As our understanding of the mechanisms of the brain and nervous system that underlie the conscious experience of pain has increased over the past 60 years, so too has the field of pain management. What began as almost exclusively the domain of anaesthetists has become multidisciplinary, and now comprises many other specialisms including neurology, psychology, nursing, occupational therapy and physiotherapy. This spate of activity has been paralleled by a similar growth in research: in neurophysiology, psychology and pharmacology as well as clinical medicine. Simultaneously, the pharmaceutical industry has spent billions of pounds and dollars in the search for better drugs for relieving pain. This ground-breaking book is compiled by former contributors to The Special Interest Group for Philosophy and Ethics of the British Pain Society. The issues discussed include satisfactory relief of chronic pain, the inadequacy of scientific biomedicine in offering answers, and ethical problems arising in pain medicine. 'Suffering cannot be found in a laboratory test or imaging study; it is only observable by communicating with the sufferer. The eleven chapters in this book approach this conundrum from vastly different perspectives, some highly personal and others broadly social. Issues such as the interface between the physician and the pharmaceutical industry are also presented. Each chapter describes a facet of the problems of suffering and some of the available paths to recovery.' John D Loeser in the Foreword

Primary sensory neurons respond to peripheral stimulation and project to the spinal cord. Specifically, the population of neurons which respond to damaging stimuli terminate in the superficial layers of the dorsal horn. Therefore, the dorsal horns constitute the first relay site for nociceptive fibre terminals which make synaptic contacts with second order neurons. It has recently become clear that the strength of this first pain synapse is plastic and modifiable by several modulators, including neuronal and non-neuronal regulators, and studies on the fundamental processes regulating the plasticity of the first pain synapse have resulted in the identification of new targets for the treatment of chronic pain. This book will be of interest to a wide readership in the pain field.

From early conception until the postpartum period, anaesthetists are required to provide pregnant women with the highest standard of anaesthetic care and pain relief whilst negotiating challenges such as concurrent systemic disease, infertility, and obesity as well as practising in accordance with new developments in fetal medicine surgery, pharmacology, and imaging. The Oxford Textbook of Obstetric Anaesthesia provides an up-to-date summary of the scientific basis, assessment for and provision of anaesthesia throughout pregnancy and labour. This highly authoritative textbook is conceptually divided into nine sections, detailing maternal and fetal physiology, fetal and neonatal assessment and therapy, anaesthesia before and during pregnancy, labour and vaginal delivery, anaesthesia for caesarean delivery, anaesthetic and obstetric complications, as well as systemic disease. Individual chapters address topics such as simulation and ultrasound. Authored by an international team of expert anaesthetists this textbook reflects current world-wide practice and guidelines. Designed for consultants and trainees in anaesthesia, the Oxford Textbook of Obstetric Anaesthesia is the definitive source of expert knowledge for anaesthetists in this subspecialty.

The success of a neural electrode is often measured by its performance in the selective stimulation of or recording from individual fascicles within a peripheral nerve without damaging the nerve. Neural prostheses are limited by the availability of peripheral neural electrodes that can be used to record the user's intention or to provide sensory feedback through functional electrical stimulation for an extended duration. Improvement in future neural prostheses may be achieved through the availability of multichannel, bidirectional neural interfaces, such as the transverse intrafascicular multichannel electrode (TIME). The aim of this thesis was to investigate the biofunctionality, biostability, and biosafety of the TIME in an animal model that bears a close neuroanatomical resemblance to the human. To this end, four research questions were formulated: 1) Is the pig model neuro-anatomically suitable for the simulation of the actions and reactions of a neural electrode in a large human-sized peripheral nerve? This question was addressed in study 1 in which a comparative morphology study was performed on the median and ulnar nerves of Danish landrace pigs and Gottingen mini-pigs. Nerve specimens were selected at different levels for analysis. The number of fascicles in each nerve was counted, and the fascicle diameters were measured. 2) How selective is the TIME compared to other intrafascicular electrodes, such as the thin-film longitudinal intrafascicular electrode (tfLIFE)? Study 2 was performed to address this question. A comparative stimulation selectivity study was performed in Danish Landrace pigs with the TIME and tfLIFE. Electrodes were implanted in the median nerve, and sequential electric stimulation was applied to individual contacts. The compound muscle action potentials of seven forelimb muscles were recorded to quantify muscle recruitment. 3) Is the TIME biostable and biofunctional for long-term implantation? This question was addressed in study 3 in which the chronic stimulation selectivity of the TIME was evaluated on Gottingen mini-pigs. 4) Does the TIME fulfil the criteria of biocompatibility and chronic stability? Study 4 was conducted to address this question. Immunohistological analysis was conducted on nerve specimens from chronic experiment pigs that had been implanted with TIMEs in study 3.