Electronic anesthesia. Electrotherapy in medicine.
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Biomedical subjects
Publications and source records attributed to C N Shealy.
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The basic neuroanatomic and physiologic aspects of the sympathetic outflow to the limbs are reviewed and correlated with the somatic sensory dermatomes. The recent literature is considered. A thermocouple thermometer was used to test 30 normal patients and 87 patients with clinically proven nerve root lesions. Thermographic imaging of the sensory dermatome is not plausible, and thermography is not recommended for clinical documentation of painful conditions of the neck, back, or limbs.
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In acute pain, TENS, ice packs, and a calm, reassuring attitude and voice are useful in reducing pain. Narcotic requirements can be reduced, and chronic pain may be prevented. Complications such as paralytic ileus and atelactasis can also be reduced. These techniques can be used in the emergency ward, the recovery room, and the doctor's office.
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A technique for radiofrequency localization and coagulation of articular nerves supplying the spinal facets is described and results are reported from a series of 207 patients followed 6 to 21 months (mean 31 months). Relief of pain was achieved in 79% of previously unoperated patients, in 41% of those with laminectomy but no fusion, and in 27% of those with an earlier fusion. No neurological complications were encountered.
Results are reviewed of dorsal column electrical stimulation for chronic pain in a series of 80 patients. In the light of the experience gained from this series, indications and patient suitability for this form of therapy are discussed. Complications occurring after implantation are tabulated.
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