RESUMEN
To explore new methods for the control of intractable pain caused by advanced cancer, the analgesic effect of electrical stimulation of the pituitary gland was investigated in 25 patients. The results were compared with a control study and with the effects of alcohol-induced pituitary neuroadenolysis (NALP) in the same patients. The pain score (0: no pain at all, 4: extreme pain) in the control study was 3.88 +/- 0.33. After electrical stimulation of the pituitary gland it was 1.24 +/- 1.61; and after NALP it was 1.0 +/- 1.60. The pain scores after electrical stimulation and NALP were significantly lower (P less than 0.01) than those in the control study; but there was no significant difference when the two were compared with each other. The duration of pain relief following NALP (59.65 +/- 68.72 days) was significantly longer compared with that recorded following electrical stimulation (2.97 +/- 2.58 days). Autopsy examinations of 3 patients who expired from their malignancies revealed that the pain relief was unrelated to the degree of necrosis induced in the pituitary by alcohol. Naloxone administration did not inhibit the analgesic effect of either NALP or electrical stimulation. The advantages and disadvantages of electrical stimulation, the pain relief mechanism activated by this method, and potential clinical applications are also discussed.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Hipofisectomía Química , Hipofisectomía , Neoplasias/complicaciones , Dolor Intratable/terapia , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Naloxona/uso terapéutico , Dolor Intratable/etiología , HipófisisAsunto(s)
Pulpa Dental/fisiología , Etanol , Potenciales Evocados , Hipofisectomía/métodos , Neoplasias/complicaciones , Dolor Intratable/prevención & control , Hipófisis/fisiología , Animales , Pulpa Dental/inervación , Estimulación Eléctrica , Etanol/administración & dosificación , Haplorrinos , Humanos , Macaca mulatta , Naloxona/farmacología , Dolor Intratable/etiología , Dolor Intratable/fisiopatología , Hipófisis/efectos de los fármacos , Hipófisis/patología , Formación Reticular/fisiología , Tálamo/fisiologíaRESUMEN
Evaluated the role of physiological arousal in the Induced Anxiety therapy procedure. Assigned 21 normal Ss to either conventional Induced Anxiety Induced Anxiety supplemented by the drug ketamine during arousal, or a no-treatment condition. The ketamine group was superior to the conventional group which was superior to the no-treatment group in reducing negative affect experienced during stressful situations. Most of the reduction was in depressive affect. The superior results obtained by increasing physiological arousal could not be accounted for by increased subjective emotional arousal.
Asunto(s)
Ketamina/uso terapéutico , Psicoterapia Breve/métodos , Estrés Psicológico/psicología , Adaptación Psicológica/efectos de los fármacos , Adolescente , Adulto , Afecto/efectos de los fármacos , Ansiedad/psicología , Nivel de Alerta/efectos de los fármacos , Depresión/terapia , Femenino , Humanos , Masculino , Terapia por Relajación , Estrés Psicológico/terapiaRESUMEN
The phencyclidine derivative, ketamine hydrochloride, combines cardiovascular stimulating effects with antiarrhythmic properties and, therefore, the drug has been shown to be a highly suitable anesthetic for coronary artery surgery. This intravenously and intramuscularly administered "dissociative" anesthetic selectively depresses pathways and regions of the central nervous system associated with pain conduction and perception, thereby avoiding undesirable total nervous system depression. 129 patients suffering from marked coronary artery insufficiency underwent aortocoronary by-pass surgery, ketamine being the main anesthetic agent. Ketamine-induced anesthesia proved to be a simple and safe method of pain control during coronary artery reconstructive surgery and, compared with halothane anesthesia, showed a marked reduction of postoperative mortality (5%).