Patient-controlled analgesia minimizes interpatient pharmacokinetic and pharmacodynamic variability to allow suitable patients to titrate a predetermined bolus of opioid against their pain (Baljantyne. etal 1993). The dose, lockout period, and bolus infusion period are set by the practitioner. Most patients experience an individually determined satisfactory level of analgesia. Usage is significantly influenced by factors such as mood, anxiety, and expectation of recovery. Patient-controlled analgesia should not be used if the negative feedback loop is not intact. A maximum limit of half the predicted hourly rate may be used if an infusion combined with patient-controlled analgesia is desired. Meperidine (pethidine) may be used for periods of 2 to 3 days, but prolonged use is associated with dysphoria and accumulation of normeperidine (norpethidine) with a risk of convulsions.
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With all the stresses and strains of modern living, panic attacks are become a common problem for many people. Panic attacks occur when the pressure we are living under starts to creep up and overwhelm us. Often it's a result of running on the treadmill of life and forgetting to watch the signs and symptoms of the effects of excessive stress on our bodies. Thankfully panic attacks are very treatable. Often it is just a matter of learning to recognize the symptoms and learn simple but effective techniques that help you release yourself from the crippling effects a panic attack can bring.