T. Goroszeniuk - Academia.edu (original) (raw)

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Papers by T. Goroszeniuk

Anaesthesia, 1991

Hysteria as a cause of failure to recover consciousness following general anaesthesia is a rare e... more Hysteria as a cause of failure to recover consciousness following general anaesthesia is a rare event. This case report describes such an instance in a young, healthy 22-year-old female suffering severe dental phobia who was undergoing dental conservation. The literature is reviewed and a summary of the possible physiological mechanisms involved is given.

Anaesthesia, 1986

A mother presented at 28 weeks with epileptiform convulsions which were due to a malignant cerebr... more A mother presented at 28 weeks with epileptiform convulsions which were due to a malignant cerebral tumour. Labour and delivery at 34 weeks were managed under epidural analgesia. The infant was healthy, but the mother died several days later following cerebral decompression.

Douleurs : Evaluation - Diagnostic - Traitement, 2012

Journal of the Royal College of Surgeons of Edinburgh, 2000

Pressure changes around the femoral nerve were monitored throughout 10 consecutive primary total ... more Pressure changes around the femoral nerve were monitored throughout 10 consecutive primary total hip replacements to identify any surgical steps that might raise pressure around the nerve and be implicated in iatropathic palsy. The only notable variable was the patient himself/herself. The only step that consistently raised pressure around the nerve, sometimes to alarming levels, was use of a retractor sited on the anterior lip of the acetabulum. Pressure changes were modest in patients with an endomorphic body type suggesting relative protection from this injury by a thicker soft cushion.

Regional Anesthesia and Pain Medicine, 2004

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Regional Anesthesia and Pain Medicine, 2004

$Research paper thumbnail of Peripheral percutaneous stimulation for refractory angina pectoris$

Regional Anesthesia and Pain Medicine, 2004

ABSTRACT An abstract is unavailable. This article is available as HTML full text and PDF.

Neuromodulation: Technology at the Neural Interface, 2011

The management of pain in chronic benign pancreatitis is complex. Celiac plexus neurolysis prov... more The management of pain in chronic benign pancreatitis is complex. Celiac plexus neurolysis provides pain relief of variable duration. Neuromodulation of splanchnic nerves with electrodes and an implantable pulse generator system is an alternative to producing long-term pain relief with minimal complications in selected cases. A 36-year-old lady with intractable abdominal pain for five years from chronic benign pancreatitis presented to our pain clinic. Multiple pharmacotherapy regimens, surgery, and interventions produced temporary pain relief of variable duration and intensity. Following a successful trial of celiac plexus stimulation, neuromodulation of the splanchnic nerves was achieved with two permanently implanted octopolar leads at the T11/T12 area connected to an implantable pulse generator. Eighteen months following the implant, the patient continues to derive satisfactory pain relief without any device related complications. Her opiate use is significantly reduced from 225 (486 mg morphine per day) to 12.5 (27 mg morphine per day) micrograms/h fentanyl patches and the fentanyl lozenges were stopped with an increase in appetite and of more than 8 kg in weight gain. The initial pain score visual analogue scale (VAS) 8-9/10 was reduced to VAS 0/10 since implantation. The pain of chronic pancreatitis has both visceral and somatic components as evidenced by the lack of complete pain relief from celiac plexus block alone and the knowledge that in chronic disease, the pathology extends to extra pancreatic somatic tissues, particularly the retro-peritoneum. We postulate that the electrical field generated by the dual octrode system extends to include splanchnic nerves and other somatic innervation of the pancreas. In our opinion, this is the first case of a successful long-term neuromodulation of splanchnic nerves with a permanently implanted device. The potential exists for its use in visceral abdominal pain of varied etiology, once more experience is obtained with this technique.