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H Adriaensen

Publications and source records attributed to H Adriaensen.

At least 19 recordsLinked to original sources
PubMed2000

The emotional stroop task and chronic pain: what is threatening for chronic pain sufferers?

Using a computer version of the emotional stroop task, it was investigated whether chronic pain patients display an involuntary attentional shift towards pain-related information (sensory, affective pain words and injury related words). Multiple regression analyses were used to investigate which pain and psychosocial variables (pain severity, pain-related fear, pain catastrophizing and negative affect) were predictive of attentional bias. Results indicated: (1) that there was an attentional bias towards the sensory pain words; and (2) that current pain intensity was predictive of the effect. No other attentional effects were found. The results are discussed in terms of possible reasons for the difficulty of demonstrating attentional bias in chronic pain patients.

Attention↗
PubMed2000

Endocrine consequences of long-term intrathecal administration of opioids.

Intrathecal administration of opioids is a very efficient tool in the long-term control of intractable nonmalignant pain. However, despite the well known role of opioids in endocrine regulation, few data are available about possible effects on hypothalamic-pituitary function during this treatment. Seventy-three patients (29 men and 44 women; mean age, 49.2 +/- 11.7 yr) receiving opioids intrathecally for nonmalignant pain were enrolled for extensive endocrine investigation. At the time of hormonal determination, the mean duration of opioid treatment was 26.6 +/- 16.3 months; the mean daily dose of morphine was 4.8 +/- 3.2 mg. The control group consisted of 20 patients (11 men and 9 women; mean age, 54.2 +/- 14.0 yr) with a comparable pain syndrome but not treated with opioids. Decreased libido or impotency was present in 23 of 24 men receiving opioids. The serum testosterone level was below 9 nmol/L in 25 of 29 men and was significantly lower than that in the control group (P < 0.001). The free androgen index was below normal in 18 of 29 men and was significantly lower than that in the control group (P < 0.001). The serum LH level was less than 2 U/L in 20 of 29 men and was significantly lower than that in the control group (P < 0.001). Serum FSH was comparable in both groups. Decreased libido was present in 22 of 32 women receiving opioids. All 21 premenopausal females developed either amenorrhea or an irregular menstrual cycle, with ovulation in only 1. Serum LH, estradiol, and progesterone levels were lower in the opioid group. In all 18 postmenopausal females significantly decreased serum LH (P < 0.001) and FSH (P = 0.012) levels were found. The 24-h urinary free cortisol excretion was below 20 microg/day in 14 of 71 opioid patients and was significantly lower than that in the control group (P = 0.003). The peak cortisol response to insulin-induced hypoglycemia was below 180 microg/L in 9 of 61 opioid patients and was significantly lower than that in the nonopioid group (P = 0.002). The insulin-like growth factor I SD score was below -2 SD in 12 of 73 opioid patients and was significantly lower than that in the control group (P = 0.002). The peak GH response to hypoglycemia was below 3 microg/L in 9 of 62 subjects and was significantly lower than that in the control group (P = 0.010). Thyroid function tests and PRL levels were considered normal. No metabolic disturbances were recorded, apart from significantly decreased high density lipoprotein cholesterol levels (P = 0.041) and elevated total/high density lipoprotein cholesterol ratio (P = 0.008) in the opioid group compared to the control group. Supplementation with gonadal steroids improved sexual function in most patients. In conclusion, of all patients receiving intrathecal opioids, the large majority of men and all women developed hypogonadotropic hypogonadism, about 15% developed central hypocorticism, and about 15% developed GH deficiency. These findings suggest that further investigations are required to determine the need for systematic endocrine work-up in these patients and the necessity for substitutive therapy.

Adult↗
PubMed1998

Behavioral assessment of facial pain in rats: face grooming patterns after painful and non-painful sensory disturbances in the territory of the rat's infraorbital nerve.

Noxious stimulation of the rat's face evokes intense face grooming with face wash strokes almost exclusively directed to the stimulated area (e.g. Clavelou et al., Neurosci. Lett., 14 (1989) 3263-3270). Similar asymmetric face grooming behavior has been observed after transection (Berridge and Fentress, J. Neurosci., 6 (1986) 325-330) and chronic constriction of the infraorbital nerve (Vos et al., J. Neurosci., 14 (1994) 2708-2723). In the present study, the relation between unilateral facial pain and asymmetric face grooming was experimentally studied in normal, intact rats: face grooming patterns evoked by non-painful sensory disturbances in the territory of the infraorbital nerve (i.c. unilateral vibrissae clipping, anesthetic infraorbital nerve blockade, application of mineral oil on vibrissae) were compared to those evoked by noxious facial stimulation (s.c. formalin injection in mystacial pad) and those observed in unstimulated control rats, using video-analysis. Only formalin-injected rats displayed significantly more face grooming activity directed to the affected infraorbital nerve territory than unstimulated control rats. Non-painful sensory disturbances (especially mineral oil application) induced an initial bout of directed face grooming; this response was transient and short-lasting. These observations suggest that directed face grooming can be used as a sign of unilateral facial pain in freely moving rodents; unilateral non-painful facial sensory disturbances do not lead to intense and persistent directed face grooming.

Animals↗
PubMed1997

Intravenous regional anesthesia. Evaluation of 4 different additives to prilocaine.

Intravenous regional anesthesia (IVRA) is an effective method of producing anesthesia of the extremities. Disadvantages are the rapid loss of anesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. This study compared the effect of four different additives to prilocaine with saline on the development of a complete sensory block, on the return of sensory function after deflation of the tourniquet and on the development of postoperative pain after IVRA for minor orthopedic surgery of the arm. Seventy-five patients, ASA class 1 or 2, were randomly divided into 5 groups. All patients received 30 ml. of prilocaine 1%, together with 5 ml. of additive. In group 1, the additive was saline, in group 2 bupivacaine 0.25%, in group 3 clonidine 150 micrograms in saline, in group 4 sufentanil 25 micrograms in saline and in group 5 tenoxicam 20 mg. The development of a complete sensory block proved significantly faster in the patients receiving sufentanil (4.8 min.) as compared to plain prilocaine (7.5 min.). The return of the sensory function was comparable for all groups. Postoperative pain scores were significantly better in the clonidine and tenoxicam groups.

Adjuvants, Anesthesia↗
PubMed1997

Accidental overdosing with intraspinal morphine caused by misprogrammation of a Synchromed pump: a report of two cases.

Spinally administered opioids must be a last step in the therapeutical arsenal of chronic benigne pain. It is an invasive technique not free from adverse effects. Two chronic pain patients received an implantable Synchromed pump for treatment with spinal opiates after a trial period of resp. 3.5 and 5.5 months. Due to a misprogrammation (both on the same day) they received very high doses of spinal opiates. This caused relatively few side effects, which did not seem to require immediate treatment. A short time development of tolerance to life threatening side-effects has been proven by this accidental administration of high-dose intraspinal opiates. It is critical that care providers are knowledgeable and well-trained about implantable infusion systems. Programmation and refills must always be performed with care.

Aged↗
PubMed1995

Efficacy and safety of oral tramadol and pentazocine for postoperative pain following prolapsed intervertebral disc repair.

In this multicenter double-blind randomized study the analgesic efficacy and safety of 50 mg tramadol was compared against 50 mg pentazocine by mouth in the treatment of 160 patients with acute pain following prolapsed intervertebral disc repair. The day of surgery patients were treated with parenteral opioids. The study started the morning after surgery. A wash out period of four hours was allowed after parenteral analgesics. Pain assessment was made using a visual analogue scale (VAS) and a verbal rating scale (VRS) during a six hours observation period. Remedication with the same drug at the same dosage was allowed if pain relief was unsatisfactory. Overall analgesic activity and spontaneously reported side effects were also registered. Results showed both treatments provided equivalent effective analgesia for the six hours observation period. The global assessment of analgesia by patient and observer was not significantly different for both treatments, although less additional medication was required in the pentazocine group. Side effects were quite common in both groups, and occurred more frequently in the pentazocine group.

Administration, Oral↗
PubMed1994

Successful treatment of postherpetic neuralgia with oral ketamine.

OBJECTIVE: To demonstrate the possibilities of the use of oral ketamine in the treatment of postherpetic neuralgia. SETTING: A pain clinic in a university hospital. PATIENT: A patient with postherpetic neuralgia of the ophthalmic nerve. INTERVENTION: Subcutaneous and later oral ketamine after classical treatment had failed. RESULTS: A complete recovery was accomplished without any sign of side effects. CONCLUSIONS: Oral ketamine may provide an alternative in the treatment of postherpetic neuralgia. The possible mechanism of action by its N-methyl-D-aspartate (NMDA) blocking properties is discussed.

Administration, Oral↗
PubMed1993

Combined continuous spinal-epidural anaesthesia with a single interspace, double-catheter technique.

A double catheter, single interspace combined spinal-epidural anaesthetic was performed in 12 ASA grade 3 patients. The technique failed in one patient in whom the intrathecal catheter could not be inserted satisfactorily. In another patient, the epidural catheter was accidentally placed intrathecally. The maximum height of the block obtained with hyperbaric lignocaine or bupivacaine was below T10 in all patients and there were no adverse cardiovascular changes. As opposed to a classical combined spinal-epidural block, this technique is most suitable for very debilitated patients. The advantages are the ability to titrate the intrathecal dose of the local anaesthetic to achieve the desired dermatomal level and to test the correct position of the epidural catheter before injecting drugs intrathecally.

Aged↗
PubMed1992

Spinal sufentanil in rats: Part II: Effect of adding bupivacaine to epidural sufentanil.

Male Wistar rats were injected epidurally with various doses of sufentanil, bupivacaine or sufentanil combined with bupivacaine either 40 or 80 micrograms. Addition of 80 micrograms bupivacaine to sufentanil produced a 2.2- to 3-fold decrease of the lowest ED50 for a tail withdrawal reaction latency greater than 6 and greater than or equal to 10 s. The potentiation was already present at low doses. Whereas both 0.16 microgram sufentanil and 80 micrograms bupivacaine were inactive, the combination of the two drugs resulted in a deep analgesia in all animals. Because the addition of low doses of bupivacaine to sufentanil did not increase the ED50's for side-effects, higher specificity ratios were obtained as compared to sufentanil given alone. These results were discussed with regard to the potentiation of the analgesic properties of epidurally administered lipophilic opioids by local anaesthetics.

Analgesia, Epidural↗
PubMed1992

Safety aspects of PCA.

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Analgesia, Patient-Controlled↗
PubMed1991

Intracranial subdural hematoma after spinal anesthesia.

We describe a 68-year old male patient with late onset signs of an intracranial subdural hematoma after repetitive spinal anesthesia procedures for urethral dilatation. The proposed mechanism is that of cerebrospinal fluid efflux. The potential for the development of such complications is so important, that it must be considered in every patient.

Aged↗
PubMed1991

The effects of a single oral dose of lorazepam and alprazolam on reaction times in young healthy volunteers.

Lorazepam (Temesta) and alprazolam (Xanax) are two benzodiazepines which are widely used for their anxiolytic activity. In this study their effect on psychomotor functions was investigated. Eight young healthy volunteers participated in the experiments. Using a double-blind cross-over design, the effect of single oral doses of lorazepam (2.5 mg) and alprazolam (0.5 mg) on a choice reaction time test to visual stimuli (letter pairs presented on a computer screen), were assessed. The experimental procedure consisted of three sessions which differed from each other either by the stimulus presentation rate, or by the presence or absence of a warning signal. In all three sessions, lorazepam, when compared with placebo, significantly prolonged the reaction times (RT), while alprazolam did not. Increasing the interstimulus interval resulted in an equal increase of the reaction times in the three conditions. On the other hand, the introduction of a warning signal which preceded the presentation of the letter pairs, improved performance in the three conditions. This improvement was more pronounced after lorazepam than after placebo. This finding is interpreted as a partial recuperative effect for the impaired performance in the baseline condition after intake of lorazepam.

Administration, Oral↗
PubMed1990

Comparison of epidural sufentanil plus clonidine with sufentanil alone for postoperative pain relief.

Sufentanil 25 micrograms plus clonidine 1 microgram/kg administered epidurally was compared with epidural sufentanil 50 micrograms alone in a double-blind fashion for pain relief in 40 patients after abdominal surgery. The duration of complete pain relief was significantly longer in those who received the mixture. Oxygen saturation was reduced 10 and 20 minutes after sufentanil alone, but remained stable after sufentanil and clonidine. There were significant decreases in arterial blood pressure in the latter group that were maximum between 20 and 120 minutes after administration.

Adult↗
PubMed1990

Effects of anesthetics on the coronary circulation.

The coronary circulation holds a unique position among the different vascular beds because it perfuses the organ that generates the perfusion pressure for the entire circulation. Therefore the maintenance of an adequate perioperative coronary flow is one of the primary goals of good anesthetic management. This is especially important when coronary flow is already diminished such as is the case with arteriosclerotic disease. All anesthetics influence coronary flow to some extent. Some of them however also affect the normal physiologic responses of this system and may compromise coronary circulation and hence myocardial function. Therefore, knowledge of the coronary physiology and the effects of anesthetics on it is essential for every anesthetist dealing with patients with coronary artery disease. This article reviews the anatomy and physiology of the coronary circulatory system and resumes the present state of knowledge of the effects of the common used anesthetics on the coronary circulation.

Anesthetics↗
PubMed1990

Effects and early perioperative diagnosis of graded reductions in regional coronary perfusion.

The effects of graded reductions and total occlusion of the flow in a small branch of the coronary circulation on regional myocardial function and metabolism and routinely monitored determinants of myocardial function, such as body surface electocardiogram, pressure tracings and dP/dt, are evaluated in mongrel dogs. Normal regional myocardial function and pH remain preserved until coronary blood flow is reduced to about one half its normal initial value. Then, important and dramatic changes in systolic regional myocardial function occur together with a significant decrease in regional pH. There were no significant changes in the global determinants of myocardial function. This study proves the inadequacy of the body surface electrocardiogram and the other routinely monitored hemodynamic determinants to detect limited regional ischemia. In addition, it stresses the importance to evaluate the sensitivity of new monitoring techniques in the detection of regional myocardial malfunctioning and the importance of research on the effects of anesthetic agents on regional myocardial function.

Animals↗
PubMed1990

Perioperative intra-aortic balloon counterpulsation in cardiosurgery: a retrospective study.

From January 1986 to March 1988 50 of 1366 patients (3.7%) undergoing cardiac surgery were treated with IABP support. The 50 patients ranged in age from 43 to 79 years (mean: 63.3 years). 88% of them underwent coronary artery bypass grafting, 6% of them mitral valve replacement and the other 6% a combined procedure. IABP was inserted preoperatively in 4 patients (8%) because of cardiogenic shock, and in 18 patients because of unstable angina (36%); intraoperatively as a help during weaning from cardiopulmonary bypass in 8 patients (16%); postoperatively because of hemodynamic deterioration in 20 patients (40%). The IABP was placed by femoral puncture in 39 patients (78%), by femoral cutdown in 6 patients (12%) and by transthoracic aortotomy in 5 patients (10%). All patients received daily infusions of heparin and broad spectrum antibiotics. The overall incidence of complications was 22%. There was no mortality due to IABP-related complications.

Adult↗