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Combination Spinal Analgesic Chemotherapy: A Systematic Review

Combination Spinal Analgesic Chemotherapy: A Systematic Review REVIEW ARTICLE Combination Spinal Analgesic Chemotherapy: A Systematic Review Suellen M. Walker, MBBS, MM(PM), MSc, FANZCA, FFPMANZCA*, Leonidas C. Goudas, MD, PhD†, AM, MD, FRCA, FANZCA, FFPMANZCA*, and Michael J. Cousins, MD, FABPM, FFPMANZCA†‡ Daniel B. Carr, *Department of Anesthesia and Pain Management, Royal North Shore Hospital and University of Sydney, Sydney, Australia; and Departments of †Anesthesiology and ‡Medicine, Tufts University School of Medicine and Tufts New England Medical Center, Boston, Massachusetts In the 25 years since the first application of spinal injury (10). Persuasive evidence has emerged that per- opioids for treating cancer pain, this mode of analgesia sistent pain, regardless of its cause, constitutes a patho- has grown to enjoy worldwide use (1,2). A natural out- logic state per se in which spinal neuronal reorganization (“plasticity”) exaggerates and perpetuates nociception growth of local-anesthetic spinal anesthesia, “the major and pain (11–13). Insight into spinal cord pathophysiol- advantages of ‘selective’ blockade of pain by spinal opi- ogy and pharmacology has spurred novel drug discov- oids [lay] in the absence of sympathetic blockade and ery and rekindled interest in spinal delivery of estab- postural hypotension, potentially allowing easy ambula- lished drugs (14,15). tion of patients, and avoidance of cardiovascular col- http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anesthesia & Analgesia Wolters Kluwer Health

Combination Spinal Analgesic Chemotherapy: A Systematic Review

Anesthesia & Analgesia , Volume 95 (3) – Sep 1, 2002

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References (163)

ISSN
0003-2999
eISSN
1526-7598
DOI
10.1213/00000539-200209000-00033
Publisher site
See Article on Publisher Site

Abstract

REVIEW ARTICLE Combination Spinal Analgesic Chemotherapy: A Systematic Review Suellen M. Walker, MBBS, MM(PM), MSc, FANZCA, FFPMANZCA*, Leonidas C. Goudas, MD, PhD†, AM, MD, FRCA, FANZCA, FFPMANZCA*, and Michael J. Cousins, MD, FABPM, FFPMANZCA†‡ Daniel B. Carr, *Department of Anesthesia and Pain Management, Royal North Shore Hospital and University of Sydney, Sydney, Australia; and Departments of †Anesthesiology and ‡Medicine, Tufts University School of Medicine and Tufts New England Medical Center, Boston, Massachusetts In the 25 years since the first application of spinal injury (10). Persuasive evidence has emerged that per- opioids for treating cancer pain, this mode of analgesia sistent pain, regardless of its cause, constitutes a patho- has grown to enjoy worldwide use (1,2). A natural out- logic state per se in which spinal neuronal reorganization (“plasticity”) exaggerates and perpetuates nociception growth of local-anesthetic spinal anesthesia, “the major and pain (11–13). Insight into spinal cord pathophysiol- advantages of ‘selective’ blockade of pain by spinal opi- ogy and pharmacology has spurred novel drug discov- oids [lay] in the absence of sympathetic blockade and ery and rekindled interest in spinal delivery of estab- postural hypotension, potentially allowing easy ambula- lished drugs (14,15). tion of patients, and avoidance of cardiovascular col-

Journal

Anesthesia & AnalgesiaWolters Kluwer Health

Published: Sep 1, 2002

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