摘要:

Epidural opioids are now established as a component of intraoperative epidural anaesthesia, improving onset time, quality, and duration of epidural blockade. For postoperative pain, labour pain, and acute post-traumatic pain, epidural opioids alone are being replaced by combinations of low-dose opioid, low-concentration local anaesthetic solution, and sometimes adrenaline or a more specific a2-agonist. Also for chronic cancer pain, such epidural mixtures are now used for otherwise intractable pain. These two- or three-component epidural mixtures reduce side effects of epidural opioids and make epidural analgesia safer on ordinary hospital wards.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We review recent developments in the pathophysiology and management of intracranial aneurysms and subarachnoid hemorrhage (SAH), and discuss some of the controversies. Topics were chosen on the basis that they would contribute to a better understanding and/or provide new therapeutic options for the management of SAH and its sequelae. Vasospasm, myocardial dysfunction, the timing of surgery, endovascular therapy, induced hypotension, cerebral protection during aneurysm surgery, and choice of anesthetic agents are all discussed.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In the search for possible means of protection against ischemic brain damage, several areas have been studied. Hypothermia as non-pharmacological treatment has given very good results. Among the pharmacological approaches, the most promising are the attempts to block the neurotoxic effects of excitatory amino acids, reduce the pathological increase in intracellular calcium, and block free radical formation and the production of platelet-activating factor.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This article reviews recent advances in the understanding of pathophysiology of spinal cord injury with emphasis on the importance of ischemia as the cause of secondary injury. This forms the basis for a new pharmacologic approach to the treatment of spinal cord injury, particularly the use of high-dose methylprednisolone. Airway management, anesthetic and monitoring implications are also reviewed.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Electrophysiologic methods assess the functional integrity of the brain and spinal cord. Current techniques include motor-evoked potentials (MEPs), sensory-evoked potentials, electroencephalography, and magneto-encephalography. These techniques are applied to improve outcome during the perioperative period, to gauge depth of anesthesia, and to assist with prognosis in the intensive care unit.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Recent studies on the interaction of anesthetics, C02, perfusion pressure, and endothelium-derived contracting/relaxing factors with cerebral blood flow (CBF) and function are reviewed. α2-Agonists and the effect of narcotics on cerebral spinal fluid (CSF) are updated. Finally, monitors of CBF and function are reviewed.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In this review some non-opioid spinally located transmitter systems, that may be exploited for clinical pain treatment, are discussed. a2-Agonists, adenosine analogues, inhibitors of nitric oxide synthesis, N-methyl-D-aspartate (NMDA)-antagonists, and somatostatin agonism all produce receptor-selective antinociceptive effects. This may lead to rational advances in pain management.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Brachial plexus block is a very reliable method of anesthetizing the upper extremity. This review covers recent investigations and case reports concerning the various techniques for producing anesthesia at the level of the brachial plexus. The clinical applications of brachial plexus block have broadened to include continuous techniques for postoperative analgesia as well as prolonged sympathetic nerve block to produce vasolidation. Advantages and disadvantages differ for each of the common approaches to the brachial plexus. Methods for ascertaining correct placement of the needle tip within the confines of the fascial sheath that envelops the plexus may yield varying success rates and complications. Choice of local anesthetic mixture is important in determining onset and duration of the block. Plasma concentrations of the local anesthetics and their metabolites are low when this block is compared to the other regional anesthetic techniques, but this is a very important area of new research. Finally, as with any anesthetic technique, certain complications or extensions of the block's effects may occur. The basis for common side effects and rare complications should be appreciated and treated correctly.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID