s97 THE USE OF EPIDURAL AND INTRATHECAL OPIATES

Chairman: Johan Spierdijk, MD, PhD Department of Anesthesiology, University of

mi

Leiden, Leiden, The Netherlands

The above-mentioned technique of using opiates for the treatment of pain is still being evaluated. For those who want to use this technique it is necessary to know the technical details of how to perform an epidural or intrathecal injection. With the help of a video presentation the details of the injections are presented. Daniel C. Moore from Seattle, is avail- able for explanation.

After that several well-known speakers will present the use of opiates in the epidural or intrathecal space. Indications, contraindications and com- plications are described. The advantages and disadvantages of certain drugs are presented. Dosages as well as methods of how to inject the drugs are discussed:

Dr. W. Tom Edwards from Massachusetts presents "Clinical use of Epidural Opiates"

Dr. M. Zenz from Germany will discuss "The Application of Epi- dural Opiates in the Chronic Pain Patient"

Dr. H.S. Greenberg from Michigan will speak about "The Applica- tion of Spinal Opiates in Cancer Pain"

Dr. W.C. Hanigan from Illinois explains the "Use of Continuous Infusion Pumps vs. Reservoir Systems"

Thereafter a general discussion will take place.

HYPNOSIS IN THE TREATMENT OF CHRONIC PAIN. F* J. E"ans

(Chairman, Carrier Foundation and UMDNJ--Rutgers Medical

school), B. Finer (University of Uppsala), C. Perry

(Concordia University), B. J. Evans* (Laurie Neurodevelopmental Institute and UMDNJ--Rutgers Medical School), and

C. Margolis (Jefferson Medical College).

Hypnosis has been used widely in the treatment of chronic pain for

many years. Recent research and well documented clinical experience has

developed to the point where some of the key issues in evaluating the effectiveness and mechanisms of hypnotic pain control can be elaborated. Studies of biochemical changes and dissociative processes have clarified

the nature of hypnotic analgesia. The treatment of chronic pain in adults and children with hypnosis must recognize the possibility of underlying depression and secondary gain, and deal with these transference issues. The use of hypnosis related to chronic illness where there is clear-cut pathology may be quite different (and more successful) than its use in those patients in which there is no clear-cut organic or physiological involvement. Different approaches for the hypnotic treatment of chronic pain syndromes and terminally ill patients (e.g.,

those with cancer) will be highlighted.