Low Preparedness Before the Loss of a Wife to Cancer and the Widower’s Chronic Pain 4-5 Years Later-a Population-Based Study.

Low preparedness before the loss of a wife to cancer and the widower’s chronic pain 4-5 years later-a population-based study.

Psychooncology. 2013 Jul 10;
Asgeirsdóttir HG, Valdimarsdóttir U, Fürst CJ, Steineck G, Hauksdóttir A

The focus of this study was on the impact of spousal loss on the development of chronic pain thereafter. More specifically, the aim was to investigate the effect of experiencing low preparedness before a wife’s death and the widower’s chronic pain 4-5 years after loss.In a population-based study in the years 2004-2005, anonymous questionnaires were sent out to 907 men in Sweden who had lost a wife to cancer in 2000 and 2001. The questionnaires contained questions on the man’s preparedness for his wife’s death and his physical and psychological health at follow-up.Altogether, 691 out of 907 questionnaires were retrieved (76%). Younger widowers (38-61 years old) with a low degree of preparedness for their wife’s death had an increased risk of experiencing symptoms of chronic pain (odds ratio 6.67; 2.49-17.82) 4-5 years after loss. The same results did not apply for older widowers (62-80 years old) (odds ratio 0.81; 0.32-2.05). Widowers who experienced chronic pain were at an increased risk for psychological morbidity, depression (relative risk [RR] 2.21; 1.31-3.74), anxiety (RR 2.11; 1.33-3.37), and sleep disorders (RR 2.19; 1.30-3.69).Our data suggest that low preparedness for a wife’s death may increase risk of chronic pain among younger widowers 4-5 years after loss. In addition, we found comorbidity between psychological symptoms and chronic pain among widowers. These findings call for studies on possible mechanisms in the association between low preparedness and morbidity and on how to increase preparedness for a wife’s death to cancer. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression


Comparison of circulatory and respiratory responses between supplementary epidural buprenorphine and eptazocine administration during and immediately after total intravenous anesthesia.

J Anesth. 1997 Jun; 11(2): 94-9
Aida S, Baba H, Shimoji K

Opioid supplements are often required in total intravenous anesthesia (TIVA). Most ?-opiate receptors are found in the spinal cord, wherea ?-opiate receptors are widespread throughout the brain and spinal cord. Buprenorphine has a strong ?-action with a minute ?-action, while eptazocine stimulates ?-receptors only. From these, epidural eptazocine is expected to exert strong spinal analgesia by ?-stimulation without ?-action, which produces circulatory and respiratory depression. Therefore, the clinical effects of epidural opioids on circulation, respiration, and analgesia were compared. Continuous epidural administration of eptazocine or buprenorphine was combined with TIVA in patients scheduled for elective abdominal surgery. Epidural opioid administration was continued throughout and for 72h after anesthesia. A significant analgesic effect (P<0.01) of epidural eptazocine without circulatory and respiratory depression was observed. With epidural buprenorphine, circulatory and respiratory depression during and immediately after anesthesia were significant (P<0.05). These results suggest that medullary ?-stimulation by an epidural opioid induces circulatory (hypervagotonicity and hypervagosensitivity) and respiratory depression, while ?-stimulation produces only minimal effects on circulatory and respiratory systems. HubMed – depression