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

This study evaluated the efficacy of hypnosis- and relaxation-induced suggestions for analgesia for reducing the strength and unpleasantness dimensions of pain evoked by noxious tooth pulp stimulation and by cold pressor stimulation. The Tellegen Absorption Questionnaire was used to assess hypnotic susceptibility for 28 subjects in order to match treatment groups according to sex and susceptibility scores. Tooth pulp stimulation consisted of a 1 sec train of 1 msec pulses at a frequency of 100 Hz, applied at 20 sec intervals to the central incisor. Six stimuli, selected between subject's pain and tolerance thresholds, were presented 3 times each in random order. Cold pressor stimulation consisted of forearm immersion in a circulating water bath maintained at 0-1 degrees C. Subjects made threshold determinations of pain and tolerance and used Visual Analogue Scales to rate the strength and the unpleasantness of both noxious stimuli before and after receiving either hypnosis- or relaxation-induced analgesia. There were no significant differences in pain reductions between hypnosis- and relaxation-induced interventions. However, the percent reduction in both strength and unpleasantness varied significantly as a function of the type of pain. Both hypnosis and relaxation significantly reduced the strength and the unpleasantness of tooth pulp stimulation, but only the unpleasantness dimension of cold pressor pain. The pain reductions were not correlated with subjects' hypnotic susceptibility levels. The results indicate that the extent and the quality of the analgesia produced by these cognitive-based therapies vary not only according to subjects' characteristics and the efficacy of the intervention, but also according to the nature of the noxious stimuli. Tooth pulp and cold pressor stimulation represent qualitatively different stimuli with respect to both the type of nerves activated and the mode of stimulus application. Discrete, randomly presented levels of noxious electrical stimulation to the teeth activate predominantly small fibers and produce brief pain sensations that vary unpredictably in intensity. In contrast, continuous cold stimulation to the forearm activates a variety of nociceptive and non-nociceptive fibers and produces progressive cold and pain sensations with a predictable increase in intensity from cold sensations to paresthesia and severe pain.
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PMID:The efficacy of hypnosis- and relaxation-induced analgesia on two dimensions of pain for cold pressor and electrical tooth pulp stimulation. 328 42

Regional anesthesia has some advantages over general anesthesia for shoulder surgery. Cervical epidural anesthesia, a regional technique not previously described for shoulder operations, was successfully used for surgical procedures on or near the shoulder joint. The technique provided good surgical anesthesia and postoperative analgesia, with few complications and a high degree of patient acceptance. Cervical epidural anesthesia offers some advantages over previously described techniques of regional anesthesia for shoulder operations, including a single needle insertion with no need to elicit paresthesias, lesser volumes of local anesthetic agents, and the ability to easily reinject the catheter intraoperatively if necessary and postoperatively for pain relief.
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PMID:Cervical epidural anesthesia for surgery of the shoulder. 345 67

Spinal intradural arachnoid cysts (S-IAC) are rarely found and only 80 cases have been reported since 1915. We report two of them. A 68-year-old male had slowly progressive dull pain in both thighs for about 6 years prior to admission. Neurological examination and plain x-ray on admission showed no abnormality. Myodil myelography showed a S-IAC at T4 vertebral level. Surgical treatment of cyst wall excision resulted in success. The other case, a 39-year-old male suddenly noticed monoparesis and sensory disturbance of left leg in the morning. On admission were observed spastic monoparesis of the left leg, analgesia at right T2-3 cord segment and sensory disturbance (hypesthesia, dysesthesia, paresthesia) below T3-4 cord segment on the left side. Plain X-ray showed no abnormality. Myodil myelography revealed a S-IAC at T3-4 vertebral level. This patient was treated not surgically but conservatively because all neurological deficits but numbness in the left leg almost subsided after bed rest. The patient has experienced no neurological deterioration for five years since then. We also discuss the clinical feature, treatment and etiology of the S-IAC, by analyzing these 82 cases. There is a slight male preponderance. The age ranges between 3 and 66 years (mean 38 years). The duration from onset to admission is 2 days to 30 years. Sixty percent (48/80) of the cases were ill far longer than a year (mean 6.7 years). Of 82 cases, 83% suffered from motor disturbance, 70% had sensery disturbance, 62% local pain and 24% urinary with/without fecal disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical study of spinal intradural arachnoid cyst]. 408 43

For replantation surgery, continuous brachial plexus block was employed using supraclavicular or axillary approach. Of a total of fifty blocks, forty-seven (94%) gave adequate surgical analgesia throughout the operations. No serious complication appeared in this series. Pneumothorax was detected in one supraclavicular block, but no surgical drainage was required. One patient had paraesthesia in the blocked arm, but it subsided within a month. No toxic reaction was recognised in spite of high dose of anaesthetic agents. Thus continuous brachial plexus block has been ascertained to be safe, reliable, and useful for the replantation and other prolonged operations in the upper extremity.
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PMID:Continuous brachial plexus block for replantation in the upper extremity. 711 25

Ninety-six women undergoing post-partum tubal ligation under spinal anaesthesia were studied to compare 26G Atraucan with 25G Whitacre spinal needles for ease of insertion, number of attempts at needle insertion, cerebrospinal fluid (CSF) flow characteristics through the needles, quality of subsequent analgesia, and incidence of perioperative complications. A higher rate of successful dural puncture at the first attempt (40/50 vs 27/46, P < 0.05) and faster (mean +/- SD, 11.5 +/- 2.2 vs 13.5 +/- 2.4, P < 0.001) CSF flow through the needle was achieved with the Atraucan than with the Whitacre needle. The incidence of failed spinal (4% vs 5%) and post-dural puncture headache (PDPH) (4% vs 4.3%) was similar with both needles, but more patients experienced paraesthesiae during needle insertion with the Whitacre than with the Atraucan needle (15% vs 2%, P < 0.05). We conclude that the use of the 26G Atraucan needle is associated with a higher rate of successful identification of the subarachnoid space at the first attempt, faster CSF backflow, and fewer paraesthesia when compared with the 25G Whitacre needle.
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PMID:Comparison of 26-gauge Atraucan and 25-gauge Whitacre needles: insertion characteristics and complications. 758 10

Over a 15-month period, 39 patients (37 men) of mean age 52 years underwent laparoscopic inguinal hernia repair. Seven patients had bilateral hernia. Forty-six hernias (33 indirect, five direct, eight both direct and indirect) were repaired. A piece of polypropylene mesh measuring 8 x 10 cm was used to cover the direct and indirect spaces with an endoscopic multifeed hernia stapler. The mean operating time for unilateral and bilateral repair was 49 and 63 min respectively (range 25-90 min). One-third of patients required no postoperative analgesia and only seven had more than one injection of pethidine. The median postoperative stay was 1 (range 1-3) days. The mean period to resumption of daily activities was 7 (range 4-21) days. Three patients complained of paraesthesia of the lateral aspect of the thigh and one developed a hydrocele. Two recurrences were noted on follow-up at 3 months.
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PMID:Early results of laparoscopic intraperitoneal onlay mesh repair for inguinal hernia. 761 54

Compartment syndrome is a serious potential complication of trauma to the extremities. Fractures, crush injuries, burns, and arterial injuries, among others, can result in increased tissue pressure within closed osseofascial or compartmental spaces. Prolonged exposure to elevated pressure can result in nerve and muscle necrosis. Extreme pain unrelieved with analgesia, subjective complaint of pressure, pain with passive muscle stretching, paresis, paresthesia, and intact pulses, in the presence of a physically tight compartment, should alert the physician to the presence of a compartment syndrome. The diagnosis is a clinical one, but it may be aided by measurements of intracompartmental tissue pressures. Compartment syndrome is a surgical emergency requiring prompt treatment by fasciotomy. Time is a critical factor; the longer the duration of elevated tissue pressure, the greater the potential for disastrous sequelae. Emergency medicine providers must be cognizant of this clinical syndrome so that early emergent surgical consultation can be obtained to avoid complications.
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PMID:Compartment syndrome: a complication of acute extremity trauma. 798 93

The use of epidural analgesia has become so widespread in recent years that many women are now requesting repeat epidural analgesia for their second or subsequent labour. This study examines the incidence of problems at insertion and of inadequate block in 71 multiparae having second epidurals compared with 150 primiparae having their first epidural. Unilateral block occurred in 6.66% of primiparae and 18.3% of multiparae (P < 0.02). There was no association between difficulty of insertion of catheter, blood in needle/catheter or paraesthesia and unilateral blockade. Epidurals were inserted at a greater dilatation (P < 0.05) and there was a shorter time to delivery (P < 0.01) in the multiparous group. We conclude that unilateral block is thus more common in women receiving repeat epidurals.
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PMID:Repeat epidural analgesia and unilateral block. 808 2

Clinical pattern of monoanesthesia with Xe:O2 (70:30) has been studied in 12 anesthesiologists volunteers in comparison with their subjective sensations. Four clinical stages of anesthesia have been identified: paresthesia and hypoalgesia, euphoria and psychomotor activity, analgesia and partial amnesia, anesthesia (analgesia and amnesia). Induction anesthesia took 5 to 6 min, anesthesia discontinuation was easy and prompt without any adverse events. In healthy men it was impossible to achieve complete amnesia with Xe:O2 (60:40). Subjective sensations from the anesthesia were pleasant. Xenone is the best alternative to N2O2.
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PMID:[Clinical stages and subjective sensations in xenon anesthesia]. 823 38

A 52-year-old woman with chronic back pain presented for lumbar extradural analgesia. The 'loss of resistance to air' technique was used to locate the extradural space. Prolonged paraesthesia and paresis of left leg occurred following the procedure. Urgent lumbar computed tomography scan revealed nerve root displacement due to extradural air.
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PMID:Extradural air as a cause of paraplegia following lumbar analgesia. 828 45


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