 laser and scissors for lysis and excision of adhesions. There were no intraoperative complications. One patient, however, was readmitted to the hospital on the fifth postoperative day because of a fever but was discharged 48 hours later. The first 10 patients were discharged on the second postoperative day. The remaining 62 were to be discharged within 24 hours of admission; 59 of them were discharged then. The last three had to be admitted to the hospital; all were discharged on the second postoperative day. One week after surgery the patients were permitted to drive and resume normal, nonstrenuous physical activity. All the surgery was videotaped and later viewed by the patients. The laparoscopic approach to hysterectomy provided all the advantages of the abdominal approach with decreased morbidity, blood loss, postoperative discomfort, pain, length of hospitalization and recovery.
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PMID:Laparoscopic hysterectomy. A review of 72 cases. 153 74

Peritoneal and ovarian endometriosis are anatomically highly polymorphous and can give rise to pain and sterility. Endometriosis can be recognized and evaluated by means of laparoscopy and an appropriate therapeutic strategy determined. Surgical laparoscopy using lasers (CO2, KTP and argon) produces excellent results. More than 80% of cases can be treated by coelioscopy, bearing in mind that severe endometriosis can require classic surgery and remains difficult to perform. However, one basic idea should not be forgotten, ie, that endometriosis is a progressive disease. Restoration of anatomic pelvic integrity (with free pouch of Douglas, mobility of appendages and functional ovaries) is the only guarantee of good fertility, achievable by interruption of progression of the disease. Following therapeutic trials with danazol, norsteroidal progestagens, gonadotrophin-releasing hormone agonists have opened up wide perspectives for use and we use them in combination with coeliac surgery. Our experience has paralleled that of Donnez and Bruhat, with almost identical results.
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PMID:Role of gonadotrophin-releasing hormone agonists in the treatment of external genital endometriosis: review of 77 cases. 153 19

This study compares and contrasts the use of the CO2 laser with the conventional cold-steel scalpel and electrocautery in cosmetic blepharoplasty. Ten patients underwent bilateral, upper, and lower eyelid cosmetic blepharoplasty using the CO2 laser as the exclusive cutting and cauterizing instrument for one eye, and the cold-steel scalpel and electrocautery as the exclusive cutting instrument and cauterizing tool for the remaining eye. This comparison evaluated administrative factors, procedural ease, and long- and short-term results. The benefits of using the CO2 laser rather than the cold-steel scalpel in blepharoplasty are reduced operative time, less bleeding, superior intraoperative visibility, less bruising and swelling, no pain or discomfort, and a shorter recuperation period. There were no complications with either the scalpel or the laser. Using the laser with standard safety protocols presents no greater risk to the patients undergoing blepharoplasty than does using the cold steel scalpel with an electrocautery device. The disadvantages of using the laser compared with the steel scalpel include the cost of purchasing and maintaining the laser equipment, the need for additional and extensive laser training for surgeons and assistants, and the need for two assistants rather than the one needed for scalpel surgery.
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PMID:CO2 laser blepharoplasty. A comparison with cold-steel surgery. 849 95

This is the first paper to study the physiological function of the spinothalamic tract in multiple sclerosis (MS) using pain-related somatosensory evoked potentials (pain SEPs) following CO2 laser stimulation. Among 12 patients with MS, hand- and foot-stimulated pain SEPs were significantly delayed or absent in 3 and 7, respectively. These results were totally consistent with clinical impairment of pain-temperature sensation. In contrast, the results of conventional electrically-stimulated SEPs were compatible with impairment of vibration sensation. Therefore, the examination of both pain and electric SEPs is very useful to evaluate the physiological function of the ascending spinal tract in patients with MS.
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PMID:Physiological study of the spinothalamic tract conduction in multiple sclerosis. 156 19

Mechanisms of pain relief induced by vibration and movement were investigated. A CO2 laser beam, which is useful for pure nociceptive stimulation, was used for recording pain-related somatosensory evoked potentials (pain SEPs) and for measuring pain threshold and reaction time (RT). Concurrently applied vibratory stimuli to and active movements of the fingers significantly reduced and prolonged pain SEPs, increased pain threshold, and prolonged RT, indicating that an increase in the inhibitory mechanisms of painful feeling was induced by the concurrently adopted sensory inputs mediated by large myelinated fibres. In contrast, continuous cooling enhanced pain SEPs and decreased pain threshold, probably due to the spatial summation of two kinds of nociceptive impulses mediated by the same pathways. The results of this investigation throw light on the mechanisms of the alleviation of pain by vibration and movement.
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PMID:Mechanisms of pain relief by vibration and movement. 158 12

In 12 volunteer subjects, noxious chemical stimulation was performed by applying precisely controlled CO2 pulses to the nasal mucosa. Each subject participated in 2 identical psychophysical sessions including: (1) determination of the pain threshold, (2) determination of stimulus response functions to different durations of CO2 pulses with fixed concentration and (3) determination of stimulus response functions to different concentrations of CO2. In this test we also examined the relative sensitivity of the visual analogue scale (VAS) and the magnitude estimation (ME) procedure. The reliability of the psychophysical data was tested by comparing the results obtained in both sessions. The intra-individual variability of the pain threshold was rather low. All the CO2 pulse widths used induced phasic pain sensations which when averaged encoded stimulus durations of up to 1 sec. Longer application periods did not further increase the pain sensations. The stimulus response functions to different concentrations of CO2 could be described well with Stevens' power functions. In our hands the VAS and ME procedures proved to be equally sensitive. The obtained psychophysical data appeared to be rather reliable since no significant differences in the ratings obtained in both sessions could be observed.
Pain 1992 Apr
PMID:Psychophysical examination of pain induced by defined CO2 pulses applied to the nasal mucosa. 159 82

Two hundred twenty-six patients underwent operative hemorrhoidectomy by a single surgeon in a three-year period. In 170 patients (75.2 percent), the operation was performed utilizing the CO2 laser. Standard closed hemorrhoidectomy was done in the rest. Patients were monitored prospectively for postoperative pain, wound healing, and complications. The feasibility of undergoing operative hemorrhoidectomy as an outpatient was also monitored. No differences were seen between laser and nonlaser hemorrhoidectomy. Outpatient surgery was done in over 72 percent of the patients without any added risk to them.
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PMID:Hemorrhoidectomy--laser vs. nonlaser: outpatient surgical experience. 164 97

Pain-related somatosensory evoked potentials (pain SEPs) following CO2 laser stimulation as well as conventional electrically stimulated SEPs (electric SEPs) were examined in 10 patients with peripheral neuropathies in whom the histopathological examination of the sural nerve was done. Results of pain SEPs showed a positive relationship with clinical impairment of pain sensation and densities of small myelinated fibers of the sural nerve. In contrast, results of electric SEPs showed a positive relationship with clinical impairment of deep and tactile sensations and with densities of large myelinated fibers of the sural nerve. Therefore, pain SEPs are considered to be generated by ascending signals mediated through nociceptive receptors and A delta fibers. The pain SEP is only one noninvasive and objective method currently available to investigate a physiological condition of the sensory pathway responsible for pain sense, and is especially useful when combined with the conventional electric SEPs.
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PMID:CO2 laser-induced pain-related somatosensory evoked potentials in peripheral neuropathies: correlation between electrophysiological and histopathological findings. 165 48


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