Chicken Pox Update
Most children aren’t seriously affected, but each year about 9,000 of them must be hospitalized and about 100 die. About 2% of cases affect adults, in whom the disease is often much more severe.
The vaccine, developed by Merck, has been studied in about 11,000 people and protected from 70% to nearly 100% of them from infection. Immunized people who still develop chicken pox usually get a mild case.
The vaccine is endorsed by the American Academy of Pediatrics. The recommended dose is one shot for children aged one to 12 and two shots four to eight weeks apart for those 13 and older, including adolescents and adults with no history of chicken pox. (Certain people, including pregnant women, should not be vaccinated.) It’s not yet known whether booster shots will be necessary. —LARRY KATZENSTEIN
New Help for Surgery Pain?
Giving painkillers right before surgery not only eases postoperative pain and the need for potent drugs to handle it but also can prevent complications that may follow surgery.
General anesthesia doesn’t ordinarily involve painkillers. Instead it puts you to sleep, paralyzes your muscles and keeps you from remembering anything about the operation—none of which helps against the pain and nausea you may feel after you wake up.
Proponents of the new treatment, called preemptive analgesia, cite recent evidence that trauma such as surgery makes nerves transmit pain messages that persist for hours or days afterward, even if you’re unconscious at the time and in spite of later painkiller use. But giving pain relievers before surgery should block those nerve impulses from being sent and thereby lessen post-op pain. The therapy is now being used at several medical centers in the U.S., Canada and Europe.
About a dozen studies over the past two years have shown that preemptive analgesia works. One of them, reported last year, included 49 patients at the University of Toronto Hospital who had gallbladders removed under general anesthesia using laparoscopic (“keyhole”) surgery, where instruments are inserted through tiny punctures made in the abdomen. Forty-five minutes before surgery, half the patients received painkiller injections while the others (the control group) were given saline. For patients in the painkiller group, analgesics were also applied to the puncture sites and even sprayed on the gallbladder during the operation.
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