RESUMO
Nine patients with terminal cancer were treated for pain with continuous subcutaneous injection of morphine via a portable battery-driven injection pump. Treatment was instituted on account of failure of other forms of treatment with oral or epidural morphine derivatives or on account of severe nausea and vomiting which necessitated parenteral administration. Treatment proved reasonably effective and no side effects of significance occurred. Two of the patients could be treated in their homes. The method is thus considered as suitable for treatment of pain in patients with terminal cancer.
Assuntos
Morfina/administração & dosagem , Neoplasias/complicações , Dor Intratável/tratamento farmacológico , Cuidados Paliativos , Adulto , Idoso , Feminino , Humanos , Bombas de Infusão , Masculino , Pessoa de Meia-IdadeRESUMO
The frequency of local venous reactions after intravenous injection of Diazemuls and Valium Mixed Micelles was studied. A material of 224 patients undergoing surgery for prolapsed lumbar disc was allocated into two groups, receiving either 10 mg of Diazemuls or Valium Mixed Micelles. The incidences of thrombophlebitis in the two groups were 1 and 2%, respectively.
Assuntos
Diazepam/administração & dosagem , Tromboflebite/induzido quimicamente , Adulto , Ensaios Clínicos como Assunto , Humanos , Injeções Intravenosas , Tecnologia FarmacêuticaRESUMO
Thirty patients who had severe incapacitating angina pectoris which had not reacted to the conventional therapeutic measures and which required massive daily opioid consumption were treated with electrical spinal cord stimulation (SCS) by means of a completely implantable stimulation system. The therapeutic effect was good in 87% of the patients who experienced considerably reduced frequency of attacks and markedly reduced opioid consumption (p less than 0.00005). Nine of the patients could reduce opioid consumption and 14 out of 27 could cease their otherwise daily opioid consumption. In four patients, the therapeutic effect was unsatisfactory. In the first 22 patients in whom a unipolar electrode was introduced, displacement of the electrode and subsequent reoperation was a frequent problem. This problem disappeared after change to multipolar electrodes as slight changes in placing of the electrode could easily be compensated for via the external programming equipment. This investigation reveals that SCS is a good therapeutic alternative for this selected patient category.
Assuntos
Angina Pectoris/terapia , Terapia por Estimulação Elétrica/métodos , Medula Espinal/fisiologia , Idoso , Angina Pectoris/fisiopatologia , Angina Pectoris/cirurgia , Terapia por Estimulação Elétrica/instrumentação , Eletrodos Implantados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SoftwareAssuntos
Embalagem de Medicamentos , Vidro , Feminino , Corpos Estranhos/diagnóstico , Humanos , Pessoa de Meia-IdadeAssuntos
Serviço Hospitalar de Anestesia , Parada Cardíaca/epidemiologia , Departamentos Hospitalares , Anestesia/efeitos adversos , Pré-Escolar , Dinamarca , Feminino , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosAssuntos
Coleta de Amostras Sanguíneas , Capilares , Feminino , Pé , Gangrena/etiologia , Humanos , Recém-Nascido , Masculino , Osteomielite/etiologia , Fatores de RiscoAssuntos
Diazepam/uso terapêutico , Fasciculação/prevenção & controle , Músculos/efeitos dos fármacos , Dor/prevenção & controle , Succinilcolina/efeitos adversos , Ensaios Clínicos como Assunto , Método Duplo-Cego , Fasciculação/induzido quimicamente , Feminino , Trietiodeto de Galamina/uso terapêutico , Humanos , Dor/induzido quimicamenteRESUMO
Over a five-year period, 304 patients with non small cell carcinoma of the lung were evaluated for pulmonary resection. The patients were divided into three groups: 1) 180 patients operated without preoperative mediastinoscopy based on a normal appearing mediastinum on plain chest x-ray; 2) 107 patients with resection of both lung tissue and mediastinal tissue due to localised positive mediastinoscopic findings; 3) 17 patients who were found inoperable either due to poor lung function or diffuse mediastinal seeding. In group 1, 24% were peroperatively found to be inoperable due to mediastinal involvement. The rest were resected and received no further therapy. In group 2, 84 patients were resected and postoperatively irradiated on the mediastinal area. The incidence of bronchopleural fistulae in group 1 was 0.7% and in group 2 16%, and the survival at any period was significantly poorer for group 2 than for group 1. We conclude that every patient with pulmonary infiltrates must be subjected to mediastinoscopy before thoracotomy and should be excluded from operative intervention in the presence of positive mediastinoscopic findings.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/secundário , Neoplasias Pulmonares/patologia , Neoplasias do Mediastino/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/terapia , Terapia Combinada , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Metástase Linfática , Masculino , Neoplasias do Mediastino/secundário , Neoplasias do Mediastino/terapia , Mediastinoscopia , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Seven patients who had chronic coronary artery disease and had undergone coronary artery bypass surgery still suffered from anginal attacks several times daily despite optimal medical treatment. An epidural system of analgesia was implanted subcutaneously and treatment with epidural morphine started. The morphine was administered by the patients themselves or members of their family. During a median observation time of four months (range three to 11) all patients were free of pain while receiving this treatment.