RESUMO
Continuous intrathecal morphine treatment of cancer pain is reviewed on the basis of a literature search. Clinical, pharmacological and technical aspects are described, and the indications and potential complications are discussed. Three case histories illustrate the practical conduct and problems. The authors conclude that continuous intrathecal morphine treatment offers significant therapeutical advantages, when pain relief is not provided by conventional methods.
Assuntos
Analgésicos Opioides/administração & dosagem , Bombas de Infusão Implantáveis , Morfina/administração & dosagem , Neoplasias/tratamento farmacológico , Cuidados Paliativos/métodos , Analgesia Controlada pelo Paciente/efeitos adversos , Analgésicos Opioides/efeitos adversos , Cateteres de Demora/efeitos adversos , Feminino , Humanos , Bombas de Infusão Implantáveis/efeitos adversos , Injeções Espinhais/efeitos adversos , Masculino , Pessoa de Meia-Idade , Morfina/efeitos adversosRESUMO
On the basis of a review of the literature, a survey is presented concerning the controversial anaesthetic agent ketamine, its pharmacology, mechanism of action and employment. Particular emphasis is placed on the cerebral, cardiovascular and pulmonary effects and the clinical employment. Similarly, the side effects and their prophylaxis are described. It is concluded that ketamine is considered to be a valuable preparation which can be employed both in and outside hospital.
Assuntos
Ketamina/farmacologia , Encéfalo/efeitos dos fármacos , Brônquios/efeitos dos fármacos , Hemodinâmica/efeitos dos fármacos , Humanos , Ketamina/administração & dosagem , Ketamina/efeitos adversosRESUMO
Continuous spinal analgesia is a recognized method of analgesia for surgical interventions which was originally described in 1907. A brief historical review is presented with a description of the current technique. Emphasis is laid on comparison with other regional techniques, particularly single-shot analgesia and epidural analgesia. A review is presented of the current knowledge about technique, particularly the equipment, analgesic agents, advantages and disadvantages and indications and contraindications. it is concluded that continuous spinal analgesia probably offers certain advantages, particularly cardiovascular stability. However, the lack of randomized comparisons of the various techniques make further clinically controlled investigations necessary to illustrate this.