Abstract:
BACKGROUND:Chronic pain of nonmalignant origin requires effective long-term treatments, as for many patients pain management will be necessary throughout the rest of their lives. Intrathecal drug delivery systems (IDDS) have become a recognized therapy for the management of severe and otherwise intractable chronic pain. However, it is still not clear whether this treatment can be effective for periods up to 10 years or longer, given the paucity of long-term follow-up. This study sought to examine the effectiveness of IDDS following an average of 13 years postimplantation. METHODS:Twenty patients participated in a longitudinal study with an average follow-up of 13.5 years (range: 10.4 to 17.9) after IDDS implantation. Investigation was carried out by means of a questionnaire before IDDS and after an average of 4 and 13 years of IDDS therapy. Assessment of pharmacological data and complications/side effects was performed. RESULTS:Statistically significant improvements between baseline and 4-year assessment were observed for the following sensory and psychosocial variables: pain intensity, pain relief, coping, self-efficacy, depression, quality of life, housework, mobility, sleep, and social life (all P<0.001). No statistically significant changes were detected between assessments at averages of 4 and 13.5 years. CONCLUSIONS:This study, with one of the longest follow-up intervals reported in the IDDS literature, shows that IDDS has the potential to be a life-long pain management solution in appropriately selected patients with chronic nonmalignant pain.
journal_name
J Neurosurg Anesthesioljournal_title
Journal of neurosurgical anesthesiologyauthors
Duarte RV,Raphael JH,Sparkes E,Southall JL,LeMarchand K,Ashford RLdoi
10.1097/ANA.0b013e31822ff779subject
Has Abstractpub_date
2012-01-01 00:00:00pages
63-70issue
1eissn
0898-4921issn
1537-1921journal_volume
24pub_type
杂志文章abstract::To reduce the incidence of neurological and neuropsychological dysfunction following hypothermic cardiopulmonary bypass (CPB), central nervous system (CNS) monitoring before, during, and after CPB seems to be necessary. Compared to the total scope of hemodynamic monitoring CNS monitoring, however, is mostly investigat...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00008506-199510000-00018
更新日期:1995-10-01 00:00:00
abstract::Overexpression of inducible Hsp70 has been shown to provide protection from cerebral ischemia both in animal models of stroke and in cell culture models. New work suggests that there are multiple routes of cell death, including apoptotic and necrotic cell death. Hsp70 is known to protect from both necrotic and apoptot...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00008506-200401000-00010
更新日期:2004-01-01 00:00:00
abstract::The relationship between intracranial pressure and arterial blood pressure during sevoflurane or halothane anesthesia was evaluated in New Zealand white rabbits after cryogenic brain injury. Fourteen rabbits were randomized to be anesthetized with 1.5 MAC of sevoflurane or halothane in oxygen. All animals were paralyz...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199410000-00006
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:In the previous study, we observed agmatine (AGM) posttreatment immediately after 30 minutes of suture occlusion of the middle cerebral artery (MCAO) reduced the infarct size and neurological deficit in diabetic rats. The aim of the present study was to investigate the anti-inflammatory effect of AGM to redu...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000195
更新日期:2016-07-01 00:00:00
abstract::We evaluated the optimal preemptive dose of gabapentin for postoperative pain relief after single-level lumbar diskectomy and its effect on fentanyl consumption during the initial 24 hours in a randomized, double-blinded, placebo-controlled study in 100 patients with American Society of Anesthesiologists physical stat...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ana.0000151407.62650.51
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Neonatal mice exposed to sevoflurane show certain cognitive and behavioral impairments in adulthood. However, the mechanisms underlying long-term cognitive deficits induced by sevoflurane exposure remain unknown. The present study was performed to investigate whether there is differential neuronal activation...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000387
更新日期:2018-01-01 00:00:00
abstract::The cause of the awareness under general anesthesia often cannot be definitely determined from retrospective reviews of handwritten records, examinations of equipment, or interviews with clinicians. Failure to deliver the intended concentrations of anesthetic agents to the patient is one possible contributing cause fo...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e318139f7df
更新日期:2007-10-01 00:00:00
abstract::The clinical effects, recovery characteristics, and costs of total intravenous anesthesia (TIVA), sevoflurane, and isoflurane anesthesia have been measured in various out-patient operations, but have not been evaluated in patients undergoing laminectomy or discectomy. In the current study, the authors assessed the hem...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00008506-200110000-00003
更新日期:2001-10-01 00:00:00
abstract:INTRODUCTION:Neurosurgical disorders are rare during pregnancy and challenge the anesthesiologist with conflicting anesthetic considerations and little evidence to guide decision-making. Our objective was to review the anesthetic management of pregnant patients undergoing intracranial neurosurgery at our institution an...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000029
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Prone positioning and positive end-expiratory pressure can improve pulmonary gas exchange and respiratory mechanics. However, they may be associated with the development of intracranial hypertension. Intracranial pressure (ICP) can be noninvasively estimated from the sonographic measurement of the optic nerv...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000295
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The purpose of the study was to compare the effects of equivolume, equiosmolar solutions of mannitol and hypertonic saline (HTS) on brain relaxation and postoperative complications in patients u...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ANA.0000000000000091
更新日期:2015-01-01 00:00:00
abstract::It has been suggested that N2O may alter the sensitivity of the brain to ischemia. To test this hypothesis. we examined the effects of N2O on the development of left-right hemispheric asymmetry in the electroencephalogram (EEG) during hemorrhagic hypotension in rats subjected to unilateral carotid occlusion. Rats were...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-198906000-00004
更新日期:1989-06-01 00:00:00
abstract::Fat embolism syndrome is a dire complication of long bone trauma. It is usually associated with neurological, hematological and respiratory involvement, the latter being the major cause of death. We present a case of severe fat embolism syndrome occurring 3 hours after a long bone injury, leading to permanent vegetati...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200007000-00004
更新日期:2000-07-01 00:00:00
abstract::In a rat model of middle cerebral artery occlusion (MCAo) and reperfusion (120 min), previous studies have demonstrated that hemodilution with molecular hemoglobin decreases ischemic brain injury. However, long-term recovery data on the therapeutic efficacy of molecular hemoglobin for cerebral ischemia are lacking. Ac...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::Translocation of cerebrospinal fluid (CSF) between the intracranial and spinal subarachnoid space was blocked by ligating the cervical spinal core in eight cats under pentobarbital and nitrous oxide anesthesia, and the effects of cerebral venous congestion on the pressure-volume index (PVI), a measure relating the cha...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199304000-00009
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:We compared the effect of propofol and sevoflurane combined with remifentanil under comparable bispectral index (BIS) levels on transcranial electric motor-evoked potentials (TceMEPs) and somatosensory-evoked potentials (SSEPs) during brainstem surgery. MATERIALS AND METHODS:A total of 40 consecutive patien...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ANA.0000000000000157
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The effect of propofol on proliferation of adult neural stem cells (ANSCs) is unclear. We investigated the effect of propofol on cultured rat ANSCs and the underlying molecular mechanisms, especially the role of activated cAMP response element binding protein (CREB). METHODS:Rat ANSCs were treated with prop...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e31828baa93
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Simple febrile seizure (SFS) affects 2% to 4% of children under 6 years of age. The purpose of this study is to examine the epidemiologic patterns and resource utilization of SFS-associated hospitalizations in children aged younger than 6 years of age in the United States. MATERIALS AND METHODS:This study i...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000546
更新日期:2019-01-01 00:00:00
abstract::The function of the central nervous system-and other organs-depends upon preservation of ionic gradients across cell membranes. In nervous tissue, the ion gradients are especially important since generation of action potentials and synaptic processes relies on transfer of ions across the plasma membrane. This report d...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-198912000-00010
更新日期:1989-12-01 00:00:00
abstract::Obstructive hydrocephalus remains a problem, and improvements in fiberoptic technology have promoted interest in neuroendoscopic ventriculostomy (NTV) as an alternative to standard cerebrospinal fluid shunts. The present study assessed 210 pediatric NTVs performed between 1994 and 2004 in patients aged 2 months to 10 ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::The affect of L-644,711, an anion transport inhibitor, on ischemic brain injury and edema was investigated. Spontaneously hypertensive rats were given one of the following doses of intrathecal L-644,711 during 180 min of middle cerebral artery occlusion and 120 min of reperfusion: control, vehicle only; dose I, 100 mi...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199112000-00003
更新日期:1991-12-01 00:00:00
abstract::Because deliberate hypothermia is becoming commonly used during neurosurgery, this study was performed to investigate the effects of a progressive reduction of body core temperature (T) on whole body oxygenation variables in patients undergoing elective intracranial surgery. In 13 patients (Hypothermic Group), T was r...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00008506-199707000-00001
更新日期:1997-07-01 00:00:00
abstract::Cerebral edema commonly accompanies brain tumors and frequently leads to lethal intracranial compartmental shifts and elevated intracranial pressure. Therapeutic modalities for tumor-associated cerebral edema include diuretics, osmotherapy, and corticosteroids. Recently, hypertonic saline (HS) has received attention a...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200207000-00003
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Albumin and mannitol may interfere with hemostasis, but their coinfluence is unclear. We aimed to determine the effects of albumin alone and in combination with mannitol or Ringer acetate (RAC) on hemostasis in crossover in vitro study. MATERIALS AND METHODS:From citrated fresh whole blood withdrawn from 10...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000438
更新日期:2018-07-01 00:00:00
abstract:PURPOSE:Measurement of brain stem auditory evoked potentials (BAEP) and midlatency auditory evoked potentials (MLAEP) using a new monitor integrated module was compared with an established device. The aim of this study was to evaluate if the new system could replace the more inconvenient established technique. MATERIA...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e3181990d00
更新日期:2009-04-01 00:00:00
abstract::The purpose of this study was to clarify whether prostaglandin E1 (PGE(1)) or corticosteroid could increase blood flow in the nerve root because neurologic symptoms in spinal stenosis may be based on the vascular insufficiency in the nerve root. Fifty-seven patients undergoing lumbar diskectomy were randomly assigned ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00008506-200304000-00002
更新日期:2003-04-01 00:00:00
abstract::Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, is widely used in pediatric anesthesia. Recently, a series of animal studies have shown that ketamine may have neurotoxic effects on the developing brain and that these effects can later cause neurofunctional impairment. However, other studies have also sho...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ANA.0000000000000027
更新日期:2014-04-01 00:00:00
abstract::This report describes a sudden decrease in blood pressure after conservative treatment of acute intracranial hypertension. A 63-year-old woman with acute hydrocephalus after undergoing clipping of an aneurysm of the right supracerebellar artery developed increased intracranial pressure, necessitating surgical manageme...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199804000-00008
更新日期:1998-04-01 00:00:00
abstract::Inflammatory response with cytokine release is reported to correlate with clinical outcome after aneurysmal subarachnoid hemorrhage (SAH). In selected cases, hypothermia and barbiturate coma are applied as means for neuroprotection after severe SAH. Hypothermia and high-dose barbiturate are reported to attenuate the i...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e31817996bf
更新日期:2008-07-01 00:00:00
abstract::Although perihematoma brain edema can significantly modify neurologic outcome after intracerebral hemorrhage (ICH), our knowledge of its natural history is incomplete. We report on the correlation between hematoma (HV) and edema volumes (EV) in 14 patients with ICH during the first week after the ictus using MRI volum...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200307000-00010
更新日期:2003-07-01 00:00:00