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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe the anaesthetic management of a parturient with Noonan's syndrome. Her problems included severe cardiac disease, facial abnormalities and extreme phobia to needles. After intrauterine death at 30 weeks gestation, induction of labour was attempted and extradural analgesia initiated using low-dose bupivacaine. She failed to progress and underwent Caesarean section under general anaesthesia using awake oral fibreoptic intubation.
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PMID:General anaesthesia for caesarean section in a parturient with Noonan's syndrome. 895 89

This work was designed to study the impact of prenatal knowledge of fetal sex both on the psychological and obstetrical aspects of the expectant mothers during pregnancy and labour. One hundred pregnant women attending the outpatient antenatal clinic of Assiut University Hospital were recruited. All were in the third trimester, parous, with normal pregnancy and having no past or present psychiatric disorders. The desired sex of the expected child was registered. Symptom checklist 90 (SCL-90) was applied before, and 2 weeks after sonographic fetal sex determination. Women who desired male sex scored significantly higher depressive symptoms than those who desired female sex. Women who were proven sonographically to have the undesired fetal sex showed significantly higher scores of depression, somatization, anxiety, hostility and phobia scales of SCL-90 than women whose desired fetal sex was confirmed. The second part of the study to evaluate the effect of knowing the fetal sex on the progress of labour was designed as a case control study including 57 women previously informed about their fetal sex and 40 women ignorant of their fetal sex as controls. Women delivering a baby with undesired sex showed more obstetric difficulties. In the first stage of labour, they had significant reduction in frequency of uterine contractions and rate of cervical dilatation. They also needed much more sedation, analgesia and oxytocin augmentation.
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PMID:Psychological and obstetrical responses of mothers following antenatal fetal sex identification. 1006 13

This article reviews neuroimaging studies of conscious and voluntary regulation of various emotional states (sexual arousal, sadness, negative emotion). The results of these studies show that metacognition and cognitive recontextualization selectively alters the way the brain processes and reacts to emotional stimuli. Neuroimaging studies of the effect of psychotherapy in patients suffering from diverse forms of psychopathology (obsessive-compulsive disorder, panic disorder, unipolar major depressive disorder, social phobia, spider phobia, borderline personality) are also examined. The results of these studies indicate that the mental functions and processes involved in diverse forms of psychotherapy exert a significant influence on brain activity. Neuroimaging investigations of the placebo effect in healthy individuals (placebo analgesia, psychostimulant expectation) and patients with Parkinson's disease or unipolar major depressive disorder are also reviewed. The results of these investigations demonstrate that beliefs and expectations can markedly modulate neurophysiological and neurochemical activity in brain regions involved in perception, movement, pain, and various aspects of emotion processing. Collectively, the findings of the neuroimaging studies reviewed here strongly support the view that the subjective nature and the intentional content (what they are "about" from a first-person perspective) of mental processes (e.g., thoughts, feelings, beliefs, volition) significantly influence the various levels of brain functioning (e.g., molecular, cellular, neural circuit) and brain plasticity. Furthermore, these findings indicate that mentalistic variables have to be seriously taken into account to reach a correct understanding of the neural bases of behavior in humans. An attempt is made to interpret the results of these neuroimaging studies with a new theoretical framework called the Psychoneural Translation Hypothesis.
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PMID:Mind does really matter: evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect. 1734 30

Mentalistic variables must be considered to reach a correct understanding of the neurophysiological basis of behavior in humans. Confusion regarding the relative importance of neurophysiological and mentalistic variables can lead to important misconceptions about causes and effects in the study of human behavior. In this article, we review neuroimaging studies of the effect of psychotherapy in patients suffering from diverse forms of psychopathology (obsessive-compulsive disorder, panic disorder, unipolar major depressive disorder, spider phobia). We also review neuroimaging studies of the placebo effect in healthy individuals (placebo analgesia, psychostimulant expectation) and patients with Parkinson's disease or unipolar major depressive disorder. Mental functions and processes involved in diverse forms of psychotherapy exert a significant influence on brain activity. With regard to the placebo effect, beliefs and expectations can markedly modulate neurophysiological and neurochemical activity in brain regions involved in perception, movement, pain and various aspects of emotion processing. The findings of the neuroimaging studies reviewed here strongly support the view that the subjective nature and the intentional content of mental processes significantly influence the various levels of brain functioning (e.g. molecular, cellular, neural circuit) and brain plasticity.
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PMID:Effect of mind on brain activity: evidence from neuroimaging studies of psychotherapy and placebo effect. 1902 97

Needle phobia affects at least 10% of the general population. Subcutaneous injections are used for many reasons, including immunizations, administration of medications such as insulin and heparin, and to provide local anesthesia, both for surgery and for intravenous cannulation. Whatever the reason for its application, the injection itself may cause discomfort and/or pain. In children, in patients with needle phobia, in those who require frequent intravenous cannulations, or in those who need daily medication, the pain at injection can reach unbearable intensity that could lead to refusal of medical care. Various approaches are employed to alleviate the pain caused by intravenous cannulation. These include the use of topical analgesia [i.e., EMLA, Ametop (tetracaine], Numby Stuff and ethylchloridespray], skin infiltration with lidocaine using 25-30-gauge needles and jet injectors. This article will review the complex topic of needle phobia and needle pain, and will summarize the currently available alternatives and the new developments intended to reduce the intensity of injection pain.
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PMID:Use of needle-free injection systems to alleviate needle phobia and pain at injection. 1980 64

Children with autistic spectrum disorders are often encountered in anesthesia practice mainly for outdoor procedural sedation or anesthesia in endoscopy and magnetic resonance imaging suites. We describe a case of a 7-year-old autistic boy who required management of dental caries. He had a phobia to intravenous cannulation, displayed increasing anxiety and became combative on the day of surgery. With parental involvement and distraction, we succeeded in giving oral midazolam by concealing it, with the intent of avoiding intramuscular injection or unnecessary restraint. Lack of knowledge about the medical condition of such a patient can lead to inadequate preoperative preparation and use of restraint on the patient, which might cause anxiety or panic attacks in the operative room. To effectively manage children with special needs one needs to have clear guidelines on the management of uncooperative children, involve parents perioperatively, plan ahead with an emphasis on perioperative analgesia and sometimes incorporate the ethical use of restraint.
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PMID:Premedication in an autistic, combative child: Challenges and nuances. 2737 93