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Alphadione (Alfatésine, Althesin, CT 1341), a steroid anaesthetic with a quick and short action, has but a very moderate analgesic activity, so it is necessary in human anaesthesian, to associate with it a morphinic analgesis systematically. Therefore it was interesting to study the response of cardiovascular system when using this type of association. Our results show that the cardiovascular depressive effects of morphinic analgesics, when they exist, are not increased by the presence of alphadione.

After unique injection LiCl enhances, in albino rat, catalepsy induced by arecoline and oxotremorine perhaps by adenylcyclase inhibition and/or decrease of acetylcholine synthesis. After repetitive injection of LiCl during 5 days, this phenomenon is not observable, probably owing to increase of acetylcholine synthesis. After unique injection of LiCl enhances catalepsy induced by dextromoramide, probably on account of cholinergic properties of this drug. In contrast catalepsy induced by morphine or pethidine is suppressed. This constatation would depend on opposite influence upon cerebral neuromediators : lithium diminishing cerebral serotonin and striatal acetylcholine levels and morphine increasing them. After repetitive injections these phenomenons are not observable.

The vesico-sphincter dyssynergia is generally observed in paraplegic patients with supra sacral lesions (40% of our cases). The neurophysiologic basis of the vesico-sphincter dyssynergia are the field of controversies. The animal experimentations have shown that a section below the ponts, induce a neural reorganization, enough to produce a normal micturation, rising sacral short loop reflexes. The reality of such mechanism is discussed by different authors who consider a normal micturation as a brain stem reflex rather than a simple sacral reflex. These factors allow the authors to undergo a neurophysiologic, neuropharmacologic and urodynamic investigation, with the intention of shedding light on the pathophysiology of the vesico-sphincter dyssynergia in 20 cases of paraplegic patients. On the basis of our data the following conclusions were made: the importance of the polysynaptic reflexes evoked by cutaneous or vesical stimulation (below the neurologic lesions) on the different degrees of vesico-sphincter dyssynergia; the quality of voiding depends on the equilibrium between extension and flexor reflexes in paraplegic patients; the presence of a neural reorganization using short loop reflexes who are the expression of a complex system rather than a simple sacral reflex; the effect of chronic intrathecal morphinic drugs on the reflex equilibrium and the quality of voiding and the eventual relation between opiate receptors and vesical sphincter dyssynergia.