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Epidural morphine for postoperative analgesia: a double-blind study
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Epidurai morphine for postoperative analgesia: a double-blind study. - E. Lanz, D. Theiss, W. Reiss and U. Sommer, Anesth. Analg. Curr. Res., 61 (1982) 236-240. Recent reports have indicated that excellent pain control can be achieved with opiates without the classical side effects of nausea, mental clouding and mood alteration by epidural administration. In this study postoperative analgesia and the side effects of epidurally injected morphine were investigated in a double-blind study. In a randomized, double-blind fashion 174 patients received either 0.1 mg/kg of morphine epidurally, 0. I mg/kg of morphine intramuscularly, or saline epidurally at the end of orthopedic surgery performed with lumbar epidural anesthesia. Following epidural morphine, postoperative pain was less frequent, less intense and of shorter duration, use of sedatives and analgesics was less frequent, and the postoperative feeling of well being was rated better than after systemic morphine or epidural saline. These effects were more frequent when bupivacaine was used for operative epidural anesthesia than when mepivacaine was employed. Side effects following epidural morphine included pruritus and disturbances of micturition. Nausea, vomiting, fatigue and headache were of comparable frequency in the three groups, and the results were independent of age. Principal component analysis of event-related cerebral potentials to mechanical and electrical stimulation in man. - B. Bromm and E. Scharein, Electroenceph. clin. Neurophysiol., 53 (1982) 94-103. Event-related potentials (ERPs) elicited by mechanical and electrical skin stimulation were investigated on a single trial basis to determine their relationship to pain. Constant current electrical and controlled force mechanical stimuli were applied to the tip of the left middle finger with four intensities of each stimulus being delivered. Forty EEG samples of 500 msec each were collected at each stimulus intensity. Data analysis was restricted to subjects who had low power in the alpha band for prestimulus EEG. Principle components analysis yielded six components that accounted for about 90% of the total variance, and five of these appeared as clearly localizable peaks in the 500 msec epoch. The 50-80 msec component discriminated between quality of stimuli while four others between 50 and 360 msec distinguished intensities. Two components (140- 160 msec and 280-360 msec) distinguished pain from non-pain conditions, but no specific component emerged when pain was reported. This study indicates that ERP waveforms elicited by noxious stimulation contain pain-specific information. Effects of moderate and high doses of marihuana on thermal pain: a sensory decision theory analysis. - W.C. Clark, MN. Janal, P. Zeidenberg and G.G. Nahas. J. clin. Pharmacol., 2 1 (198 1) 2993-3 10s. This study examined the potential analgesic properties of Cannabis satioa using sensory decision theory procedures. Sixteen habitual marihuana users, selected for their good mental and physical health, were hospitalized for three months in the New York State Psychiatric Institute. During the first month, the subjects were drug free; during the second month, they smoked marihuana cigarettes (2% THC, 20 mg per cigarette) at the rate of 3-12/day. A modified Hardy-Wolff dolorimeter was
Epidurai morphine for postoperative analgesia: a double-blind study. - E. Lanz, D. Theiss, W. Reiss and U. Sommer, Anesth. Analg. Curr. Res., 61 (1982) 236-240. Recent reports have indicated that excellent pain control can be achieved with opiates without the classical side effects of nausea, mental clouding and mood alteration by epidural administration. In this study postoperative analgesia and the side effects of epidurally injected morphine were investigated in a double-blind study. In a randomized, double-blind fashion 174 patients received either 0.1 mg/kg of morphine epidurally, 0. I mg/kg of morphine intramuscularly, or saline epidurally at the end of orthopedic surgery performed with lumbar epidural anesthesia. Following epidural morphine, postoperative pain was less frequent, less intense and of shorter duration, use of sedatives and analgesics was less frequent, and the postoperative feeling of well being was rated better than after systemic morphine or epidural saline. These effects were more frequent when bupivacaine was used for operative epidural anesthesia than when mepivacaine was employed. Side effects following epidural morphine included pruritus and disturbances of micturition. Nausea, vomiting, fatigue and headache were of comparable frequency in the three groups, and the results were independent of age. Principal component analysis of event-related cerebral potentials to mechanical and electrical stimulation in man. - B. Bromm and E. Scharein, Electroenceph. clin. Neurophysiol., 53 (1982) 94-103. Event-related potentials (ERPs) elicited by mechanical and electrical skin stimulation were investigated on a single trial basis to determine their relationship to pain. Constant current electrical and controlled force mechanical stimuli were applied to the tip of the left middle finger with four intensities of each stimulus being delivered. Forty EEG samples of 500 msec each were collected at each stimulus intensity. Data analysis was restricted to subjects who had low power in the alpha band for prestimulus EEG. Principle components analysis yielded six components that accounted for about 90% of the total variance, and five of these appeared as clearly localizable peaks in the 500 msec epoch. The 50-80 msec component discriminated between quality of stimuli while four others between 50 and 360 msec distinguished intensities. Two components (140- 160 msec and 280-360 msec) distinguished pain from non-pain conditions, but no specific component emerged when pain was reported. This study indicates that ERP waveforms elicited by noxious stimulation contain pain-specific information. Effects of moderate and high doses of marihuana on thermal pain: a sensory decision theory analysis. - W.C. Clark, MN. Janal, P. Zeidenberg and G.G. Nahas. J. clin. Pharmacol., 2 1 (198 1) 2993-3 10s. This study examined the potential analgesic properties of Cannabis satioa using sensory decision theory procedures. Sixteen habitual marihuana users, selected for their good mental and physical health, were hospitalized for three months in the New York State Psychiatric Institute. During the first month, the subjects were drug free; during the second month, they smoked marihuana cigarettes (2% THC, 20 mg per cigarette) at the rate of 3-12/day. A modified Hardy-Wolff dolorimeter was