Idiopathic pelvic pain. The relationship to depression.

Episodic and chronic idiopathic pelvic pain is enigmatic for both physician and patient. Antidepressant drug therapy combined with behavior modification techniques is beneficial in improving the functional status of some patients. Whether the decrease in frequency, intensity, and duration of pelvic pain complaints results from treatment of underlying depression or analgesic effects of the antidepressant drugs is difficult to determine.

Sufentanil and alfentanil pattern of consumption during patient-controlled analgesia: a comparison with morphine.

Pattern of drug consumption and side effects of sufentanil and alfentanil were compared to morphine, using "on-demand" patient-controlled analgesia (PCA). After a non-narcotic general anesthetic, a bolus dose of the narcotic was given intravenously towards the end of surgery. PCA was started in the recovery room.

Extension of pain relief beyond the operating room.

Physicians have in their armamentaria of drugs and techniques sufficient methods of relieving postoperative pain to maintain an analgesic state in postsurgical patients. The extent of the problem, and the options available, are discussed and described.

ASRA lecture 1988. The changing role of the anesthesiologist in pain management.

Changing concepts of pain mechanisms deemphasize the somatic aspects of chronic pain and enhance the concept that chronic pain is primarily a psychological disorder. As such, interruption of straight-through pain pathways through nerve blocking may not always be the treatment of choice. Evidence is given encouraging anesthesiologists to modify their thinking on the value of nerve blocks in the treatment of chronic pain and direct their efforts to the management of acute, postoperative, and cancer pain problems.

Comparison of pH-adjusted lidocaine solutions for epidural anesthesia.

One hundred forty-eight adult patients having epidural anesthesia for cesarean section, postpartum tubal ligation, lower extremity orthopedic procedures, or lithotriptic therapy were assigned to five groups. Group 1 patients were given a commercially prepared 1.5% lidocaine solution with 1:200,000 epinephrine plus 1 ml of normal saline per 10 ml of lidocaine; the solution pH was 4.

Pulsed galvanic stimulation: effects of current frequency and polarity on blood flow in healthy subjects.

The effects of pulsed galvanic stimulation on peripheral blood flow were studied in ten healthy volunteers. Electrodes were placed over vascular channels of the upper extremity and stimulation was carried out at several frequencies on two occasions with polarity reversed. Changes in blood flow and cutaneous temperature were measured by photoplethysmography and cutaneous thermistors, respectively.

A comparison of low back pain patients in the United States and New Zealand: psychosocial and economic factors affecting severity of disability.

One hundred and ninety-eight patients suffering from chronic low back pain seen at the University of Virginia (U.S.) Pain Center and 117 similar patients seen at the Auckland Hospital, Auckland, New Zealand (N.

A comparison of health locus of control beliefs in low-back patients from the U.S. and New Zealand.

In order to study differences in health control attitudes between chronic low-back patients from the U.S. and New Zealand, the Health Locus of Control (HLC) was administered to 284 consecutive admissions to pain clinics in those countries: 96 patients seen at the Auckland (New Zealand) Pain Clinic and 188 seen at the University of Virginia (U.

Stability of self-report measures of improvement in chronic pain: a five-year follow-up.

Seventy patients with chronic low-back pain not due to malignancy returned a questionnaire assessing functional status 5 years following treatment with epidural or subarachnoid nerve blocks. One hundred fifty-one patients had been surveyed 3 years earlier in an initial follow-up. The respondents to the present survey were older and more able to bend and took more medication for pain than non-respondents.

Treatment of bladder pain with transsacral nerve block.

Fifteen patients with bladder spasticity and pain of three different etiologies were referred to the pain clinic by urologic specialists. These patients were refractory to all prior methods of treatment, excluding major surgical procedures. In a prospective study started in 1976, these patients were treated with transsacral nerve blocks using 0.

Control of pain in the head and neck.

The patient with head or neck pain should be managed primarily with medication that will adequately prevent, rather than relieve, pain. The terminal patient should receive medication to which he will not develop tolerance and that will permit him to function in his normal environment. Although nerve blocks are not a panacea for all pain syndromes, in carefully selected subjects, chemical interruption of nerve pathways can provide significant relief for chronic pain sufferers.

Coordinated out-patient management of chronic pain at the University of Virginia Pain Clinic.

The Pain Clinic at the University of Virginia Medical Center is a comprehensive facility providing a coordinated team approach to the management of chronic pain syndromes. The Clinic is primarily an out-patient facility, although in-patient therapy in clinic-assigned beds is available for special problems. Approximately 1,500 new patients are seen annually in the Clinic's own facilities, resulting in approximately 3,500 patient visits.

Epidural steroid effects on nerves and meninges.

There have been encouraging reports of symptomatic improvement in patients with low back pain following injection of a mixture of a local anesthetic and a corticosteroid into the lumbar epidural space. However, there is a lack of animal or human studies which examined possible long-term effects of this combination on the exposed neural tissues. This study evaluated by both light and electron microscopy the effect of triamcinolone diacetate in vehicle and of the vehicle itself (both in 2% lidocaine) in 48 cats after percutaneous epidural injections were done at the lumbosacral space.

Lidocaine as an analgesic for experimental pain.

The purpose of this study was to evaluate the analgesic contribution of intravenously administered lidocaine and to correlate it with blood levels of the drug. In a double-blind manner, 14 healthy male volunteers received saline solution or lidocaine, 0.2 per cent, at three increasingly greater rates of infusion on two separate days.

Relieving pain with nerve blocks.

Pain syndromes in elderly patients are seldom psychogenic or due merely to "old age." Careful differential diagnosis is important, as judicious use of nerve blocks as adjunctive therapy often can relieve pain and restore activity. In the acute phase of shoulder pain, intrabursal injection of local anesthetic and steroid inhibits the inflammatory process.