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Transsphenoidal Stereotaxic Cryohypophysectomy for the Management of Pain in Disseminated Prostatic Carcinoma
'\'~lith i'ransc11ta11eo11s Elect?'lcal I\Te:z:,v-e St:h:n_'"' ufation fol' Relief ofintrn,ctable Pain in Cancer Patients
ONCOLOGY AND CHEMOTHERAPY The Role of Analgesic .'Ll'•'-''"·"'"'u"' in the ,,,.,u«>.1a:1t,mct.,u of Cancer Pain: Current Trends. A Review Article P.C.LuND, J.l!lernorial 1"-1,n,ntat,
J. Med., 13: 161-182, 1982 This is a review article on mechanism, indication and type of analgesic blocking procedures for pain in cancer patients. This review is based on extensive search of the literature on the subject as well as 30 yearn of experience of the author. The primary causes of pain in cancer patients include co-1npr1es,;ion infiltrating obstruction of a hollow organ, occlusion of blood vessels and swelling of tissue with pain-sensitive nerves adjacent to the tumor. Some of the most severe pains are those from metastases causing compression of nerve tn1nks or bone involvement. In this article a review of pain and its treatment in various systems is discussed. The author indicated that in abdominal and pelvic pain subarachnoid and peridural nerve blocks are effective in interrupting somatic pain pathways from the lower half of the body. A part of the effectiveness of the block is to the blocking of the sympathetic nerve that is associated with subarachnoid nerve blocks. However, somatic nerve blocks are not useful in these areas. Perinea! and rectal can be managed phenol after subarachnoid alcohol nerve blocks. However, the risk of urinary and rectal incontinencE should be considered. The from the bladder can be controlled effectively by somatic and lumbar sympathetic nerve blocks. Prostatic cancer causes lumbar pain that is difficult to handle but a trial of blocking lumbar sympathetic nerves should be undertaken. This author also reviews the controversial methods of relieving spinal fluid barbotage, subarachnoid cold or n~,r.~+A;n; electrostimulation and acupuncture. N.J. 1 table, 14 references
The Management of the Patient With Chronl.c Pafo Du.e to Advanced Malignancy
AM. AVELLANOSA AND C.R. gery, Roswell Park JJ/Iemorial
N.eurosurNew York
J, Med., 13: 203-213, 1982
These authors studied 60 '"~'""'rn"" with intractable cancer v,ith transcutaneous electrical stimulation. The results after 2 weeks of therapy are reported. Of the 60 patients 17 (28 per cent) had excellent response, 22 (36.2 per cent) had fair response and 21 (35 per cent) had no relief. Reassessment after 3 months revealed that 9 e,uc,~.nco (15 per cent) had excellent response, 11 (18.3 per cent) had fair response and 40 (67 per cent) were failures. Perineal and pelvic is most difficult to treat. Although the authors cannot describe the mechanism of action of transcutaneous electrical stimulation they question the gate hypothesis as well. The equipment is a battery-operated device that is with extensive wiring and a long antenna that needs,~,_,. ~ .. ~--~-·• The authors have indicated that this type of noninvasive means of controlling pain is an important addition to the lists of pain management in cancer patients. N.J. 5 tables, 12 references
for of Pain in Disseminated Px'ostatfo Carc:inmna
A. M. AvELLANOSA AND C. R gery, Roswell Park lvlemorial '"·"'·'"·"·'" J. 13: 215-221, 1982 Hypophysectomy has been advocated as a method of tion in the management of with intractable pain from cancer. there are a number of methods to ablate the function of the a non.direct extracranial ap-
cancer associated with intractable eotaxic ervor,vnon vse,ctcimv A
and
Medicine, 1ni.ssion and extended survival. The authors concluded that sedation and
1
"· of aclvanced cancer is rraodera.te to sev,sre n,•non•D,COmD as the cancer prog-resses. The
been used as µL,u,,u,.1au.H is the preferred method for the control of cancer Pain to bone metastases usually can be relieved partially corticosteroids. Morphine and methadone n,.,.,,.,,n,u can be effective means in dealing with chronic pain in cancer patients. However, Brompton's mixture is no more effective than oral morphine but does lead to a sense of well being. The concept that the brain produces endogenous analgesia with activity at the morphine receptor is becoming important especially with the discovery of enkephalins and ,B-endorphan in the central nervous system. These substances are structurally identical to a part of the larger pituitary peptide hormone and ,B-lipotrophin. N.J. 1 figure, 1 table
low blood N.J. 2 tables, 15 references
Use oflntrathecal and E:pid11.ral for Pain Relief in Patients With. ·"~="'·"'·"~'"" Diseases: A Preliminary R. C. Rwo, G. H. HOBIKA, A. M. AvELLANOSA, R. J. TRUDNOWSKI, J. REMPEL AND C. R. WEST, Departments of Anesthesiology and Neurosurgery, Roswell Park Memorial Institute, Buffalo, New York
J. Med., 13: 223-231, 1982 It has been shown that morphine sulfate provides a selective depressing action on nociceptive pathways in Rexed's lamina 1, 2 and 5 of the dorsal horn. The extent to which intrathecal and epidural opiates can maintain suppression of pain perception is
ONCOLOGY AND CHEMOTHERAPY The Role of Analgesic .'Ll'•'-''"·"'"'u"' in the ,,,.,u«>.1a:1t,mct.,u of Cancer Pain: Current Trends. A Review Article P.C.LuND, J.l!lernorial 1"-1,n,ntat,
J. Med., 13: 161-182, 1982 This is a review article on mechanism, indication and type of analgesic blocking procedures for pain in cancer patients. This review is based on extensive search of the literature on the subject as well as 30 yearn of experience of the author. The primary causes of pain in cancer patients include co-1npr1es,;ion infiltrating obstruction of a hollow organ, occlusion of blood vessels and swelling of tissue with pain-sensitive nerves adjacent to the tumor. Some of the most severe pains are those from metastases causing compression of nerve tn1nks or bone involvement. In this article a review of pain and its treatment in various systems is discussed. The author indicated that in abdominal and pelvic pain subarachnoid and peridural nerve blocks are effective in interrupting somatic pain pathways from the lower half of the body. A part of the effectiveness of the block is to the blocking of the sympathetic nerve that is associated with subarachnoid nerve blocks. However, somatic nerve blocks are not useful in these areas. Perinea! and rectal can be managed phenol after subarachnoid alcohol nerve blocks. However, the risk of urinary and rectal incontinencE should be considered. The from the bladder can be controlled effectively by somatic and lumbar sympathetic nerve blocks. Prostatic cancer causes lumbar pain that is difficult to handle but a trial of blocking lumbar sympathetic nerves should be undertaken. This author also reviews the controversial methods of relieving spinal fluid barbotage, subarachnoid cold or n~,r.~+A;n; electrostimulation and acupuncture. N.J. 1 table, 14 references
The Management of the Patient With Chronl.c Pafo Du.e to Advanced Malignancy
AM. AVELLANOSA AND C.R. gery, Roswell Park JJ/Iemorial
N.eurosurNew York
J, Med., 13: 203-213, 1982
These authors studied 60 '"~'""'rn"" with intractable cancer v,ith transcutaneous electrical stimulation. The results after 2 weeks of therapy are reported. Of the 60 patients 17 (28 per cent) had excellent response, 22 (36.2 per cent) had fair response and 21 (35 per cent) had no relief. Reassessment after 3 months revealed that 9 e,uc,~.nco (15 per cent) had excellent response, 11 (18.3 per cent) had fair response and 40 (67 per cent) were failures. Perineal and pelvic is most difficult to treat. Although the authors cannot describe the mechanism of action of transcutaneous electrical stimulation they question the gate hypothesis as well. The equipment is a battery-operated device that is with extensive wiring and a long antenna that needs,~,_,. ~ .. ~--~-·• The authors have indicated that this type of noninvasive means of controlling pain is an important addition to the lists of pain management in cancer patients. N.J. 5 tables, 12 references
for of Pain in Disseminated Px'ostatfo Carc:inmna
A. M. AvELLANOSA AND C. R gery, Roswell Park lvlemorial '"·"'·'"·"·'" J. 13: 215-221, 1982 Hypophysectomy has been advocated as a method of tion in the management of with intractable pain from cancer. there are a number of methods to ablate the function of the a non.direct extracranial ap-
cancer associated with intractable eotaxic ervor,vnon vse,ctcimv A
and
Medicine, 1ni.ssion and extended survival. The authors concluded that sedation and
1
"· of aclvanced cancer is rraodera.te to sev,sre n,•non•D,COmD as the cancer prog-resses. The
been used as µL,u,,u,.1au.H is the preferred method for the control of cancer Pain to bone metastases usually can be relieved partially corticosteroids. Morphine and methadone n,.,.,,.,,n,u can be effective means in dealing with chronic pain in cancer patients. However, Brompton's mixture is no more effective than oral morphine but does lead to a sense of well being. The concept that the brain produces endogenous analgesia with activity at the morphine receptor is becoming important especially with the discovery of enkephalins and ,B-endorphan in the central nervous system. These substances are structurally identical to a part of the larger pituitary peptide hormone and ,B-lipotrophin. N.J. 1 figure, 1 table
low blood N.J. 2 tables, 15 references
Use oflntrathecal and E:pid11.ral for Pain Relief in Patients With. ·"~="'·"'·"~'"" Diseases: A Preliminary R. C. Rwo, G. H. HOBIKA, A. M. AvELLANOSA, R. J. TRUDNOWSKI, J. REMPEL AND C. R. WEST, Departments of Anesthesiology and Neurosurgery, Roswell Park Memorial Institute, Buffalo, New York
J. Med., 13: 223-231, 1982 It has been shown that morphine sulfate provides a selective depressing action on nociceptive pathways in Rexed's lamina 1, 2 and 5 of the dorsal horn. The extent to which intrathecal and epidural opiates can maintain suppression of pain perception is