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Biomedical subjects

H Carron

Publications and source records attributed to H Carron.

At least 19 recordsLinked to original sources
PubMed1989

Idiopathic pelvic pain. The relationship to depression.

Episodic and chronic idiopathic pelvic pain is enigmatic for both physician and patient. Antidepressant drug therapy combined with behavior modification techniques is beneficial in improving the functional status of some patients. Whether the decrease in frequency, intensity, and duration of pelvic pain complaints results from treatment of underlying depression or analgesic effects of the antidepressant drugs is difficult to determine. Addressing the psychological component of idiopathic pelvic pain through education and counseling is essential to long-term resolution of symptoms.

Abdomen↗
PubMed1989

Extension of pain relief beyond the operating room.

Physicians have in their armamentaria of drugs and techniques sufficient methods of relieving postoperative pain to maintain an analgesic state in postsurgical patients. The extent of the problem, and the options available, are discussed and described.

Humans↗
PubMed1989

Sufentanil and alfentanil pattern of consumption during patient-controlled analgesia: a comparison with morphine.

Pattern of drug consumption and side effects of sufentanil and alfentanil were compared to morphine, using "on-demand" patient-controlled analgesia (PCA). After a non-narcotic general anesthetic, a bolus dose of the narcotic was given intravenously towards the end of surgery. PCA was started in the recovery room. Data were retrieved postoperatively for a total of 24 h. Results showed a wide range of pattern of drug consumption and uniform acceptance of therapy by the nurses and the patients in all the groups. The frequency of use of incremental doses was greater than 2-2.5-fold for the sufentanil and alfentanil groups, respectively, compared with morphine. The bolus dose of the narcotics failed to achieve adequate analgesia for 2 h for morphine and sufentanil and for 6 h for alfentanil. Overall patients were most sedated with morphine and least sedated with sufentanil. At the time intervals sampled, there was a higher incidence of oxygen desaturation--less less than 95% with morphine and alfentanil, compared with sufentanil. There was a similar incidence of nausea in all the groups. Further study is needed to determine precisely the best dose regimens for sufentanil and alfentanil, especially in reference to optimum loading doses. Sufentanil appears to be a promising drug for PCA use.

Acute Disease↗
PubMed1986

Comparison of pH-adjusted lidocaine solutions for epidural anesthesia.

One hundred forty-eight adult patients having epidural anesthesia for cesarean section, postpartum tubal ligation, lower extremity orthopedic procedures, or lithotriptic therapy were assigned to five groups. Group 1 patients were given a commercially prepared 1.5% lidocaine solution with 1:200,000 epinephrine plus 1 ml of normal saline per 10 ml of lidocaine; the solution pH was 4.6. Group 2 patients were given commercially prepared 1.5% lidocaine solution plus 1:200,000 epinephrine, with 1 mEq (1 ml) NaHCO3 per 10 ml of lidocaine; the solution pH was 7.15. Group 3 patients received the commercial solution of 1.5% lidocaine with 1:200,000 epinephrine; the solution pH was 4.55. Group 4 patients were given a mixture of 18 ml of 2% lidocaine with 30 ml of 1.5% lidocaine, both commercially packaged with 1:200,000 epinephrine, plus 1 mEq (1 ml) of NaHCO3 added per 10 ml of solution; the solution pH was 7.2. Group 5 patients received 1.5% plain lidocaine to which epinephrine was added to a final concentration of 1:200,000; the solution pH was 6.35. Times of onset of analgesia (time between the completion of the anesthetic injection and loss of scratch sensation at the right hip (L-2 dermatome] and of surgical anesthesia (time between completion of injection and loss of discomfort following tetanic stimulation produced by a nerve stimulator applied to skin on the right hip) were significantly more rapid in the groups that received the pH-adjusted solutions (groups 4 and 2). Group 4 had the fastest mean onset time, 1.92 +/- 0.17 min, followed by group 2, 3.31 +/- 0.23 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗
PubMed1985

Pulsed galvanic stimulation: effects of current frequency and polarity on blood flow in healthy subjects.

The effects of pulsed galvanic stimulation on peripheral blood flow were studied in ten healthy volunteers. Electrodes were placed over vascular channels of the upper extremity and stimulation was carried out at several frequencies on two occasions with polarity reversed. Changes in blood flow and cutaneous temperature were measured by photoplethysmography and cutaneous thermistors, respectively. A trend toward greater blood flow was seen at the highest frequencies and negative polarity. There were no significant temperature variations from baseline with any frequencies. This study suggests that, based on clinical evidence, able-bodied volunteers may vary in response from patients with vasospastic disorders.

Adult↗
PubMed1984

Frostbite.

Explore the source record for details and available documents.

Child↗
PubMed1982

Treatment of bladder pain with transsacral nerve block.

Fifteen patients with bladder spasticity and pain of three different etiologies were referred to the pain clinic by urologic specialists. These patients were refractory to all prior methods of treatment, excluding major surgical procedures. In a prospective study started in 1976, these patients were treated with transsacral nerve blocks using 0.25% bupivacaine and, in most cases, subsequent 6% aqueous phenol at the right S-3 ventral foramen. If indicated, transsacral nerve blocks were performed at other levels, as described in the text. Of the patients studied 53% have had significant or complete relief of pain for an average of 26.5 months. The associated morbidity was negligible and there was no mortality. This is in contrast to the morbidity and mortality associated with some major surgical "curative" procedures. The technique is proposed as a successful and economical approach to treatment that can be managed on an outpatient basis.

Bupivacaine↗
PubMed1981

Coordinated out-patient management of chronic pain at the University of Virginia Pain Clinic.

The Pain Clinic at the University of Virginia Medical Center is a comprehensive facility providing a coordinated team approach to the management of chronic pain syndromes. The Clinic is primarily an out-patient facility, although in-patient therapy in clinic-assigned beds is available for special problems. Approximately 1,500 new patients are seen annually in the Clinic's own facilities, resulting in approximately 3,500 patient visits. All diagnostic facilities are readily available, and all somatic modulation and psychotherapeutic techniques are utilized for pain management. Referrals are accepted only from physicians and then only after all medical records, the Clinic's Patient Assignment Inventory Narrative (a screening brochure), and special studies are reviewed. The initial evaluation includes, as well, history taking, physical examination, psychological testing and interview, special studies, specialty consultations, and family interview. A therapeutic plan is then developed and discussed with the patient and family members. The Clinic's philosophy is to encourage the patient to assume responsibility for all aspects of the treatment program including drug detoxification, activity and exercise programs, and functional performance.

Chronic Disease↗
PubMed1978

Relieving pain with nerve blocks.

Pain syndromes in elderly patients are seldom psychogenic or due merely to "old age." Careful differential diagnosis is important, as judicious use of nerve blocks as adjunctive therapy often can relieve pain and restore activity. In the acute phase of shoulder pain, intrabursal injection of local anesthetic and steroid inhibits the inflammatory process. In the later stages, suprascapular nerve block relieves pain and interrupts afferent pain pathways. The occipital pain and headache of cervical arthritis also often respond to injection of 2 to 3 ml of long-acting anesthetic into the greater and lesser occipital nerves at the sites where they pierce the trapezius. Minor causalgia, shoulder-arm syndrome, or chronic traumatic edema may follow either forearm fracture or inflammation around the shoulder joint. Five stellate ganglion blocks with 1% lidocaine on alternate days, followed by 3 to 4 months of active and passive exercise, is the most effective treatment. This regimen usually produces a fully functional extremity. In degenerative disk disease, osteoarthritis, and metastatic disease, the cause of back pain is essentially the same--edema and inflammation of nerve roots at the intervertebral foramina. Injection of local anesthetic and steroid into the epidural space usually reduces swelling and inflammation. Patients are evaluated in 2 weeks and reblocked if improvement has plateaued. Pain relief most often is prompt and persists for an indefinite period.

Acute Disease↗