Pain Management and Anesthesiology: Papers presented at the 43rd Annual Postgraduate Course in Anesthesiology, February 1998 PDF
Preview Pain Management and Anesthesiology: Papers presented at the 43rd Annual Postgraduate Course in Anesthesiology, February 1998
PAIN MANAGEMENT AND ANESTHESIOLOGY DEVELOPMENTS IN CRITICAL CARE MEDICINE AND ANESTHESIOLOGY Volume 33 The titles published in this series are listed at the end of this volume. PAIN MANAGEMENT AND ANESTHESIOLOGY Papers presented at the 43rd Annual Postgraduate Course in Anesthesiology, February 1998 edited by MICHAEL A. ASHBURN, PERRY G. FINE AND THEODORE H. STANLEY Department of Anesthesiology, The University of Utah Medical School, Salt Lake City, Utah, USA. SPRINGER-SCIENCE+BUSINESS MEDIA, B.V. A CLP. Catalogue record for this book is available from the Library of Congress. ISBN 978-94-010-6162-9 ISBN 978-94-011-5145-0 (eBook) DOI 10.1007/978-94-011-5145-0 Printed on acid-free paper Al l Rights Reserved ©1998 Springer Science+Business Media Dordrecht Originally published by Kluwer Academic Publishers in 1998 Softcover reprint of the hardcover 1st edition 1998 No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner TABLE OF CONTENTS Preface ix List of Contributors xi Mechanisms of Opioid Analgesia and Tolerance Allan Basbaum 1 Descending Facilitation of Pain Gerald F. Gebhart 13 The Contribution of NMDA and Second Messengers to the Persistent Pain States Produced by Tissue and Nerve Injury Allan Basbaum 19 New Clinical Pharmacology Concepts in Pain Management Talmage D. Egan 29 The Contribution of Substance P to Long-term Changes in the Spinal Cord Dorsal Horn: Reorganization in the Setting of Persistent Injury Allan Basbaum 55 Pain and the Surgical Stress Response Henrik Kehlet 65 Visceral Pain and Visceral Hyperalgesia Gerald F. Gebhart 75 Postoperative Pain: Assessment and Choice of Methods of Treatment L. Brian Ready 81 Patient-controlled Analgesia (Part I): Historical Perspective Paul F. White 95 VI Peripheral Treatment of Acute Pain Henrik Kehlet and Juri Lind Pedersen 103 Patient-controlled Analgesia (Part II): Update on Its Clinical Usage Paul F. White 109 Organization and Operation of an Acute Pain Server L. Brian Ready 125 Use of Non-opioid Analgesic Techniques Paul F. White 137 Pain Management in Children Linda Jo Rice 153 Effect of Postoperative Pain on Surgical Outcome Henrik Kehlet 167 Pain Assessment in Kids-The Fifth Vital Sign Linda /0 Rice 173 Complications and Relative Safety of Regional Anesthesia in Children Lynn M. Broadman 185 Pediatric Sedation Challenges Outside the Operating Room Linda /0 Rice 205 Spinal Opioids: Clinical Applications for Acute and Chronic Pain Suellen M. Walker, Michael f. Cousins, and Daniel B. Carr 217 Epidural Steroids Alan P. Winnie 237 vii Mechanisms and Treatment of Spinal Cord Injury Pain: An Update Philip J. Siddall, David A. Taylor, and Michael J. Cousins 247 Prevention of Post-Herpetic Neuralgia Alon P. Winnie 263 Update on Anatomy, Physiology and Pharmacology of Epidural Neural Blockade Michael J. Cousins and Bernadette T . Verring 277 The Interface Between Acute and Chronic Pain Management L. Brian Ready 295 Radiation Safety for the Pain Physician and the Use of a Laser Guided C-arm to Facilitate Pain Block Placements Lynn M. Broadman 303 Preface Michael A. Ashburn, M.D. Pain contains the refresher course manuscripts of the 43rd Annual Postgraduate Course in Anesthesiology which took place at the Cliff Conference Center in Snowbird, Utah on February 20-24, 1998. The chapters reflect recent advances in the understanding of the basic science and clinical management of pain. Sections on basic science related to pain processes as well as sections on the clinical management of acute, chronic, cancer-related, and pediatric pain are included. Each chapter represents a focused summary of the salient points pertaining to the subject of interest and has been edited only to the extent necessary to produce a coherent book. The purposes of this textbook are to 1) act as a reference for the individuals attending the meeting and 2) serve as a concise review of the topic for those unable to participate in the meeting. Each presentation is intended to stand by itself, but the views expressed by the multiple authors offer the reader the opportunity to understand the multifaceted aspect of this field. This textbook is the sixteenth in a continuing series documenting the proceedings of the postgraduate course in Salt Lake City. We hope that this series continues to serve as a resource to document the continuing evolution of anesthesiology and pain management. ix T. H. Stanley et al. (eds.), Pain Management and AnestheSiology, ix. © 1998 Kluwer Academic Publishers. LIST OF CONTRIBUTORS Allan Basbaum, PhD Department of Anatomy, University of California, San Francisco, San Francisco, California, U.S.A. Lynn M. Broadman, M.D. Departments of Anesthesiology and Pediatrics, West Virginia University, Morgantown, West Virginia, U.S.A. Daniel B. Carr, MD, PhD Departments of Anaesthesia and Medicine Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts, U.S.A. Michael J. Cousins, AM, MBBS, MD, FRCA, FANZCA Department of Anesthesia and Pain Management, University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia Talmage D. Egan, MD Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A. Gerald F. Gebhart, PhD Department of Pharmacology, The University of Iowa College of Medicine, Iowa City, Iowa, U.S.A. Henrik Kehlet, MD, PhD Department of Surgical Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark Juri Lindy Pedersen, MD Department of Surgical Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark L. Brian Ready, MD Acute Pain Service, University of Washington School of Medicine, Seattle, Washington, U.S.A Linda Jo Rice, MD Anesthesia Specialists, St. Petersburg, Florida, U.S.A. xi xii Philip J. Siddall, MBBS, PhD, MMed (Pain Management) Department of Anesthesia and Pain Management, University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia David A. Taylor, MA (Hons), MAppliedSc, PhD Department of Anesthesia and Pain Management, University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia Bernadette T. Verring, MD, PhD Department of Anaesthesiology, University of Leiden, Leiden, The Netherlands Paul F. White, PhD, MD, FFARACS, FANZCA Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, U.s.A. Suellen M. Walker, MBBS, FANZCA Department of Anesthesia and Pain Management, University of Sydney Royal North Shore Hospital, St. Leonards, NSW, Australia Alon P. Winnie, MD Department of Anesthesiology and Critical Care, Cook County Hospital, Chicago, Illinois 60612
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