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Biomedical subjects

O B Hansen

Publications and source records attributed to O B Hansen.

17 recordsLinked to original sources
PubMed2006

Breakthrough pain in opioid-treated chronic non-malignant pain patients referred to a multidisciplinary pain centre: a preliminary study.

BACKGROUND: Breakthrough pain (BTP) has not formerly been discussed as such in chronic non-malignant pain patients referred to pain centres and clinics. The purpose of the study was to investigate the prevalence, characteristics and mechanisms of BTP in opioid-treated chronic non-malignant pain patients referred to a pain centre and to assess the short-term effects of pain treatment. METHODS: Patients were assessed at referral (T(0)) and after a treatment period of 3 months (T(3)) using the visual analogue scale (VAS) of the brief pain inventory (BPI) within somatic nociceptive, neuropathic and/or visceral pain conditions, the mini mental state examination (MMSE) and the hospital anxiety and depression scale (HADS). The main treatment intervention from T(0) to T(3) was to convert short-acting oral opioids to long-acting oral opioids and to discontinue on demand and parenteral use of opioids. RESULTS: Thirty-three patients were assessed at T(0) and 27 at T(3). The prevalence of BTP declined significantly from T(0) (90%) to T(3) (70.4%). Worst, least, average and current pain intensities as well as duration of BTP were significantly reduced from T(0) to T(3.) The majority of BTPs were exacerbation of background pain assumed to be of the same pain mechanisms. High average pain intensity (BPI) was significantly associated with high scores for both anxiety and depression (HADS). CONCLUSION: BTP in chronic non-malignant pain patients seems to be surprisingly frequent and severe. Stabilizing the opioid regimen seems to reduce pain intensity in general as well as the intensity and duration of BTP. Average pain intensity was associated with anxiety and depression.

Administration, Oral↗
PubMed2001

Low back pain in Norwegian helicopter aircrew.

The size and consequences of low back pain (LBP) in Norwegian helicopter aircrew has been investigated in a retrospective and prospective survey. With 50.5% reporting such pain in a 2-yr period, and Sea King aircrew reporting LBP on on almost half (49.3%) of the missions flown, the magnitude of the problem equals that reported from other air forces. Pilots reported LBP six times more often than other crewmembers and almost half (48.6%) felt the pain influenced the quality of work. This could have flight safety implications. Crewmembers with total flying time over 2,000 h have a significantly higher incidence of sick leave than those with less than 2,000 h. Only 1 pilot out of 10 with total flying time under 500 h had had flight-related LBP.

Aerospace Medicine↗
PubMed1994

[Time consumption at an orthopedic operating theatre. Physicians' ability to predict their own time consumption].

The aim of the study was to investigate the time spent on different procedures in an orthopaedic operating theatre, and to evaluate the ability of doctors to predict their own time consumption. Time schedules were registered for 146 operations, of these 104 were either knee or hip replacements. Sixty percent of the total time was spent on surgery. The median misjudgment was 15 minutes for surgeons and five minutes for anaesthetists. An improvement in the doctors' ability to predict their own time consumption in the course of the study period could not be demonstrated. Comparing the study period with the similar period the year before it was not possible to demonstrate a change in the number of cancelled operations or the number of days with overtime. Epidural anaesthesia with bupivacaine was the most time consuming anaesthesia, the differences between the other forms of anaesthesia used were insignificant.

Denmark↗
PubMed1993

Enhanced heart rate response to haemorrhage by ileus in the pig.

Effects of ileus on cardiovascular and hormonal responses to haemorrhage were evaluated in 10 anaesthetized pigs. Ileus was induced and the bleeding sequence repeated on the following day. Before ileus, a resting heart rate (HR) of 105 (range 83-140) beats min-1 remained unchanged until haemorrhage amounted to 15% of the blood volume. With a blood loss of 28% HR increased to a maximum of 162 (126-245) beats min-1. In contrast, ileus increased HR upon initiation of haemorrhage from a similar resting value to a maximum of 200 (152-250) beats min-1 (P < 0.0005). There were neither statistical differences in mean arterial pressure, cardiac output, central venous pressure, thoracic electrical impedance, pulmonary arterial mean pressure, pulmonary wedge pressure, pulmonary and systemic vascular resistances, nor in plasma concentrations of dopamine, adrenaline, vasopressin and aldosterone during haemorrhage before and after ileus. Plasma noradrenaline increased more with haemorrhage after than before ileus: from 2.8 (1.2-5.0) to 13 (2.3-59.0) vs. 3.0 (1.5-4.2) to 3.6 (2.7-17.5) nmol l-1 (P < 0.005). Also, the pancreatic polypeptide response to haemorrhage was enlarged with ileus (29 (0-60) to 90 (45-145) vs. 23 (0-64) to 57 (27-106) pmol l-1 (P < 0.005)). No significant differences could be detected in cardiovascular and hormonal responses to haemorrhage before and after a sham-operation in three pigs. Results demonstrate an immediate and enhanced HR response to haemorrhage in the pig with ileus, reflected in sympathetic activation as indicated by plasma noradrenaline.

Animals↗
PubMed1993

The effect of epidural anaesthesia with 1% lidocaine on the pressor response to dynamic exercise in man.

1. In order to examine the sensitivity to local anaesthetics of afferent neural feedback from working muscle during dynamic exercise, sixteen subjects cycled for 12 min before and after epidural anaesthesia using 1% lidocaine. The presence of afferent neural blockade was verified by elimination of the blood pressure response to a cold pressor test, laser-induced evoked potentials and increases in pain detection and tolerance thresholds of the foot. Conversely, epidural anaesthesia had no effect on these variables in the unblocked skin areas or on electrically evoked potentials in blocked or unblocked skin. 2. During dynamic exercise, heart rate increased as did mean arterial pressure and cardiac output. Mean arterial pressure remained at the exercise level during post-exercise ischaemia, but heart rate and cardiac output decreased while total peripheral resistance increased. Epidural anaesthesia did not significantly affect these variables during rest, dynamic exercise, post-exercise ischaemia or recovery. 3. The results of this study show that, in order to affect blood pressure during dynamic exercise, epidural anaesthesia must block the pressor response to post-exercise ischaemia. The implication of these data is that complete or almost complete block of group III and/or group IV muscle afferents is necessary to inhibit the pressor response to dynamic exercise in man.

Adult↗
PubMed1991

CVP catheter electrocardiography: an alternative to radiographic control after cannulation of central veins?

We evaluated 160 electrocardiograms taken after placement of central venous catheters (CVC) to determine their locations. Usable recordings were obtained in 154 patients. Subsequent radiographs revealed 30 misplaced catheters. Twenty-five of those were detected by CVC electrocardiograms. There were five false positive and five false negative traces. The sensitivity of CVC electrocardiography was 96%, the specificity 83.3%, and the total predictive power 93.5%. Electrocardiograms obtained from guide-wires were of significantly better quality than those from 0.9% NaCl filled catheters. The technique is accurate, safe and easy to learn. It may reduce the need for routine radiographic control to less than 10% of patients.

Adolescent↗
PubMed1990

Effect of surgery on sensory threshold and somatosensory evoked potentials after skin stimulation.

We have studied the effect of surgical injury on cutaneous sensitivity and somatosensory evoked potentials (SSEP) to dermatomal electrical stimulation in 10 patients undergoing hysterectomy. Forty-eight hours after surgery, sensory threshold increased from 2.2 (SEM 0.3) mA to 4.4 (1.1) mA (P less than 0.01) and SSEP amplitudes in P1, N1, P2 and the peak-to-peak amplitudes decreased (P less than 0.05). Latency was prolonged only in the N3 component (P less than 0.05). No changes were seen in threshold and SSEP in a control group studied over the same interval. The results suggest that surgical injury activates antinociceptive modulatory systems.

Adult↗
PubMed1989

Effect of epidural clonidine on somatosensory evoked potentials to dermatomal stimulation.

The effect of lumbar epidural clonidine 150 micrograms on early (less than 0.5 s) somatosensory evoked potentials (SEP) to electrical stimulation of the L1 and S1 dermatomes was examined in twelve cancer patients. Epidural clonidine led to a minor but significant decrease in amplitude of two components (N1 and N3) following S1 stimulation while SEP latency was prolonged only in the P1 and P3 components (P less than 0.05). In all patients the pain score decreased, mean score at rest from 4.9 +/- 0.5 to 0.6 +/- 0.2 and during mobilization from 7.4 +/- 0.6 to 1.3 +/- 0.5 (P less than 0.01). Mean systolic and diastolic blood pressures decreased from 118 +/- 4/72 +/- 5 mmHg to 99 +/- 5/60 +/- 3 mmHg (P less than 0.01), respectively. It is concluded that epidural clonidine has a minor effect on the early SEPs to electrical dermatomal stimulation. Additionally, a pronounced effect on cancer pain was seen.

Aged↗
PubMed1987

Effect of extradural morphine on somatosensory evoked potentials to dermatomal stimulation.

The effect of the extradural (L2-3) administration of morphine 6 mg on early (less than 0.5 s) somatosensory evoked cortical potentials (SEP) to electrical stimulation of the L1- and S1-dermatomes was examined in eight patients. Extradural morphine did not influence SEP amplitude. SEP latency did not change, except for a minor increase in the latencies of the onset and the P2 components following S1 stimulation.

Adult↗
PubMed1987

Effect of intrathecal bupivacaine on somatosensory evoked potentials following dermatomal stimulation.

The effect of spinal anesthesia with 3.6 +/- 0.1 ml (mean +/- SEM) of 0.5% bupivacaine on early (less than 150 msec) somatosensory evoked potentials (SEPs) with electrical stimulation of the L1 and S1 dermatomes was examined in 12 patients. The mean level of sensory analgesia (pinprick) was T8,9 +/- 1.0 (+/- SEM) and the mean degree of motor blockade was 1.3 +/- 0.1 (Bromage scale). Intrathecal bupivacaine significantly (P less than 0.05) decreased the amplitude of all SEP components after stimulation of the L1 dermatome and most components during stimulation of the S1 dermatome. Intrathecal bupivacaine also increased the latency of SEPs (P less than 0.05) of both dermatomes. The L1 SEP disappeared in 7 and the S1 SEPs in 5 of the 12 patients during neural blockade. In three patients the SEPs disappeared at both locations. Sensory thresholds increased significantly during blockade. We found no correlation between decrease of amplitude and degree of motor blockade or level of sensory analgesia. Thus, intrathecal plain bupivacaine has a strong depressant effect on the neural afferent transmission as assessed by SEPs. However, despite clinically effective blockade as assessed by pinprick and motor blockade nerve potentials after nociceptive stimulation within the area of sensory block were often able to pass to the cerebral cortex.

Adult↗
PubMed1987

Effect of thoracic epidural bupivacaine on somatosensory evoked potentials after dermatomal stimulation.

The effect of epidural bupivacaine (9 ml 0.5%) analgesia on early (less than 500 msec) somatosensory evoked potentials (SEPs) with electrical stimulation of the T-10 and L-1 dermatomes was examined in eight patients. Cortical amplitudes decreased only insignificantly after stimulation of both dermatomes, despite the presence of sensory analgesia (pin prick) from T-3.5 +/- 0.4 to L-2.9 +/- 0.4 (mean +/- SEM). Latency of the SEP components remained unchanged and sensory threshold increased only insignificantly during blockade. We conclude that thoracic epidural analgesia with conventional doses of bupivacaine provides only a limited blockade of fast conducting afferent nerve fibers.

Adult↗
PubMed1987

Effect of epidural bupivacaine on somatosensory evoked potentials after dermatomal stimulation.

The effect of lumbar epidural analgesia with plain bupivacaine, 0.5%, on early (less than 0.5 sec) somatosensory evoked potentials (SEP) to electrical stimulation of the T-10, L-1, and S-1 dermatomes and the posterior tibial nerve was examined in eight patients. A decrease of the cortical amplitude and an increase in latency were seen, most pronounced at the L-1 level, but with only minor effect on the S-1 dermatome. No correlation was found between segmental level of analgesia and decrease in amplitude of the evoked potentials. Thus despite clinically adequate surgical anesthesia, the neural pathways as assessed by SEP were incompletely blocked except at the L1 dermatome near the epidural injection site.

Adult↗
PubMedDate not supplied

Effects of etidocaine administered epidurally on changes in somatosensory evoked potentials after dermatomal stimulation.

The effect of lumbar epidural anesthesia with similar volumes (approximately 20 ml) of 1% and 1.5% etidocaine on early (less than 0.5 seconds) somatosensory evoked potentials (SEPs) to electrical stimulation of the S1, L1, and T10 dermatomes was examined in two groups of ten patients in a randomized, double-blind study. Level of analgesia to pinprick was T7.7 +/- 0.9 in the 1% group and T6.6 +/- 0.6 in the 1.5% group and all patients had total motor block. Despite similar analgesia to pinprick, SEP amplitude was more reduced in the 1.5% group, in which SEPs were abolished in all patients at the L1 level.

Adult↗
PubMedDate not supplied

Effect of epidural 0.25% bupivacaine on somatosensory evoked potentials to dermatomal stimulation.

The effect of lumbar epidural analgesia with similar volumes (about 25 ml) of 0.25% and 0.5% bupivacaine on early (less than 0.5 seconds) somatosensory evoked potentials (SEPs) to electrical stimulation of the S1, L1, and T10 dermatomes was examined in two groups of ten patients. Level of sensory analgesia to pinprick was T5.7 +/- 0.8 and T6.4 +/- 0.7 in the 0.25% and 0.5% bupivacaine group, respectively. Motor blockade was more pronounced in the 0.5% bupivacaine group (p less than 0.05). Despite similar analgesia to pinprick, SEPs were more reduced during 0.5% bupivacaine than during 0.25%. These results support previous findings that quantitative assessment of neural blockade by SEP measurements may be more precise than pinprick analgesia.

Adult↗