Search results for "Anesthesiology and Pain Medicine"
showing 10 items of 1004 documents
Persistent antinociception through repeated self-injury in patients with borderline personality disorder.
2012
Abstract Patients with borderline personality disorder, mostly female, exhibit severe autoaggressive behavior, namely an intentionally performed, nonsuicidal self-injury and severe blunting of pain perception, the mechanism of which is hitherto not understood. Because the nociceptive system displays a high degree of plasticity, the aim of this study was to analyze the relationship of pain perception to self-injurious behavior. Pain perception of mechanical and chemical noxious stimuli was studied by quantitative sensory testing in 22 patients (15 female, 7 male) with borderline personality disorder (BPD) according to DSM-IV and 22 age- and gender-matched controls. BPD patients exhibited a s…
Intraoperative monitoring of cerebral microcirculation and oxygenation--a feasibility study using a novel photo-spectrometric laser-Doppler flowmetry.
2009
The present study assesses the utility of a novel invasive device (O2C-, oxygen-to-see-device) for intraoperative measurement of the cerebral microcirculation. CO2 vasoreactivity during 2 different propofol concentrations was used to investigate changes of capillary venous cerebral blood flow (rvCBF), oxygen saturation (srvO2), and hemoglobin concentration (rvHb) during craniotomy.Thirty-four patients were randomly assigned to a low propofol (4 mg/kg/h) versus a high propofol (6 mg/kg/h) group. A fiberoptic probe was applied on the cortex next to the surgical site. Measurements were performed during lower (35 mm Hg) and higher (45 mm Hg) levels of partial pressure of carbon dioxide (paCO2).…
Tissue hypoxia in complex regional pain syndrome.
2003
Untreated complex regional pain syndrome (CRPS) may progress from acute stages with increased hair and nail growth in the affected limb to chronic stages with atrophy of the skin, muscles and bones. The aim of this study was to investigate whether tissue hypoxia could be one mechanism responsible for this late CRPS symptoms. Nineteen patients with CRPS and two control groups (healthy control subjects, surgery patients with edema) participated in this study. Skin capillary hemoglobin oxygenation (HbO(2)) was measured non-invasively employing micro-lightguide spectrophotometry (EMPHO). The EMPHO probe was mounted force-controlled onto the skin of the affected and unaffected hand. HbO(2) was m…
Cross-validation of the SCL-27: a short psychometric screening instrument for chronic pain patients
2001
We constructed a short multidimensional screening instrument for chronic pain patients based on the items contained in the Symptom Check List-90-Revised (SCL-90-R). The proposed dimensional structure of the SCL-90-R was recently shown to be irreproducible in chronic pain patients. As a consequence, the use of the Global Severity Index (GSI) was recommended, although it did not capture all information contained in the many items of the SCL-90-R. Based on an exploratory factor analysis, a six-dimensional structure using 27 items from the SCL-90-R was explored utilizing the data of 2780 chronic pain patients. A short form was prospectively tested on 581 patients in the same setting. Criteria f…
Phantom Limb Pain in Daily Practice—Still a Lot of Work to Do!
2012
Objectives. Effective treatment of phantom limb pain (PLP, pain felt in the part of the body of an amputated limb) is still difficult to achieve, and improved treatment is needed. It is therefore of paramount interest to understand the current practice of PLP therapy outside pain centers. Design. As a part of a nationwide survey, 537 amputees were asked 11 questions related to their treatment experiences and the pain relief. Furthermore, the patients' opinion about the quality of medical care was also asked. Results. Five hundred thirty-seven out of 1088 amputees returned the questionnaire (49.4%). Four hundred (74.5%) suffered from PLP. The patients rated their caregivers' knowledge about …
Orthotopic liver transplantation in a malignant hyperthermia susceptible patient.
2005
We present a patient with hepatitis C and D and hepatocellular carcinoma who underwent preoperative evaluation for orthotopic liver transplantation. In his past medical history, he reported a life-threatening event during tonsillectomy in 1975. Intubation was impossible due to extreme jaw muscle tension, followed by excessive elevation in body temperature, tachycardia, and coma for a few days. We evaluated him for malignant hyperthermia, according to the European Malignant Hyperthermia Group Protocol, and found him highly positive in both the halothane and caffeine test, respectively. Three months later, we performed an orthotopic liver transplantation. During retransplantation 4 years late…
Pseudoradicular and radicular low-back pain--a disease continuum rather than different entities? Answers from quantitative sensory testing.
2006
To assess whether pseudoradicular low-back pain may be associated with subclinical sensory deficits in the distal extremity, we applied the quantitative sensory testing protocol of the German Research Network on Neuropathic Pain (DFNS) in 15 patients with pseudoradicular pain distribution. Sixteen age- and gender-matched healthy control subjects as well as 12 patients with radicular pain syndromes (L4-S1) were studied with the same protocol. Radicular pain was diagnosed using clinical criteria (pain radiation beyond the knee, motor-, sensory-, or reflex deficits, positive Lasegue's test). Z-score QST profiles revealed a selective loss of vibration detection, detection of v. Frey hair contac…
Topical prazosin attenuates sensitivity to tactile stimuli in patients with complex regional pain syndrome
2015
Background The sympathetic nervous system may play an important role in certain forms of chronic pain. The main aim of this study was to determine whether functional blockade of α1-adrenoceptors would alter sensitivity to cutaneous stimulation in patients with complex regional pain syndrome (CRPS). Methods and Results In an initial study, high-performance liquid chromatography-mass spectrometry of intradermal interstitial fluid collected from the forearms of three healthy individuals established that the α1-adrenoceptor antagonist prazosin penetrated the skin barrier when mixed in Lipoderm® cream base. Next, we found that application of this cream to the forearm of 10 healthy participants a…
Mental load during cognitive performance in complex regional pain syndrome I.
2018
Background Complex regional pain syndrome (CRPS) is associated with deficits in limb recognition. The purpose of our study was to determine whether mental load during this task affected performance, sympathetic nervous system activity or pain in CRPS patients. Methods We investigated twenty CRPS‐I patients with pain in the upper extremity and twenty age‐ and sex‐matched healthy controls. Each participant completed a limb recognition task. To experimentally manipulate mental load, the presentation time for each picture varied from 2 s (greatest mental load), 4, 6 to 10 s (least mental load). Before and after each run, pain intensity was assessed. Skin conductance was recorded continuously. R…
Computed tomography-based tracheobronchial image reconstruction allows selection of the individually appropriate double-lumen tube size
1999
Objectives: To determine whether individualized selection of double-lumen tubes or alternatives based on three-dimensional reconstruction of the tracheobronchial image from routine preoperative computed tomography (CT) scans leads to clinically appropriate choices. Design: Prospective observational study; comparison to historic controls. Setting: Anesthesia and radiology facilities of a university medical center. Participants: Forty-nine patients undergoing thoracic surgery requiring one-lung ventilation. Interventions: Three-dimensional image reconstruction of individual tracheobronchial anatomy was performed from routine preoperative spiral CT scans as well as from scans of five left-side…