Effects of Bupivacaine on Opioid Patient-Controlled Intrathecal Analgesia in Chronic Pain Patients Implanted with Drug Delivery Systems.

Background: Combining neuraxial opioids and local anesthetics in acute pain results in improved duration of analgesia and reduced dosages and adverse effects. Although commonly used in intrathecal drug delivery systems (IDDS) for chronic pain, the effectiveness of this admixture has not been examined specifically in relation to patient-controlled intrathecal analgesia (PCIA).

Methods: IDDS-implanted chronic noncancer pain patients receiving opioids with bupivacaine (O + B) were randomized to receive either opioids without bupivacaine (O) or O + B in a double-blind manner, at IDDS refills, for one week and then crossed over to the other solution for another week.

An Allied Anesthetic?: De Preissac's Political Cartoon of Hitler's Surgery.

During World War II, the French Resistance used political cartoons while fighting for France's freedom from Nazi domination. Reprinting Jean de Preissac's 1945 political cartoon of Allied leaders operating as Hitler's anesthetist and surgeons, a commemorative postcard was issued on the 20th anniversary of the radio broadcast credited with founding the French Resistance, General Charles de Gaulle's "Appeal of 18 June 1940."