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

In 38 patients requiring diagnostic bronchoscopy, three different procedures of anesthesia have been investigated. Of the three, neurolept analgesia combined with topical anesthesia of the airway proved by far the best form. It is followed by psychic indifference without lessening the patient's voluntary control, thus facilitating intricate technical manipulations on the bronchial system. No severe side effects arise when suitable equipment for diagnosing and treating respiratory and cardiovascular depression is available.
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PMID:Neurolept analgesia for bronchoscopic examinations. 23 64

Congenital indifference to pain is often mistaken for congenital insensitivity. It is characterized by the occurrence since childhood of lesions, mainly cutaneous and osteoarticular secondary to strictly painless traumas. However, despite the lack of pain, the patient is able to discriminate a painful stimulus. Autopsy shows no abnormality of the nervous system. A dysfunction of the central endomorphinic systems has been suggested. Congenital analgesia is associated with anhidrosis in Swanson's syndrome (in which Lissauer the tractus is absent in the spinal cord) and with dysautonomia in Riley-Days's disease (in which there is a lack of amyelicinic fibres). On account of these data, some authors refuse the autonomy of congenital indifference and classify it in the group of the various autonomic and sensory neuropathies. However it seems justified to acknowledge the congenital analgesia with two varieties: congenital indifference in which there is no sensation of pain but normal sensory pathway and tonic function of endomorphinic system, congenital insensitivity in which the painful stimulus is not transmitted to the central nervous system.
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PMID:[Congenital indifference and congenital insensitivity to pain]. 138 39

Inborn analgesia (IA) is described in 3 members of a family: a 14 month-old girl, hel father and grandfather on the paternal line. Generalized indifference to pain and visceral analgesia with other senses intact was noted in all patients since birth. Profound reflexes, intellectual development, karyotype, motor and sensory nervous excitation propagation velocities, somatosensory evoked potentials were all normal. Notedly, the IA inheritance was found to be autosome-dominant in this family.
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PMID:[A case of familial congenital analgesia with autosome-dominant type of inheritance]. 247 79

This paper describes an assisted local anaesthetic technique which we have used almost exclusively for extracapsular cataract extraction and posterior chamber intraocular lens implant surgery over the last 12 months. This ALACS technique was developed from a combined neurolept-local anesthetic into an assisted local anaesthetic suitable for day-stay cataract surgery. The technique combines the advantages of purely local (retrobulbar and facial) anaesthesia with the advantages usually inherent in a good general anaesthetic. Thus the patient is in a state of general quiescence and psychic indifference throughout the procedure. ALACS provides excellent and long-lasting akinesia and analgesia, with adequate proptosis of the eye which facilitates surgical access. ALACS is suitable for almost all adult cataract and implant surgery. Our results in 104 cases of ALACS are reviewed in terms of visual results and complications both ocular and anaesthetic; the results appear good and the complications minimal. The results of blood gas estimations done intraoperatively in a small number of patients are also presented, and suggest that the technique is systemically safe.
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PMID:Assisted local anaesthesia for cataract surgery (ALACS). 367 10

A 16-year-old boy had congenital absence of pain sensitivity and no impairment of other sensory modalities. Routine electrophysiologic investigation showed no abnormalities. The threshold and latency of electrically elicited corneal reflex and cortical potentials evoked by tooth pulp stimulation were normal, but suprathreshold electric stimulation of corneal mucosa and dental pulp, as well as electric stimulation of dorsal roots, did not elicit pain. The total CSF opioid activity was raised. However, naloxone hydrochloride administration failed to reverse the analgesia. The axon reflex to intradermal injection of histamine dihydrochloride was absent. Cutaneous nerve branches showed unspecific changes affecting part of unmyelinated axons. most of the unmyelinated as well as the myelinated axons were normal. We consider the case an example of congenital indifference to pain.
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PMID:Congenital absence of pain. 616 87

This paper reports the case of a boy aged 10 months who suffers from congenital analgesia in its pure form. All clinical, biochemical, neuro=physiological and histological data considered to be significant in the differential diagnosis are presented. The findings in all diseases in which impairment of pain sensation occurs are tabulated. 38 patients meet the diagnostic criteria for pure congenital analgesia. The diagnostic criteria are generalized indifference to pain dating from birth; no impairment of other sensory modalities; normal intelligence; normal deep tendon reflexes; no visceral pain perception; normal skin biopsy; no diminution of myelinated or un-myelinated nerve fibres in sural nerve biopsy; normal motor and sensory nerve conduction velocities and normal karyotype. The mode of inheritance remains unclear, but it is assumed, that congenital analgesia might be an autosomal-recessively inherited disease.
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PMID:The differential diagnosis of congenital analgesia and other diseases with diminished pain perception in childhood. Case report and review. 616 92

CSF from a patient with congenital indifference to pain was found to produce analgesia in the rat following intracerebroventricular injections. The analgesic effect was attenuated by pretreatment with naloxone suggesting the involvement of hyperactive endogenous opiate mechanisms in this patient.
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PMID:Intracerebroventricular injection of cerebrospinal fluid (CSF) from a patient with congenital indifference to pain induces analgesia in rats. 621 Feb 10

The hypothesis of this paper states that at least some suicidal individuals are characterized by a disposition toward dissociation manifested in relative insensitivity to physical pain and indifference to their bodies. Three main topics are discussed: dissociation and suicide, psychological aspects of pain, and pain and suicide. Various theoretical and experimental studies suggest that certain stress conditions lead to the development of dissociative tendencies, and that once these tendencies are established, they become an integral part of suicidal behavior. Psychological variables that affect pain tolerance are presented and they include perception, motivation, emotions, and behavioral and cognitive strategies of pain control. These can increase tolerance of pain in suicidal individuals, making the suicidal act possible. The specific relationships of pain and suicide are then introduced through an examination of pain analgesia in the phenomenon of self-harm. The integration of the material suggests that early and continuous stress lead to the simultaneous development of dissociative tendencies (including indifference to the body and pain) and heightened vulnerability to stress. These dispositions may facilitate suicidal behavior in the face of mounting intolerable stress, helplessness, and hopelessness. Preliminary empirical support for the present hypothesis is cited. This hypothesis shifts the focus of attention from the question of what causes suicide to what facilitates suicide, and in so doing suggests new directions for research and therapy.
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PMID:Dissociation, physical pain, and suicide: a hypothesis. 820 10

Hypnotic analgesia has occupied a pivotal place in experimental and clinical hypnosis. It emerged early in the 19th century when effective clinical techniques for pain management had not yet developed, and the relief of pain and suffering had not even become a well-defined social goal. Its acceptance was further complicated by political struggles surrounding the humanitarian transformation of medicine during this era as well as a redefinition of the physician-patient relationship that wrested control from the patient. The initial struggle for professional acceptance was won only when the debate became almost entirely localized within the professional community. Acceptance of hypnosis by professional organizations has been followed by alternating periods of interest and indifference. While the evidence for the powerful effects of suggestion and related variables has often been observed and reported in nonhypnotic contexts, their relationship to hypnotic phenomena has often not been appreciated. Since the mid-20th century, scientific information about hypnotic analgesia has grown substantially and has had significant influence on strategies for acute and chronic pain management. If recent calls for its wider application in pain management are to succeed, it will require additional data from clinical populations and a balanced and scientifically prudent approach by its advocates.
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PMID:Hypnotic control of pain: historical perspectives and future prospects. 930 65

CADASIL (cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leu-koencephalopathy) is an infrequent inherited disease that could have anesthetic implica-tions. However these have rarely been reported. We present a male patient previously diagnosed with CADASIL, who had suffered an ischemic vascular cerebral accident with a MRI compatible with leukoencephalopathy, and who was dependent for daily activities, and sustained dementia, mood alterations, apathy, and urine incontinence. He had famil-ial antecedents of psychiatric symptoms and ischemic stroke events in several relatives including his father, two brothers and one sister. He was scheduled for arthrodesis of the left knee because of multiple infectious complications of prosthetic knee surgery. He was under clopidogrel treatment which was withdrawn seven days before surgery. The pro-cedure was performed under combined spinal-epidural anesthesia, intraoperative seda-tion with midazolam, and postoperative multimodal analgesia including epidural patient controlled analgesia. The perioperative management was uneventful and we outline the adequacy of managing these patients under regional anesthesia and analgesia, as these permit to maintain hemodynamic stability leading to adequate cerebral perfusion, key to avoid an increase in the effects of the chronic arteriopathy patients with CADASIL sustain.
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PMID:Anesthetic management of a patient diagnosed with CADASIL (cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leukoencephalopathy). 2248 May 57


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