Advances in Pain Therapy I by Michael J. Cousins (auth.), J. Chrubasik M.D., E. Martin

By Michael J. Cousins (auth.), J. Chrubasik M.D., E. Martin M.D., M. Cousins M.D. (eds.)

Since 1961, whilst discomfort treatment used to be brought via Bonica, the- re were world-wide efforts to set up simple regimens for the remedy of continual soreness. but many sufferers nonetheless proceed to be afflicted by intractable soreness regardless of the availa- bility of potent remedy that may tremendously enhance their caliber of lifestyles. the shortcoming of experts conversant in fresh advancements is among the factors. there's con- sequently a very good call for for interdisciplinary discomfort clinics and expert education courses. This e-book constitutes either a priceless advent and an summary of present simple regimens and the most recent refined recommendations in ache therapy.

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The use of a morphine solution "weighted" with glucose permits limitation of supraspinal perfusion of morphine, which carries the inherent risk of central respiratory depression. One can also observe, by pharmacokinetic studies in the CSF and plasma, the slower diffusion of morphine in hyperbaric solution than in normobaric solution. This gives longer-lasting analgesia and improves stability, glucose acting as a preservative. Indications The indications for local morphine therapy are based on rigorous clinical criteria: Surgical Techniques in the Treatment of Pain 53 Fig.

Analgesic Hypophysectomy Analgesic hypophysectomy consists of hypophyseal lysis using stereotactically controlled transnasal neurolytic agents (pure alcohol or thermocoagulation) [6]. The principle lies in the fact that refractory pain resulting from disseminated metastases of hormone-dependent cancers (prostate and breast) are ameliorated by the destruction of the hypophysis. Despite the fact that the technique is simple, due to the use of specific stereotactic measures developed by Talairach [19], it is very rarely indicated and has been superseded by local morphine therapy.

One can also observe, by pharmacokinetic studies in the CSF and plasma, the slower diffusion of morphine in hyperbaric solution than in normobaric solution. This gives longer-lasting analgesia and improves stability, glucose acting as a preservative. Indications The indications for local morphine therapy are based on rigorous clinical criteria: Surgical Techniques in the Treatment of Pain 53 Fig. 9. Control radiographs of a port implanted at the lumbar level after opacification of the port and after opacification of the subarachnoid space Fig.

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