PubMed Health⌕ Search

Biomedical subjects

B J Urban

Publications and source records attributed to B J Urban.

At least 19 recordsLinked to original sources
PubMed1991

Cerebrospinal fluid concentrations of beta-endorphin in chronic low back pain patients. Influence of depression and treatment.

Cerebrospinal fluid (CSF) beta-endorphin concentrations were determined before and after treatment in 28 patients suffering chronic neuralgic low back pain/sciatica. Nine patients carried the additional diagnosis of major depressive disorder. Pain treatment was multimodal and resulted in variable pain reduction. CSF beta-endorphin concentrations spanned a wide range with no association to age, gender, pain ratings, depressive symptomatology, and drug intake. CSF beta-endorphin concentrations were not influenced by the presence of major depressive disorder and did not change with successful treatment of pain and resolution of depression.

Adult↗
PubMed1984

Treatment of chronic pain with nerve blocks and stimulation.

Nerve blocks and impulse augmentation represent two relatively noninvasive somatic procedures of use in the treatment of some chronic pain patients. In this paper the author outlines the clinical evidence for these procedures and the nature of the procedures. The author argues for their usefulness in modulating pain and their place within a more complete multi-disciplinary program.

Afferent Pathways↗
PubMed1984

Long-term use of narcotic analgesics in chronic pain.

The use of narcotic analgesics have been avoided by clinicians in patients with chronic pain syndromes. Uncertainty as to the etiological cause of chronic pain, development of addiction and habituation and associated psychological and behavioral symptoms found in chronic pain states which are not amenable to narcotic medications are the major reasons narcotics are not prescribed. This communication describes the long-term use of low dose narcotic analgesics as a treatment component of a comprehensive pain management program and addresses the questions of whether or not narcotic efficacy is maintained in long-term use, improvement of patients' function is continued and side effects develop as a result of this treatment.

Adolescent↗
PubMed1983

The effects of intravenous regional guanethidine and reserpine. A controlled study.

We investigated the effects of intravenous regional injection of guanethidine and reserpine in a prospective, randomized, double-blind study of seven volunteers. The sympatholytic activities of these drugs were assessed separately for cholinergic and adrenergic function. Cold challenge was employed to magnify the effect on digital temperatures and alterations in pulse-volume. Only guanethidine significantly increased temperature (p less than 0.025) after cold challenge, this effect lasting for three days. No anticholinergic effect was found. Intravenous regional guanethidine may be useful in the treatment of vasospastic disorders and as prophylaxis for surgically treated patients in whom this complication may be expected to occur.

Adult↗
PubMed1982

Combined epidural and peripheral nerve stimulation for relief of pain. Description of technique and preliminary results.

A technique is described that combines percutaneous epidural with peripheral nerve stimulation to provide limited paresthesia to a lower extremity. The peripheral electrode is placed percutaneously and positioned along the course of the anterior division fo the spinal nerve anterolateral to the vertebral bodies. This is accomplished by a modified epidural tap. Combined stimulation was carried out in 23 patients with intractable leg pain. Sixteen patients proceeded to chronic autostimulation; follow-up time extended to 18 months. The procedure proved simple; there were no perioperative and only few minor late complications. Results were similar to those from conventional epidural stimulator implantation. It is concluded that combined epidural-peripheral nerve stimulation constitutes a valid therapeutic alternative for patients with unilateral lower extremity pain.

Adult↗
PubMed1982

Onset and progression of intravenous regional anesthesia with dilute lidocaine.

Intravenous regional anesthesia was induced in seven healthy volunteers using dilute lidocaine solution. Onset and progression were documented by sequential detailed neurologic examinations and compared with changes following intravenous regional administration of normal saline. On average, lidocaine produced sensory loss earliest on the radial forearm and in the first dorsal web space, although the sequence of development of analgesia was variable, e.g., fingertip analgesia could occur before or after forearm sensory loss. Motor paralysis could precede or follow sensory loss in tissues supplied by the same peripheral nerve; the only consistent finding was persistence of strength in the flexor digitorum profundus of the little finger. The pattern of development of intravenous regional anesthesia was related to the anatomic distribution of the peripheral nerves; it is hypothesized that the primary mechanism of action is block of the small distal nerve branches.

Adult↗
PubMed1978

Percutaneous epidural stimulation of the spinal cord for relief of pain. Long-term results.

Percutaneous epidural stimulation of the spinal cord was carried out in 20 patients with intractable pain. The procedure proved simple, and no major complications were encountered. The long-term results were comparable to the results obtained after a dorsal column stimulator implant by laminectomy. The percutaneous technique allowed extended trial stimulation without committing the patient to a major operation. Those patients in whom stimulation did not alleviate pain could be identified during a 2-week observation period, and the system could be removed easily. Seven patients were placed on chronic autostimulation and only one of those failed to experience continuing pain relief throughout the follow-up time of up to 2 years. It is concluded that percutaneous epidural stimulation constitutes a valid alternative to dorsal column stimulator implantation.

Adult↗
PubMedDate not supplied

Upper extremity pain of 10 years duration caused by a glomus tumor.

BACKGROUND AND OBJECTIVES: Long-standing limb pain typically has a multifactorial etiology not amenable to causal therapy. We present a case of chronic progressing upper extremity pain caused by a glomus tumor; the excision was curative. METHODS: A 39-year-old woman presented with 10-year history of constant deep internal throbbing, aching pain localized to the radial aspect of the left index finger and additional intermittent shooting pains radiating up the arm toward the shoulder. Pain was increased after minor local trauma, following cold exposure, and for unknown reasons. A blotchy, bluish skin discoloration could appear on the radial aspect of the index finger during severe pain. Nonsteroidal antinflammatory drugs, narcotics, amitriptyline, local heat, bracing, and a sympathetic nerve block had all been ineffective. The physical examination was characterized by exquisite pressure tenderness over the radial aspect of the left index finger, most pronounced just distal to the distal interphalengeal joint. RESULTS: Inflation of a left arm blood pressure cuff to above systolic pressures abolished pain. A glomus tumor was suspected and confirmed by histologic examination. CONCLUSIONS: Glomus tumors are rare, benign neoplasms (1 to 5% of all hand tumors), developing from neuromyoarterial glomus bodies. They usually present with pain and may mimic other painful conditions, delaying the average time until diagnosis for up to 10 years. The classic diagnostic triad consists of local pain, pressure tenderness, and cold hypersensitivity. Abolition of pain following inflation of a blood pressure cuff to above systolic levels (ischemia test) is highly diagnostic. We suggest routine use of this test in cases of upper limb pain of unclear etiology.

Adult↗