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Der Schmerz 12건

  1. [해외논문]   [New modes of opioid administration.].  

    Striebel, H W , Schwagmeier, R , Boerger, N
    Der Schmerz v.7 no.3 ,pp. 131 - 139 , 1993 , 0932-433x ,

    초록

    In the last few years great interest has developed in new modes of opioid administration; oral transmucosal, transdermal, peripheral, and nasal administration.Oral transmucosal administration of fentanyl citrate (OTFC) has most often been used for premedication in children. Meanwhile, studies on the use of OTFC in cancer patients for postoperative pain management have also been published. While OTFC may have a limited role in postoperative pain management, it may prove very helpful in the management of incident and breakthrough cancer pain. Patient acceptance is high, and the onset of action is relatively rapid.Transdermal administration of fentanyl (TTS fentanyl) has been extensively examined, especially in postoperative patients. Patient acceptance is high, and TTS-fentanyl-related side-effects (e.g. mild erythema at the site of application) are minor. Application is performed at 72-h intervals. Kinetics are stable with repeated dosing, and serum concentrations approach steady state with the first dose. The slow rise/decline in fentanyl plasma concentration with patch application/removal makes it less well suited for postoperative pain management. However, TTS fentanyl seems to be a promising mode of opioid administration for cancer patients.-Recent papers have unequivocally demonstrated a peripheral antinociceptive effect oflocally applied opioids, especially in inflamed tissue. However, the results of clinical investigations are equivocal so far: about half the reports demonstrate an analgesic effect of peripherally administered opioids, and the other half, not.Intranasal administration was introduced for premedication in children, but benzodiazepines seem to be the better and safer choice. Nonetheless, intranasal opioids guarantee a rapid rise in opioid plasma concentrations as well as a rapid onset of pain relief. This mode of administration seems to be especially suitable for the treatment of acute pain syndromes, such as breakthrough cancer pain or incident pain. Patient acceptance is high, and no local problems were reported.

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  2. [해외논문]   [Perioperative analgesia in adults : The concept of balanced analgesia.].  

    Jage, J
    Der Schmerz v.7 no.3 ,pp. 140 - 153 , 1993 , 0932-433x ,

    초록

    The spectrum of perioperative pain treatment is discussed in the present review. The analgesic efficacy of various drugs and the dosage methods of administration and side effects reported for them in such reference works as the practical guide on the management of acute pain recently published by the International Association for the Study of Pain (IASP) are described. Effective postoperative analgesia can diminish stress reactions following surgery. Recovery and physical mobilization are improved as the result of adequate treatment. Results obtained in recent studies have demonstrated that primary adaptive hyperalgesia in the peripheral nociceptive area may develop into secondary maladaptive hypersensibility with a high degree of nociceptive excitability and pain. Chronic pain can develop following acute alterations. Increasing nociceptive activity of primary afferents induces alterations in the dorsal horn of the spinal cord. These alterations imply an increase in the excitability of nociceptive neurons, which has been described as neuronal plasticity. Clinical results have demonstrated prevention or delay of acute postoperative pain after injection of local anaesthetics, analgesic premedication or epidural injection of opioids just before the start of surgery. Continuous perioperative spinal analgesia has contributed significantly to the prevention of phantom limb pain in patients undergoing amputation of extremities. The development of pain memory may be prevented as a result of effective acute pain treatment. Several changes to the terminology of acute pain treatment for animal and clinical studies have recently been proposed, including such new terms as preemptive analgesia and pain prevention, which indicate new strategies in the treatment of postoperative pain. The concept of balanced analgesia refers to a strategy for the improvement of analgesic efficacy as a result of a combination of drugs with different local actions on nociception. The combination of systemic analgesics (opioids in low dosages) with nonsteroidal analgesics (e.g. diclofenac or ketorolac) and the combination of regional analgesic procedures with opioids have been shown to be very effective. The peripheral action of morphine offers new options in pain therapy. Different regional analgesic techniques and continuous infusions of local analgesics are described. The synergistic action of low dosages of local anaesthetics (bupivacaine 0.006%) with low dosages of fentanyl 0.0001-0.0002% are of interest for the treatment of obstetric pain and for pain in opioid-tolerant patients. Investigations performed by the author of this review have shown that epidural infusion of highly diluted mixtures of bupivacaine/fentanyl is highly effective in the analgesic treatment of patients undergoing prostatectomy, providing excellent physical mobilization. The potential dangers of drug combinations and contraindications are also discussed. The concept of using balanced analgesia to induce additive or synergistic effects following the administration of analgesic drugs requires further clinical studies.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  3. [해외논문]   [Treatment of acute gastrointestinal pain.].  

    Bierbach, H
    Der Schmerz v.7 no.3 ,pp. 154 - 159 , 1993 , 0932-433x ,

    초록

    Abdominal pain is an important and the most frequent symptom of acute gastrointestinal diseases; crucial hints on the diagnosis can be gleaned from its location and from associated symptoms and signs. As symptomatic therapy the treatment of pain plays a major role in acute gastrointestinal diseases, e.g. the acute abdomen, acute pancreatitis, biliary colic, peptic ulcer disease and diverticulitis. Acute pain arising from peptic ulcer disease is effectively treated with the H(+)-, K(+)-ATPase inhibitor omeprazole or one of the H(2)-receptor antagonists. While moderate to severe pain caused by these conditions can be effectively treated by intravenous administration of nonopioid analgesic drugs, supplemented by butylscopolamine in a biliary colic, more severe pain or inadequate responsiveness to nonopioid analgesic drugs requires the intravenous administration of a highly potent opioid. Acute severe pain arising from biliary colic and acute pancreatitis should be treated with an opioid that does not influence the sphincter of Oddi or the pressure in the common bile duct, e.g. buprenorphine, nalbuphine or tramadol. An effective but not widely known therapy for colic pain is parenteral administration of a nonsteroidal anti-inflammatory drug, e.g. indomethacin or diclofenac.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  4. [해외논문]   [Pain therapy in acute renal colic.].  

    Tschuschke, C , M?ller, S C , Hertle, L
    Der Schmerz v.7 no.3 ,pp. 160 - 166 , 1993 , 0932-433x ,

    초록

    The severe pain of a renal colic is an emergency and requires a fast and sufficient analgesic therapy with few side-effects. The release of the ureteral obstruction is secondary to this initial treatment. Inhibition of prostaglandin synthesis directly interferes with the mechanism of renal colic pain. Dipyrone, indomethacin and diclofenac are the drugs of choice. They should be administered intravenously if possible. Narcotic agents and their derivatives are the second choice. Spasmolytic agents are unnecessary in the treatment of renal colic.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  5. [해외논문]   [Reduced postoperative opioid requirement with perioperative administration of naproxen. A randomized study in 86 patients with intravenous on-demand analgesia after orthopaedic surgery.].  

    Steffen, P , Opderbeck, S , Seeling, W
    Der Schmerz v.7 no.3 ,pp. 167 - 173 , 1993 , 0932-433x ,

    초록

    In a double-blind, randomized, placebo-controlled study, 86 patients (44 verum, 42 placebo), scheduled for knee-joint arthrotomies or minor orthopaedic operations received either naproxen, a nonsteroidal antiinflammatory analgesic, or placebo orally in three doses: the first immediately before the operation and the others 6 h and 12 h after the first. The verum group received 1250 mg naproxen in total. Postoperative pain intensity was measured by the category splitting procedure. All patients were allowed to self-administer piritramide from a PCA (patient-controlled analgesia) pump (Prominjekt, Pharmacia, Sweden) in 2-mg boluses every 5 min during a 6-h period and subsequently every 15 min for another 18 h after surgery. The patients receiving verum had significantly (P

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  6. [해외논문]   [Intranasal fentanyl for breakthrough cancer pain. A pilot study.].  

    Striebel, H W , Wessel, A , Rieger, A
    Der Schmerz v.7 no.3 ,pp. 174 - 177 , 1993 , 0932-433x ,

    초록

    Despite regular administration of analgesics, a high percentage of patients with chronic malignant pain experience break-through cancer pain or incident pain. Such pain peaks in patients with chronic malignant pain require "rescue" medication in addition to basic analgesia with for example slow-release morphine or buprenorphine. For rescue medication a fast acting and powerful analgesic should be available to the patient. Recent studies have shown that intranasal fentanyl provides rapid onset of pain relief.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  7. [해외논문]   [The localized form of reflex sympathetic dystrophy-a case report.].  

    Blumberg, H , Wakhloo, A K , Hoffmann, U , Wokalek, H
    Der Schmerz v.7 no.3 ,pp. 178 - 181 , 1993 , 0932-433x ,

    초록

    The reflex sympathetic dystrophy (RSD) syndrome usually shows a distally generalized distribution pattern of symptoms. Here we report a case with a distally localized form of RSD.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  8. [해외논문]   [Ten years of therapy resistant intercostal neuralgia-suspected postherpetic neuralgia following herpes zoster sine herpete.].  

    Zw?lfer, W , Hartmann, T , Spacek, A , Grubhofer, G , Porges, P
    Der Schmerz v.7 no.3 ,pp. 182 - 184 , 1993 , 0932-433x ,

    초록

    We report the case of a 65 year old man who has been suffering from segmental back pain for 10 years. The diagnosis postherpetic neuralgia following herpes zoster sine herpete was fixed 9 years after the beginning of pain. All treatments prior to ours were ineffective. Acupuncture and the use of homeopathic drugs led to success at last.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  9. [해외논문]   Acute pain service— Traum oder verpflichtung? : 1. KOlner Anaesthesie-Symposium 1993, KOln, 24. April 1993  

    Grond, S. , Lehmann, K. A.
    Der Schmerz v.7 no.3 ,pp. 185 - 187 , 1993 , 0932-433x ,

    초록

    We report the case of a 65 year old man who has been suffering from segmental back pain for 10 years. The diagnosis postherpetic neuralgia following herpes zoster sine herpete was fixed 9 years after the beginning of pain. All treatments prior to ours were ineffective. Acupuncture and the use of homeopathic drugs led to success at last.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  10. [해외논문]   Analgesie durch Opioide in der PAdiatrie : Leserbrief zu der Arbeit von C. SchlUnder Der Schmerz (1992) 6:229-239  

    Olligs, J. , Stadler, T.
    Der Schmerz v.7 no.3 ,pp. 188 - 189 , 1993 , 0932-433x ,

    초록

    We report the case of a 65 year old man who has been suffering from segmental back pain for 10 years. The diagnosis postherpetic neuralgia following herpes zoster sine herpete was fixed 9 years after the beginning of pain. All treatments prior to ours were ineffective. Acupuncture and the use of homeopathic drugs led to success at last.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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