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Items 1 - 7 of 7 |
One page. |
Comment on:
High hopes for cannabinoid analgesia.
Watts G.
geoff@scileg.freeserve.co.uk
Publication Types:
PMID: 15258005 [PubMed - indexed for MEDLINE]
A reassessment of trends in the medical use and abuse of opioid analgesics and implications for diversion control: 1997-2002.
Gilson AM, Ryan KM, Joranson DE, Dahl JL.
Pain and Policy Studies Group, University of Wisconsin-Madison Comprehensive Cancer Center, 53711-1068, USA.
This study updates a previous analysis of trends in medical use and abuse of opioid analgesics, and provides data from 1997 through 2002. Two research questions were evaluated: 1) What are the trends in the medical use and abuse of frequently prescribed opioid analgesics used to treat severe pain, including fentanyl, hydromorphone, meperidine, morphine, and oxycodone? 2) What is the abuse trend for opioid analgesics as a class compared to trends in the abuse of other drug classes? Results demonstrated marked increases in medical use and abuse of four of the five studied opioid analgesics. In 2002, opioid analgesics accounted for 9.85% of all drug abuse, up from 5.75% in 1997. Increase in medical use of opioids is a general indicator of progress in providing pain relief. Increases in abuse of opioids is a growing public health problem and should be addressed by identifying the causes and sources of diversion, without interfering with legitimate medical practice and patient care. Copyright 2004 U.S. Cancer Pain Relief Committee
Publication Types:
PMID: 15276196 [PubMed - indexed for MEDLINE]
Physicians advised on how to offer pain relief while preventing opioid abuse.
Hampton T.
Publication Types:
PMID: 15353519 [PubMed - indexed for MEDLINE]
Comment on:
Cautious optimism on reducing spinal headache with spinal catheters.
Lambert D.
Publication Types:
PMID: 15138919 [PubMed - indexed for MEDLINE]
Comment on:
Are subarachnoid catheters really safe?
Rosenblatt MA, Bernstein HH, Beilin Y.
Publication Types:
PMID: 15138918 [PubMed - indexed for MEDLINE]
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Electrical nerve stimulation using a stimulating catheter: what is the lower limit?
Wehling MJ, Koorn R, Leddell C, Boezaart AP.
Department of Anesthesiology, College of Nursing, University of Iowa, 200 Hawkins Drive, 6-JCP, Iowa City, IA 52242, USA.
OBJECTIVES: To minimize the risk of intraneural injection when performing nerve blocks, some authors caution against injecting through a needle placed with motor responses observed at nerve stimulator output settings of 0.3 mA or less. We present a case of placing a continuous cervical paravertebral catheter with brisk motor response while stimulating the catheter at 0.05 mA, with no adverse sequelae. CASE REPORT: A 56-year-old man scheduled for rotator cuff repair received a continuous cervical paravertebral block for intraoperative and postoperative pain control. A stimulating catheter was used for the block. During catheter placement, nerve stimulator output was decreased to 0.05 mA at 300 micros and the motor response remained brisk. The patient was not significantly sedated and experienced no pain during placement or with injection of 40 mL of 0.5% ropivacaine through the catheter. Narcotic drugs were not required during surgery, and the block provided excellent postoperative pain control. Catheter position was evaluated by fluoroscopy to further identify the catheter's relationship to the brachial plexus. The nerve trunks of C5 and C6 were clearly visible after 1 mL of iohexol (Omnipaque) was injected through the catheter. The catheter was removed the following day. At the follow-up visit 2 weeks later, the patient's neurological examination remained unremarkable. CONCLUSION: We present a single case of successful placement of a stimulating catheter with no neurological injury even when motor response occurred at very low nerve stimulator output settings.
Publication Types:
PMID: 15138908 [PubMed - indexed for MEDLINE]
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The use of cervical paravertebral block as the sole anesthetic for shoulder surgery in a morbid patient: a case report.
Koorn R, Tenhundfeld Fear KM, Miller C, Boezaart A.
Department of Anesthesiology, College of Nursing, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
OBJECTIVES: The purpose of this case report is to describe the use of the cervical paravertebral block as the sole anesthetic for shoulder surgery in a patient unable to tolerate general anesthesia. Recent literature describes the continuous cervical paravertebral block as an effective alternative to the interscalene block for the management of postoperative pain after shoulder surgery. CASE REPORT: An 85-year-old man with severe respiratory and cardiac disease presented for major shoulder surgery. The patient's complex medical history required an anesthetic technique that would avoid general anesthesia and preserve phrenic nerve function. This case report describes, to our knowledge, the first successful use of the continuous cervical paravertebral block as the sole anesthetic for shoulder surgery. CONCLUSIONS: Continuous cervical paravertebral block provided excellent surgical conditions and postoperative pain relief for this patient and allowed gradual and intermittent dosing of the catheter and continuous assessment of the anesthetic impact on respiratory function.
Publication Types:
PMID: 15138907 [PubMed - indexed for MEDLINE]
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