The efficacy of a multimodal analgesic approach for ligation excision haemorrhoidectomy was evaluated in a prospective series of 62 patients. Opioid was given as intravenous fentanyl intra-operatively, as part of a standardised general anaesthetic technique, followed by post-operative parenteral fentanyl or oral oxycodone as required. Pre-emptive local anaesthesia was provided via ischiorectal ...

TOPICS COVERED IN THIS CHAPTER Peripheral pain mechanisms Primary afferent nociceptors Visceral afferents Sympathetic nervous system Peripheral sensitisation/inflammation Role of nerve growth factor in peripheral sensitisation Silent nociceptors Peripheral nerve injury Clinical implications for peripheral analgesic action Dorsal horn mechanisms Termination sites of primary afferents Outputs fro...

Implication for health policy/practice/research/medical education: Due to expertise of anesthesiologists in analgesics pharmacology, epidural and peripheral nerve blockade, they have pioneered in the postoperative pain management. Reading this article is beneficial for physicians, interventional pain managers and who care about pain medicine. The practice of modern anesthesiology has been devel...

BACKGROUND CMV disease remains a major complication of lung transplantation and attempts to prevent it have met with marginal success. In a previous study we documented that universal prophylaxis did not prevent CMV disease but merely delayed it, and was very costly. METHODS We compared the efficacy and cost of pre-emptive therapy with ganciclovir, guided by CMV antigenemia, to that of histor...