Pub Date : 2007-10-01DOI: 10.1179/016911107X376936
S. F. Galinski, J. Pereira, Y. Maestre, S. Francés, F. Escolano, M. Puig
Abstract Objectives: Ketamine and dexamethasone have been reported to improve postoperative analgesia and chronic post-surgical pain. In patients undergoing inguinal hernia repair, we have compared the effects of each drug individually with their combination. Patients and methods: Sixty male patients randomly distributed in three groups, received double-blind: (i) dexamethasone 8 mg, 1 h before surgery (Group D); (ii) a bolus of ketamine 0.5 mg/kg after endotracheal intubation (Group K); or (iii) their combination (Group DK). Anaesthesia was maintained with sevoflurane and remifentanil. Dexketoprofen (50 mg, i.v.), paracetamol (1 g, i.v.) and wound infiltration with bupivacaine were used before closing. In the recovery room, boluses of 25 mg of tramadol were administered every 15 min until a visual analogue scale (VAS) score of less than 3 was recorded. After discharge, ibuprofen plus paracetamol was used for analgesia. Postoperatively, we assessed pain intensity (VAS 0–10), tramadol consumption, and adve...
{"title":"The combination of intravenous dexamethasone and ketamine does not improve postoperative analgesia when compared to each drug individually","authors":"S. F. Galinski, J. Pereira, Y. Maestre, S. Francés, F. Escolano, M. Puig","doi":"10.1179/016911107X376936","DOIUrl":"https://doi.org/10.1179/016911107X376936","url":null,"abstract":"Abstract Objectives: Ketamine and dexamethasone have been reported to improve postoperative analgesia and chronic post-surgical pain. In patients undergoing inguinal hernia repair, we have compared the effects of each drug individually with their combination. Patients and methods: Sixty male patients randomly distributed in three groups, received double-blind: (i) dexamethasone 8 mg, 1 h before surgery (Group D); (ii) a bolus of ketamine 0.5 mg/kg after endotracheal intubation (Group K); or (iii) their combination (Group DK). Anaesthesia was maintained with sevoflurane and remifentanil. Dexketoprofen (50 mg, i.v.), paracetamol (1 g, i.v.) and wound infiltration with bupivacaine were used before closing. In the recovery room, boluses of 25 mg of tramadol were administered every 15 min until a visual analogue scale (VAS) score of less than 3 was recorded. After discharge, ibuprofen plus paracetamol was used for analgesia. Postoperatively, we assessed pain intensity (VAS 0–10), tramadol consumption, and adve...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"24 1","pages":"223-229"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89094163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-10-01DOI: 10.1179/016911107X396925
Ali A. Eissa, Abdelhafez M. Elhosainy, Maged S. Alansary
AbstractThe objective of this study was to determine the safety and efficacy of three tibial nerve blocks at the ankle with bupivacaine and triamcinolone in the treatment of chronic painful diabetic neuropathy of the foot resistant to medical treatment compared to that of three placebo tibial nerve blocks over a period of 7 days to 6 months.
{"title":"Tibial nerve block in treatment of painful distal diabetic neuropathy","authors":"Ali A. Eissa, Abdelhafez M. Elhosainy, Maged S. Alansary","doi":"10.1179/016911107X396925","DOIUrl":"https://doi.org/10.1179/016911107X396925","url":null,"abstract":"AbstractThe objective of this study was to determine the safety and efficacy of three tibial nerve blocks at the ankle with bupivacaine and triamcinolone in the treatment of chronic painful diabetic neuropathy of the foot resistant to medical treatment compared to that of three placebo tibial nerve blocks over a period of 7 days to 6 months.","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"53 1","pages":"219-222"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74377631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-10-01DOI: 10.1179/016911107X396934
T. Fukushige, S. Yamada, T. Kano
AbstractBackground: Far lateral lumbar disc herniation (FLLDH) compresses the nerve root or dorsal ganglion outside the spinal canal at the same level as the herniation, producing severe pain on the anterolateral thigh. The pain is so severe that many patients cannot even walk. The severity of pain is attributed not only to compression, but also some chemical inflammation. Objective: To report a case of FLLDH whose nerve root was depicted during discography.Case report: A 55-year-old-man presented with severe pain from the left buttock to the left anterolateral thigh and leg. Abnormal shadowing suggested left FLLDH at the L5/S1 level on magnetic resonance imaging. During discography, a shadow suggestive of the left fifth lumbar nerve sheath was depicted. Comparing the computed tomography (CT) after discography and CT after rootgraphy, the root sheath-like shadow on discography was confirmed as the nerve root sheath. After nerve root block, pain decreased and the patient was discharged. Conclusions: The co...
{"title":"Connection between herniated nucleus pulposus and nerve roots in far lateral lumbar disc herniation","authors":"T. Fukushige, S. Yamada, T. Kano","doi":"10.1179/016911107X396934","DOIUrl":"https://doi.org/10.1179/016911107X396934","url":null,"abstract":"AbstractBackground: Far lateral lumbar disc herniation (FLLDH) compresses the nerve root or dorsal ganglion outside the spinal canal at the same level as the herniation, producing severe pain on the anterolateral thigh. The pain is so severe that many patients cannot even walk. The severity of pain is attributed not only to compression, but also some chemical inflammation. Objective: To report a case of FLLDH whose nerve root was depicted during discography.Case report: A 55-year-old-man presented with severe pain from the left buttock to the left anterolateral thigh and leg. Abnormal shadowing suggested left FLLDH at the L5/S1 level on magnetic resonance imaging. During discography, a shadow suggestive of the left fifth lumbar nerve sheath was depicted. Comparing the computed tomography (CT) after discography and CT after rootgraphy, the root sheath-like shadow on discography was confirmed as the nerve root sheath. After nerve root block, pain decreased and the patient was discharged. Conclusions: The co...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"13 1","pages":"247-250"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76795969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-10-01DOI: 10.1179/016911107X396907
L. Saberski
{"title":"Managing chronic pain: finding our way to the land of milk and honey","authors":"L. Saberski","doi":"10.1179/016911107X396907","DOIUrl":"https://doi.org/10.1179/016911107X396907","url":null,"abstract":"","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"2 1","pages":"204-205"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74336290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-10-01DOI: 10.1179/016911107X396943
C. Doran, X. Yi
AbstractIt is well known that local anesthetics produce analgesia, anesthesia and anti-arrhythmia by blocking sodium channels. However, the anti-inflammatory properties of local anesthetics and their clinical implications though mechanisms not directly related to sodium channels have stimulated escalating interest of clinicians and researchers in local anesthetics over the past decade. By interfering with the inflammatory cascade at different levels, local anesthetics attenuate the inflammation and this effect has been employed to treat some acute and chronic inflammatory diseases. The anti-inflammatory properties of local anesthetics may also play an important role in the effect of pain control. In this review, we discuss the effect of local anesthetics on inflammation and its molecular mechanism. It appears that by extending the exposure of local anesthetics to areas of inflammation, one may decrease the concentration of local anesthetics needed to possibly down-regulate the expression of Gq protein. Th...
{"title":"The anti-inflammatory effect of local anesthetics","authors":"C. Doran, X. Yi","doi":"10.1179/016911107X396943","DOIUrl":"https://doi.org/10.1179/016911107X396943","url":null,"abstract":"AbstractIt is well known that local anesthetics produce analgesia, anesthesia and anti-arrhythmia by blocking sodium channels. However, the anti-inflammatory properties of local anesthetics and their clinical implications though mechanisms not directly related to sodium channels have stimulated escalating interest of clinicians and researchers in local anesthetics over the past decade. By interfering with the inflammatory cascade at different levels, local anesthetics attenuate the inflammation and this effect has been employed to treat some acute and chronic inflammatory diseases. The anti-inflammatory properties of local anesthetics may also play an important role in the effect of pain control. In this review, we discuss the effect of local anesthetics on inflammation and its molecular mechanism. It appears that by extending the exposure of local anesthetics to areas of inflammation, one may decrease the concentration of local anesthetics needed to possibly down-regulate the expression of Gq protein. Th...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"74 1","pages":"207-213"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83983182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-10-01DOI: 10.1179/016911107X268765
C. Bahadır, G. Gurleyik, Sena Topatan, D. Kurtulus
AbstractElastofibroma dorsi is a rare pseudotumoural lesion which arises almost always from the tissues between the lower angle of the scapula and the thoracic wall. Pathogenesis of the elastofibroma dorsi has not been cleared. Although most cases are asymptomatic, it might cause pain and snapping scapula. It can be clinically mistaken with other benign and malign neoplasms developed in this area. As malign transformation is not reported, radical surgery is not recommended in asymptomatic and small tumours. This study presents a case of bilateral elastofibroma dorsi with persistent shoulder pain and a review of the literature.
{"title":"Elastofibroma dorsi: a rare cause of persistent shoulder pain","authors":"C. Bahadır, G. Gurleyik, Sena Topatan, D. Kurtulus","doi":"10.1179/016911107X268765","DOIUrl":"https://doi.org/10.1179/016911107X268765","url":null,"abstract":"AbstractElastofibroma dorsi is a rare pseudotumoural lesion which arises almost always from the tissues between the lower angle of the scapula and the thoracic wall. Pathogenesis of the elastofibroma dorsi has not been cleared. Although most cases are asymptomatic, it might cause pain and snapping scapula. It can be clinically mistaken with other benign and malign neoplasms developed in this area. As malign transformation is not reported, radical surgery is not recommended in asymptomatic and small tumours. This study presents a case of bilateral elastofibroma dorsi with persistent shoulder pain and a review of the literature.","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"100 1","pages":"240-242"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80310314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-10-01DOI: 10.1179/016911107X268792
N. Avcu, Arzu Alan, O. Kansu, Z. Şekerci, H. Kansu
AbstractPalatal lesions and associated palatal pain are a common occurrence, whereas spontaneous aneurysm of a cerebral artery is rare. We report a case involving a spontaneous aneurysm of the middle cerebral artery that manifested initially as palatal pain. It is important for dental practitioners to be familiar with unusual causes of palatal pain. Those cases that cause palatal pain must be evaluated appropriately to avoid potentially serious complications.
{"title":"Palatal pain caused by unruptured cerebral artery aneurysm","authors":"N. Avcu, Arzu Alan, O. Kansu, Z. Şekerci, H. Kansu","doi":"10.1179/016911107X268792","DOIUrl":"https://doi.org/10.1179/016911107X268792","url":null,"abstract":"AbstractPalatal lesions and associated palatal pain are a common occurrence, whereas spontaneous aneurysm of a cerebral artery is rare. We report a case involving a spontaneous aneurysm of the middle cerebral artery that manifested initially as palatal pain. It is important for dental practitioners to be familiar with unusual causes of palatal pain. Those cases that cause palatal pain must be evaluated appropriately to avoid potentially serious complications.","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"73 1","pages":"243-246"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87425059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-10-01DOI: 10.1179/016911107X396853
A. Kanai, H. Okamoto
Abstract Objective: Patients with chronic pain frequently have depression, which may augment their pain. The selective serotonin re-uptake inhibitor, paroxetine, is widely used in the treatment of depression. The purpose of this study was to examine the effectiveness of paroxetine in the treatment of refractory chronic pain. Patients and methods: Fifty patients with a history of at least 6-month persistent chronic pain participated in this study. Paroxetine was orally administered once daily at a dose of 10 mg initially, then increased weekly by 10 mg until a maximum of 40 mg. The dose was reduced when an adverse reaction occurred, and treatment was continued for 2 weeks at the optimal dose. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The state of depression was evaluated using the Self-Rating Depression Scale (SDS), and that of pain using the Visual Analogue Scale (VAS). Results: Overall, 70% of the patients had depression. The SDS score was h...
{"title":"Paroxetine improves pain and depression in patients with refractory chronic pain","authors":"A. Kanai, H. Okamoto","doi":"10.1179/016911107X396853","DOIUrl":"https://doi.org/10.1179/016911107X396853","url":null,"abstract":"Abstract Objective: Patients with chronic pain frequently have depression, which may augment their pain. The selective serotonin re-uptake inhibitor, paroxetine, is widely used in the treatment of depression. The purpose of this study was to examine the effectiveness of paroxetine in the treatment of refractory chronic pain. Patients and methods: Fifty patients with a history of at least 6-month persistent chronic pain participated in this study. Paroxetine was orally administered once daily at a dose of 10 mg initially, then increased weekly by 10 mg until a maximum of 40 mg. The dose was reduced when an adverse reaction occurred, and treatment was continued for 2 weeks at the optimal dose. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The state of depression was evaluated using the Self-Rating Depression Scale (SDS), and that of pain using the Visual Analogue Scale (VAS). Results: Overall, 70% of the patients had depression. The SDS score was h...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"15 1","pages":"235-239"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79877432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-08-01DOI: 10.1179/016911107X217509
L. Saberski
{"title":"It is all a matter of perspective. It's about time","authors":"L. Saberski","doi":"10.1179/016911107X217509","DOIUrl":"https://doi.org/10.1179/016911107X217509","url":null,"abstract":"","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"35 7 1","pages":"3-3"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89600843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-08-01DOI: 10.1179/016911107X396880
T. Satoh
AbstractImprovements in technology have finally enabled direct visualisation of the epidural space, a longed-for requirement. From 1996, an epiduroscope from Myelotec has been employed widely in clinical practice. However, results suggest that further refinements are necessary. In the future, epiduroscopy should be a an integral part of surgery, be less-invasive, and used in conjunction with operative instruments such as a drilling device, an ultrasonic probe, or a laser beam. Such applications will lead to a reduction in medical costs.
{"title":"The future of epiduroscopy","authors":"T. Satoh","doi":"10.1179/016911107X396880","DOIUrl":"https://doi.org/10.1179/016911107X396880","url":null,"abstract":"AbstractImprovements in technology have finally enabled direct visualisation of the epidural space, a longed-for requirement. From 1996, an epiduroscope from Myelotec has been employed widely in clinical practice. However, results suggest that further refinements are necessary. In the future, epiduroscopy should be a an integral part of surgery, be less-invasive, and used in conjunction with operative instruments such as a drilling device, an ultrasonic probe, or a laser beam. Such applications will lead to a reduction in medical costs.","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"75 1","pages":"200-202"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80743265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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