The recent development of the use of spinal opiates as a rational therapy for pain rests on clear and certain experimental data. We have long known the spinal cord to be a highly complex structure. Anatomical studies of the substantia gelatinosa have repeatedly demonstrated signs of massive synaptic interaction between primary afferents, descending pathways and intrinsic neurons. Yet, to date that knowledge, insofar as clinical therapy is concerned, has permitted us only to destroy certain connections within the spinal cord in the hopes that the substrate mediating pain could be anatomically differentiated from those which mediate other function. Though cordotomies are clearly effective under certain circumstances, they suffer from the fact the spinal cord is not organized in such an anatomically discrete fashion as is often times drawn in basic medical text. Rather, functions intertwine exquisitely and specific physical interventions are no more likely to produce a specific effect than smashing of the fmgertip with a hammer will produce just a loss of the fingernail. The development of specific therapies of the spinal cord has come about by our growing aware ness of the intricate organization of the pharmacological substrates associated with specific neural function.
Reihe
Sprache
Verlagsort
Verlagsgruppe
Zielgruppe
Für Beruf und Forschung
Research
Illustrationen
5
5 s/w Abbildungen
XII, 150 p. 5 illus.
Maße
Höhe: 244 mm
Breite: 170 mm
Dicke: 10 mm
Gewicht
ISBN-13
978-3-540-11036-1 (9783540110361)
DOI
10.1007/978-3-642-68261-2
Schweitzer Klassifikation
Animal Studies on the Spinal Action of Opiates in Analgesia.- Theoretical Aspects and Practical Considerations Concerning Selective Opiate-Analgesia.- Dangers and Complications of Intrathecal and Epidural Opiates.- Mechanism of Intrathecally Administered Morphine Analgesia.- Actions of Epidural Morphine in Normal Human Subjects.- Epidural Opiate Analgesia (EOA): Compatibility of Opiates with Tissue and CSF.- Epidural Morphine: A new Approach to Postoperative Analgesia in Urological Surgery.- Therapeutic and Diagnostic Uses of Morphine Epidurals in the Management of Pain.- Epidural Morphine for 24 Hours of Postoperative Analgesia.- Epidural Low-Dose Morphine and Postoperative Pain: A Controlled Study.- A Step to Complete Pain Relief After Surgery.- Peridural Bupivacaine and Morphine for Residual Pain After Peripheral Vascular Surgery.- Postoperative Hypoalgesia by Epidural Morphine After Abdominal Surgery.- The Perioperative Use of Epidural Opiates.- Pain Relief with Morphine, Applied Intrathecally or Epidural.- The Use of Epidural Buprenorophine for the Treatment of Postoperative Pain.- Postoperative Analgesia in Cesarean Section, with Epidural Morphine.- Continuous Epidural Analgesia in the Perioperative Period.- The Control of Postoperative Pain by Thoracic Fentanyl Epidural and its Effect Upon the Stress Response.- Postoperative Pain Therapy by Epidural Morphine.- Epidural Morphine in the Treatment of Cancer Pain.- Intrathecally Applied Morphine for Treatment of Postoperative and Chronic Pain.- Comparison Between Morphine and Local Anesthetic Injections of Stellate and Celiac Ganglia in Chronic Pain Syndromes.- Epidural Opiates for Relief of Cancer Pain.- Intrathecal Morphine in Cancer Patients Tolerant to Systemic Opiates.- Pain Therapy with Epidural Morphine in Patients with Terminal Cancer.
