PubMed Health⌕ Search

Biomedical subjects

Y Shir

Publications and source records attributed to Y Shir.

51 records · Page 3Linked to original sources
PubMed1989

Extradural bupivacaine and methadone for extracorporeal shock-wave lithotripsy.

Combined extradural bupivacaine and methadone analgesia was investigated in 144 patients who underwent extracorporeal shock wave lithotripsy (ESWL). Patients were assigned randomly to one of three groups: group I--extradural 0.5% bupivacaine hydrochloride 0.75 mg kg-1; group II--extradural 0.1% methadone hydrochloride 4 mg after the bupivacaine; group III--as group II, plus a continuous extradural infusion of methadone 0.3 mg h-1 after operation. In all patients, only partial motor deficit occurred. During ESWL, patients who received extradural bupivacaine and methadone had significantly less pain compared with those who had bupivacaine alone (P less than 0.025). Extradural anaesthesia and immersion in the warm water bath were accompanied by only mild fluctuations in arterial pressure. After ESWL, significantly more patients with continuous methadone infusion were pain free (P less than 0.05) and they required less systemic analgesics. The anaesthesia during and after the ESWL procedure may be carried out safely and effectively by the administration of small doses of bupivacaine combined with methadone followed by infusion of the opioid.

Analgesia, Epidural↗
PubMed1988

Lack of sensitization of primary afferent receptors by prostaglandins in a rat model of causalgic chronic pains.

Unilateral entrapment of half of the sciatic nerve in a ligature rapidly produces in rats bilateral hyperalgesia: decreased withdrawal thresholds to von-Frey hair touch and to noxious CO2 laser heat pulses and unilateral hyperpathic responses to a supra-maximal noxious heat pulse. These abnormal pain responses last many months and are very similar to those seen in humans with causalgia. In the present study we determined whether the underlying mechanism involves bilateral sensitization of primary afferent receptors. Since the responses of rats with partial sciatic injury to stimulation of rostral areas (forepaws, muzzle and auricles) were normal, we presume that the hyperalgesia at the contralateral hindpaw could not be due to receptor sensitization, but to rapid central plasticity. Moreover, since indomethacin did not prevent the bilateral hyperalgesia, we conclude that the causalgiform pain disorders seen in the ipsilateral hindpaw did not derive from receptors sensitized by prostaglandins.

Animals↗
PubMed1988

Life-threatening torsade de pointes arrhythmia associated with head injury.

Torsade de pointes (atypical ventricular tachycardia) occurred in a 75-year-old man 1 day after blunt head injury, in association with a focal intracerebral hematoma in the left thalamic area. The causal relationship between the traumatic stimulation of the left sympathetic pathway and the development of this life-threatening arrhythmia is discussed.

Aged↗
PubMed1987

One-lung high-frequency ventilation in the management of traumatic tear of bronchus in a child.

An 8-yr-old child suffered traumatic bilateral pneumothoraces and a ruptured right main bronchus. Surgical repair of the bronchus was postponed for 18 h after a definite diagnosis was established due to severe hypoxemia and hypercarbia. Only left endobronchial high-frequency ventilation with muscle relaxation corrected this pulmonary dysfunction sufficiently to enable surgical intervention.

Accidental Falls↗
PubMed1987

Application of a new method for measurement of plasma methadone levels to the use of epidural methadone for relief of postoperative pain.

A method is described for measurement of plasma methadone concentrations using a gas chromatic technique that is rapid and specific and enables the detection of concentrations of less than 1 ng/ml in plasma samples of only 1 ml. The method, when used to determine the plasma methadone levels in patients given continuous epidural infusions of methadone plus on-demand supplementation for relief of postoperative pain, showed plasma methadone plateaus of around 10 ng/ml (starting at 15 min and lasting over 2 hr) and 20 ng/ml (starting at 3 hr and lasting over the period of treatment) (P less than 0.001) after an initial 2-mg methadone epidural bolus and with continuous epidural methadone. Mean plasma methadone levels of around 10 ng/ml were associated with pain relief. Analgesia could be safely maintained for 24 hr.

Adult↗
PubMed1984

[Antibiotic sensitivity of strains of Brucella].

The susceptibility of 31 strains of Brucella to various antibiotics was investigated by agar dilution technique. When tested with inocula ranging from 10(4) to 10(6) bacteria/ml, all strains were susceptible to tetracycline, chloramphenicol, streptomycin and gentamicin. More than 25% were resistant to the combination trimethoprim-sulfamethoxazole. With this combination, the maximal antibacterial effect was obtained at a trimethoprim/sulfamethoxazole ratio of 1:19. In 90% of the strains, stable mutants, highly resistant to rifampicin (CMI greater than or equal to 1024 micrograms/ml) were detected. The mutation rate was about 10-7.

Anti-Bacterial Agents↗
PubMedDate not supplied

Sympathetically-maintained causalgiform disorders in a model for neuropathic pain: a review.

Partial nerve injury is the main cause of sympathetically maintained causalgiform pain disorders in humans. We present here an animal model of this condition, produced in rats by a unilateral ligation of about half of the sciatic nerve. Starting hours after the operation and for several months thereafter, the rats developed signs of spontaneous pain, touch-evoked allodynia and hyperesthesia, and mechanical and thermal hyperalgesia in the partially denervated as well as the intact contralateral foot. These disorders were maintained by the sympathetic outflow and disappeared following postoperative sympathectomy. In neonatally capsaicinated rats we found that touch-evoked allodynia and hyperesthesia were mediated by A-fibers whereas thermal hyperalgesia was mediated by C-fibers. These disorders were not due to receptor sensitization of remaining afferent fibers by prostaglandins. We found strain differences and genetic inheritance of these causalgiform disorders which were correlated with the expression of autotomy to hind-paw denervation.

Animals↗