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Biomedical subjects

Melvin C Gitlin

Publications and source records attributed to Melvin C Gitlin.

5 recordsLinked to original sources
PubMed2003

President's message.

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History, 20th Century↗
PubMed2002

Improvement in the level of psychosocial functioning in chronic pain patients with the use of risperidone.

Psychiatric morbidity is a common complication of chronic pain. Psychopathology may lead to psychosocial dysfunction and poor prognosis for rehabilitation. Emotional factors associated with chronic pain may include depression with anxious and angry affect. Antidepressant medication is a common adjuvant pharmacological treatment in the chronic pain patient. While uncomplicated depression may respond well to antidepressants, some cases are treatment resistant. We present two cases of chronic pain patients with associated depression with angry affect that did not respond to conventional treatment. Addition of the atypical antipsychotic risperidone resulted in symptomatic improvement and higher levels of psychosocial functioning. Atypical antipsychotics may be useful in selected patients with chronic pain and treatment-resistant depression.

Journal Article↗
PubMedDate not supplied

Dexmedetomidine and low-dose ketamine provide adequate sedation for awake fibreoptic intubation.

PURPOSE: We report the use of the alpha2 agonist, dexmedetomidine, with low-dose ketamine as a safe and effective treatment strategy to provide adequate comfort and sedation for a patient who fulfilled criteria of a difficult airway and required awake fibreoptic intubation (AFOI). CLINICAL FEATURES: A 52-yr-old male with prostate cancer presented for radical prostatectomy. He reported several failed intubations with previous surgeries and airway examination was consistent with a difficult intubation. In addition, previous fibreoptic intubations were unsuccessful. The patient reported extreme apprehension concerning his airway management. The goal of medicating patients for AFOI includes providing comfort and sedation without causing a change in ventilatory status. Dexmedetomidine has a high affinity for the alpha2 receptor and results in sedation without change in ventilatory status. In addition, dexmedetomidine is a potent anti-sialgogue which makes it desirable for cases involved with airway instrumentation. A loading dose of dexmedetomidine followed by a continuous infusion provided comfort and sedation within ten minutes. While bradycardia and hypotension have been reported with dexmedetomidine use, concurrent low-dose ketamine was employed in this case for it's cardiostimulatory properties and no bradycardia and hypotension were noted. The airway was anesthetized with selective nerve blocks and conditions for airway instrumentation were excellent. There was no change in oxygen saturation or ventilatory status during the administration of medications or airway manipulation. The patient was comfortable, sedated and tolerated the procedures well. There was no recall of the procedure. CONCLUSION: Dexmedetomidine and concurrent low-dose ketamine provided sedation and comfort to this patient who required an AFOI.

Dexmedetomidine↗