Pub Date : 2022-12-01DOI: 10.4103/ijpn.ijpn_103_22
S. Rastogi, A. Agarwal, Yasum Litin, N. Singh, Hitesh Patel
Introduction: Metastatic vertebral fractures (VF) commonly cause severe disabling pain in cancer patients. VFs are common among elderly patients and account for approximately 1.5 million per year in the general population. Objective: Bone metastasis, which is a second major cause of pathologic fracture, may lead to severe intolerable pain, life-threatening hypercalcemia, spinal cord compression, and immobility. The purpose of this study was to evaluate pain relief and improvement in quality of life (QOL) in patients with metastatic VF undergoing percutaneous vertebroplasty (PVP). Methods: Ten cancer patients having metastatic VF underwent PVP from July 2018 to August 2020. All demographic data, procedures, improvement in pain, and analgesic requirements of patients were taken from a computer data system and telephonic follow-up. Results: Majority of patients were suffering from carcinoma lung followed by carcinoma pancreas. The mean ± standard deviation of Visual Analog Scale preoperatively was 8.8 ± 1.35, reduced to 2.14 ± 2.11 at 6 months postoperatively, suggesting significant pain reduction. Eight patients had reduction in analgesic requirements and two did not require any analgesics postoperatively. During the entire follow-up, there was no delayed complication. Conclusion: PVP is an effective, safe, and minimally invasive procedure for treating painful metastatic vertebral compression fracture refractory to conservative treatments. It provides a marked reduction of pain, maintains mechanical stability of the vertebrae, and improves QOL.
{"title":"Percutaneous vertebroplasty in metastatic vertebral fracture: A retrospective cross-sectional study","authors":"S. Rastogi, A. Agarwal, Yasum Litin, N. Singh, Hitesh Patel","doi":"10.4103/ijpn.ijpn_103_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_103_22","url":null,"abstract":"Introduction: Metastatic vertebral fractures (VF) commonly cause severe disabling pain in cancer patients. VFs are common among elderly patients and account for approximately 1.5 million per year in the general population. Objective: Bone metastasis, which is a second major cause of pathologic fracture, may lead to severe intolerable pain, life-threatening hypercalcemia, spinal cord compression, and immobility. The purpose of this study was to evaluate pain relief and improvement in quality of life (QOL) in patients with metastatic VF undergoing percutaneous vertebroplasty (PVP). Methods: Ten cancer patients having metastatic VF underwent PVP from July 2018 to August 2020. All demographic data, procedures, improvement in pain, and analgesic requirements of patients were taken from a computer data system and telephonic follow-up. Results: Majority of patients were suffering from carcinoma lung followed by carcinoma pancreas. The mean ± standard deviation of Visual Analog Scale preoperatively was 8.8 ± 1.35, reduced to 2.14 ± 2.11 at 6 months postoperatively, suggesting significant pain reduction. Eight patients had reduction in analgesic requirements and two did not require any analgesics postoperatively. During the entire follow-up, there was no delayed complication. Conclusion: PVP is an effective, safe, and minimally invasive procedure for treating painful metastatic vertebral compression fracture refractory to conservative treatments. It provides a marked reduction of pain, maintains mechanical stability of the vertebrae, and improves QOL.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"40 - 45"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49624904","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}
Various pain generators can lead to low backpain. It includes conditions affecting the muscles, lumbar spine, joints, traversing and exiting nerve roots etc. The IASP named 2021 the year as the Global Year About Back Pain, highlighting its importance. Multiple modalities exist for the treatment of conditions causing low-back pain, including non-pharmacological therapies, drugs, percutaneous minimally invasive techniques and surgeries. This review aims at providing a cursory view of the common ailments causing low backache and its corresponding minimally invasive techniques.
{"title":"Minimally invasive pain and spine interventions for low backache","authors":"Pravesh Kanthed, Nitika Vyas, Prateek Arora, Samarjit Dey","doi":"10.4103/ijpn.ijpn_122_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_122_22","url":null,"abstract":"Various pain generators can lead to low backpain. It includes conditions affecting the muscles, lumbar spine, joints, traversing and exiting nerve roots etc. The IASP named 2021 the year as the Global Year About Back Pain, highlighting its importance. Multiple modalities exist for the treatment of conditions causing low-back pain, including non-pharmacological therapies, drugs, percutaneous minimally invasive techniques and surgeries. This review aims at providing a cursory view of the common ailments causing low backache and its corresponding minimally invasive techniques.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"24 - 30"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47341256","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 : 2022-12-01DOI: 10.4103/ijpn.ijpn_123_22
G. Das, Pankaj N Surange, A. Agarwal, K. Kothari, Samarjit Dey, Karthic Babu Natarajan, Palak H. Mehta, G. Sharma, Uttam Siddhaye, Neeraj Jain, V. Mohan
Chronic pain is a frequent, intricate, and adverse condition that has a considerable influence on individuals and society at large. In India, its prevalence is around 20%. Although a spectrum of conservative treatment modalities is available, a significant proportion of patients with chronic pain syndromes remain refractory and require surgical intervention. In these groups of patients, radiofrequency ablation (RFA) techniques are safe minimally invasive treatments and provide significant and durable pain relief. Thus, we aimed to formulate the Indian Society for the Study of Pain (ISSP) guidelines for the management of chronic pain syndromes with various RFA techniques. An in-depth literature review by experts in Pain Medicine practising in India, was used to produce 16 statements across 4 common chronic pain syndromes, including knee pain, headache and facial pain, lumbar facet joint pain, and sacroiliac joint pain. The quality of evidence was assessed with the Third US Preventive Service Task Force guidance document and the strength of the recommendation was determined by the Delphi consensus process. The level of evidence for most of the statements was I. Moreover, for most statements, the level of agreement between the experts was good (≥80% of the experts). The ISSP guidelines for the management of chronic pain syndromes are developed by experts in pain medicine. For most of the statements, the highest level of evidence was available and inter-expert agreement was good. However, further high-quality research is required to formulate more inclusive guidelines in this evolving pain medicine speciality.
{"title":"Radiofrequency ablation in chronic pain syndromes: An evidence- and consensus-based indian society for the study of pain guidelines, 2022","authors":"G. Das, Pankaj N Surange, A. Agarwal, K. Kothari, Samarjit Dey, Karthic Babu Natarajan, Palak H. Mehta, G. Sharma, Uttam Siddhaye, Neeraj Jain, V. Mohan","doi":"10.4103/ijpn.ijpn_123_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_123_22","url":null,"abstract":"Chronic pain is a frequent, intricate, and adverse condition that has a considerable influence on individuals and society at large. In India, its prevalence is around 20%. Although a spectrum of conservative treatment modalities is available, a significant proportion of patients with chronic pain syndromes remain refractory and require surgical intervention. In these groups of patients, radiofrequency ablation (RFA) techniques are safe minimally invasive treatments and provide significant and durable pain relief. Thus, we aimed to formulate the Indian Society for the Study of Pain (ISSP) guidelines for the management of chronic pain syndromes with various RFA techniques. An in-depth literature review by experts in Pain Medicine practising in India, was used to produce 16 statements across 4 common chronic pain syndromes, including knee pain, headache and facial pain, lumbar facet joint pain, and sacroiliac joint pain. The quality of evidence was assessed with the Third US Preventive Service Task Force guidance document and the strength of the recommendation was determined by the Delphi consensus process. The level of evidence for most of the statements was I. Moreover, for most statements, the level of agreement between the experts was good (≥80% of the experts). The ISSP guidelines for the management of chronic pain syndromes are developed by experts in pain medicine. For most of the statements, the highest level of evidence was available and inter-expert agreement was good. However, further high-quality research is required to formulate more inclusive guidelines in this evolving pain medicine speciality.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"2 - 23"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44290923","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}
Botulinum toxin (BoNT) is a type of bacterial exotoxin that has been included in medical practice for multiple purposes, one of which is pain management. Some of the proposed mechanisms state that BoNT can reduce neurogenic inflammation by blocking the discharge of neuropeptides, including substance P and calcitonin gene-related peptides. Here, we present three patients with myofascial syndrome and fibromyalgia whose main symptom was pain in the dorsal region, wherein BoNT administered in the erector spinae bilaterally provided prolonged pain relief.
{"title":"Botulinum toxin application in erector spinae blockade for the management of myofascial syndrome in patients with fibromyalgia: A case series","authors":"German Rangel J, Karina Ortega A, Ximena Cediel C","doi":"10.4103/ijpn.ijpn_66_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_66_22","url":null,"abstract":"Botulinum toxin (BoNT) is a type of bacterial exotoxin that has been included in medical practice for multiple purposes, one of which is pain management. Some of the proposed mechanisms state that BoNT can reduce neurogenic inflammation by blocking the discharge of neuropeptides, including substance P and calcitonin gene-related peptides. Here, we present three patients with myofascial syndrome and fibromyalgia whose main symptom was pain in the dorsal region, wherein BoNT administered in the erector spinae bilaterally provided prolonged pain relief.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"46 - 49"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48061043","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 : 2022-12-01DOI: 10.4103/ijpn.ijpn_119_22
A. Agarwal, S. Rastogi, Neha Singh, Manish Singh, Yasum Litin, Sunny Bhasin
Background: Minimally invasive and percutaneous treatments are effective treatment options for idiopathic trigeminal neuralgia (TN).Objectives: Multiple approaches have been described for the treatment of TN. This narrative review has been done to evaluate the current literature on different percutaneous treatment options for TN and to determine whether anyone treatment is better. Methods: The literature through a search of PubMed and Google Scholar was done and the review of the citations of relevant literature, and the authors knowledge of the literature and activity in the field. The literature was reviewed to find the preferred technique of preferred percutaneous treatment by different investigators and the difference in the outcome and/or complications and side effects. Results: Multiple techniques of such as percutaneous retrogasserian glycerol rhizolysis (PRGR), radiofrequency thermal coagulation (RFTC), and percutaneous balloon compression (PBC) for idiopathic TN have been used by different researchers. Effective pain relief and improved quality of life have been reported to be achieved by all the approaches. RFTC has been the most extensively used method, but PBC has been found to be more suitable for corneal preservation in cases of ophthalmic (V1) division pain. The most common imaging method used by large number of researchers is fluoroscope, though few authors have recommended computed tomography scan guidance for placement of cannula in foramen ovale and Meckle's cave, especially in cases with difficult anatomy. Limitations: This review has focused only on percutaneous techniques used by pain physicians. Other techniques such as radiosurgery and gamma knife used by radiologists and neurologists are not included. Conclusions: minimally invasive and percutaneous treatments such as PRGR, RFTC, and PBC are effective methods for the treatment of idiopathic TN. Selection of approach is largely dependent on the pain physician's choice, experience, and equipment available and can be used interchangeably; although for V1 neuralgia, PBC has superiority due to the preservation of corneal reflex.
{"title":"Percutaneous treatment of trigeminal neuralgia: A narrative review","authors":"A. Agarwal, S. Rastogi, Neha Singh, Manish Singh, Yasum Litin, Sunny Bhasin","doi":"10.4103/ijpn.ijpn_119_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_119_22","url":null,"abstract":"Background: Minimally invasive and percutaneous treatments are effective treatment options for idiopathic trigeminal neuralgia (TN).Objectives: Multiple approaches have been described for the treatment of TN. This narrative review has been done to evaluate the current literature on different percutaneous treatment options for TN and to determine whether anyone treatment is better. Methods: The literature through a search of PubMed and Google Scholar was done and the review of the citations of relevant literature, and the authors knowledge of the literature and activity in the field. The literature was reviewed to find the preferred technique of preferred percutaneous treatment by different investigators and the difference in the outcome and/or complications and side effects. Results: Multiple techniques of such as percutaneous retrogasserian glycerol rhizolysis (PRGR), radiofrequency thermal coagulation (RFTC), and percutaneous balloon compression (PBC) for idiopathic TN have been used by different researchers. Effective pain relief and improved quality of life have been reported to be achieved by all the approaches. RFTC has been the most extensively used method, but PBC has been found to be more suitable for corneal preservation in cases of ophthalmic (V1) division pain. The most common imaging method used by large number of researchers is fluoroscope, though few authors have recommended computed tomography scan guidance for placement of cannula in foramen ovale and Meckle's cave, especially in cases with difficult anatomy. Limitations: This review has focused only on percutaneous techniques used by pain physicians. Other techniques such as radiosurgery and gamma knife used by radiologists and neurologists are not included. Conclusions: minimally invasive and percutaneous treatments such as PRGR, RFTC, and PBC are effective methods for the treatment of idiopathic TN. Selection of approach is largely dependent on the pain physician's choice, experience, and equipment available and can be used interchangeably; although for V1 neuralgia, PBC has superiority due to the preservation of corneal reflex.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"31 - 39"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42850528","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}
{"title":"Fluoroscopic landmarks related to gasserian ganglion intervention","authors":"R. Sharma, Ajit Kumar, G. Purohit, S. Goyal","doi":"10.4103/ijpn.ijpn_92_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_92_22","url":null,"abstract":"","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"50 - 50"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49511708","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}
Context: Landmark-guided fascia iliaca compartment block (FICB) has been used in operation theater to facilitate patient position before administration of subarachnoid block, but its utilization is yet to be explored in the accident and emergency department for acute pain relief in patients with femoral fractures. Aims: The study aims to compare dexmedetomidine and dexamethasone as adjuvants to ropivacaine for FICB for onset and duration of analgesia. Settings and Designs: This was a prospective randomized controlled study performed in Mahatma Gandhi Memorial Medical College, Indore. Subjects and Methods: Ninety patients with femoral factures were allocated into three groups, and each group received 15 ml of study drug; (i) ropivacaine with dexmedetomidine (RD) group (0.2% ropivacaine with 50 μg dexmedetomidine), (ii) ropivacaine with dexamethasone (RM) group (0.2% ropivacaine with 4 mg dexamethasone), and (iii) ropivacaine alone (RP) group (0.2% ropivacaine). Patients were assessed for onset, duration of analgesia, and need for rescue analgesic. Severity of pain was assessed using Numerical Rating Scale (NRS) score. Statistical Analysis Used: Comparison of means of three groups was done using One-Way ANOVA and pair-wise comparisons using post hoc Tukey's test. Results: The onset of analgesia was earlier in Group RD at 4.38 min followed by Group RM at 4.45 min and Group RP at 7.86 min, whereas the duration of analgesia was longer in Group RD at 725 min followed by Group RM at 594 min and Group RP at 275 min. NRS Score was comparable before application of FICB. After the block, the mean NRS score in Group RD was 3.83, in Group RM was 5.30, and in Group RP was 7.93. Conclusions: FICB is an effective alternative to intravenous opioids and nonsteroidal anti-inflammatory drugs for acute pain relief in patients with femoral fractures, and dexmedetomidine and dexamethasone can be used as adjuvants to ropivacaine as they both enhance quality of block.
{"title":"Comparison of efficacy of fascia iliaca compartment block using ropivacaine versus ropivacaine with dexmedetomidine versus ropivacaine with dexamethasone for acute pain relief in patients with femoral fractures: A prospective randomized controlled study","authors":"K. Arora, Ritu Pauranik, Minanshu Mittal","doi":"10.4103/ijpn.ijpn_32_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_32_22","url":null,"abstract":"Context: Landmark-guided fascia iliaca compartment block (FICB) has been used in operation theater to facilitate patient position before administration of subarachnoid block, but its utilization is yet to be explored in the accident and emergency department for acute pain relief in patients with femoral fractures. Aims: The study aims to compare dexmedetomidine and dexamethasone as adjuvants to ropivacaine for FICB for onset and duration of analgesia. Settings and Designs: This was a prospective randomized controlled study performed in Mahatma Gandhi Memorial Medical College, Indore. Subjects and Methods: Ninety patients with femoral factures were allocated into three groups, and each group received 15 ml of study drug; (i) ropivacaine with dexmedetomidine (RD) group (0.2% ropivacaine with 50 μg dexmedetomidine), (ii) ropivacaine with dexamethasone (RM) group (0.2% ropivacaine with 4 mg dexamethasone), and (iii) ropivacaine alone (RP) group (0.2% ropivacaine). Patients were assessed for onset, duration of analgesia, and need for rescue analgesic. Severity of pain was assessed using Numerical Rating Scale (NRS) score. Statistical Analysis Used: Comparison of means of three groups was done using One-Way ANOVA and pair-wise comparisons using post hoc Tukey's test. Results: The onset of analgesia was earlier in Group RD at 4.38 min followed by Group RM at 4.45 min and Group RP at 7.86 min, whereas the duration of analgesia was longer in Group RD at 725 min followed by Group RM at 594 min and Group RP at 275 min. NRS Score was comparable before application of FICB. After the block, the mean NRS score in Group RD was 3.83, in Group RM was 5.30, and in Group RP was 7.93. Conclusions: FICB is an effective alternative to intravenous opioids and nonsteroidal anti-inflammatory drugs for acute pain relief in patients with femoral fractures, and dexmedetomidine and dexamethasone can be used as adjuvants to ropivacaine as they both enhance quality of block.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"135 - 139"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43268900","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}
Background: Chronic pain is a silent pandemic with a prevalence varying from 15% to 30% globally. Yet there is widespread ignorance among health professionals as well as society. We conducted this institution-based study among chronic pain patients with the aim to know their awareness and knowledge about chronic pain and pain physicians. The gist of this study can help us in future to bridge the gap and create mindfulness among the masses regarding chronic pain. Materials and Methods: Two hundred and seventy-three people with chronic pain were questioned about their knowledge and awareness of chronic pain through a questionnaire comprising eight questions. Results: Out of 273 participants, 84.62% took treatment for chronic pain. Yet only 2% consulted pain physicians. 62.64% and 73.63% had no idea about chronic pain being a disease in itself and pain physicians, respectively. All the illiterate participants were unaware of the presence of pain specialists and 89.47% of them were ignorant of the sound effects of physical activities in treating chronic pain conditions. Conclusion: The majority of the participants were not aware that chronic pain can be a disease in itself and that there are pain physicians who specialize in treating this condition. However, most of them had an idea about the beneficial effects of performing daily physical activities. Furthermore, the level of education had an impact with illiterates having the least insight about the participants. These lacunae can be improved by educating people, creating more awareness, and further encouraging pain services.
{"title":"Knowledge, awareness, and practices of chronic pain among uttarakhand patients","authors":"Kirtika Saini, N. Gupta, Ajit Kumar","doi":"10.4103/ijpn.ijpn_79_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_79_22","url":null,"abstract":"Background: Chronic pain is a silent pandemic with a prevalence varying from 15% to 30% globally. Yet there is widespread ignorance among health professionals as well as society. We conducted this institution-based study among chronic pain patients with the aim to know their awareness and knowledge about chronic pain and pain physicians. The gist of this study can help us in future to bridge the gap and create mindfulness among the masses regarding chronic pain. Materials and Methods: Two hundred and seventy-three people with chronic pain were questioned about their knowledge and awareness of chronic pain through a questionnaire comprising eight questions. Results: Out of 273 participants, 84.62% took treatment for chronic pain. Yet only 2% consulted pain physicians. 62.64% and 73.63% had no idea about chronic pain being a disease in itself and pain physicians, respectively. All the illiterate participants were unaware of the presence of pain specialists and 89.47% of them were ignorant of the sound effects of physical activities in treating chronic pain conditions. Conclusion: The majority of the participants were not aware that chronic pain can be a disease in itself and that there are pain physicians who specialize in treating this condition. However, most of them had an idea about the beneficial effects of performing daily physical activities. Furthermore, the level of education had an impact with illiterates having the least insight about the participants. These lacunae can be improved by educating people, creating more awareness, and further encouraging pain services.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"152 - 155"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44382908","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 : 2022-09-01DOI: 10.4103/ijpn.ijpn_111_22
Prateek Arora, Samarjit Dey
{"title":"Artificial neural network in clinical pain medicine and research","authors":"Prateek Arora, Samarjit Dey","doi":"10.4103/ijpn.ijpn_111_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_111_22","url":null,"abstract":"","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"117 - 119"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46258928","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}
We report here to draw attention to an uncommon complication that could arise from routinely performed procedure in pain practice such as percutaneous trigeminal radiofrequency ablation (RFA). We report a case of a 53-year-old female who underwent trigeminal nerve RFA for trigeminal neuralgia. RFA after adequate assessment with sensory and motor stimulation is performed as a routine procedure followed by 0.2 ml 1% lignocaine for dense sensory block at the target, following which the patient developed giddiness, nausea, vomiting, and nystagmus. After 2 h of rest and gaze fixation, her symptoms improved, with a decline in the severity of nystagmus. Symptoms gradually resolved over a period of 3 h. Proximity of the membranous part of the auditory tube to the foramen ovale might lead to such mishaps. Direct administration of 1% lignocaine into the middle ear via the auditory tube might be the most likely reason for her condition.
{"title":"A rare event of vestibular complication following percutaneous trigeminal radiofrequency ablation","authors":"Sudheer Dara, V. Elumalai, M. Chandra","doi":"10.4103/ijpn.ijpn_46_21","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_46_21","url":null,"abstract":"We report here to draw attention to an uncommon complication that could arise from routinely performed procedure in pain practice such as percutaneous trigeminal radiofrequency ablation (RFA). We report a case of a 53-year-old female who underwent trigeminal nerve RFA for trigeminal neuralgia. RFA after adequate assessment with sensory and motor stimulation is performed as a routine procedure followed by 0.2 ml 1% lignocaine for dense sensory block at the target, following which the patient developed giddiness, nausea, vomiting, and nystagmus. After 2 h of rest and gaze fixation, her symptoms improved, with a decline in the severity of nystagmus. Symptoms gradually resolved over a period of 3 h. Proximity of the membranous part of the auditory tube to the foramen ovale might lead to such mishaps. Direct administration of 1% lignocaine into the middle ear via the auditory tube might be the most likely reason for her condition.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"156 - 158"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47886319","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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