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Ultrasound and peripheral blocks for acute and chronic pain: A reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: In the regional anesthesia field we assisted to an increasing study and use of ultrasound imaging for peripheral nerve blocks. This approach has been appreciated for good reliability in terms of clinical outcome of blocks and in terms of safety of the procedure. For this reason, ultrasound guidance is nearing to become the standard of care in regional anesthesia and for postoperative pain management. However, its role in invasive procedures in pain medicine is still discussed. The availability of other imaging techniques and lack of familiarization with ultrasonographic imaging are some of the reasons beneath thi...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Giorgio Danelli, Marco Gardini, Daniela Gemmi, Alessandra Markidis, Federico Bizzarri, Alessandro Dallospedale, Claudio Fattibene, Guido Fanelli Source Type: journals

Ultrasound and facet blocks: A reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Facet or zygapophysial joints are considered to be common sources of chronic spinal pain. In addition to causing localized spinal pain, facet joints may refer pain to adjacent structures. Cervical facet-joint pain may radiate to the head, neck, and shoulders. Thoracic facets may produce paraspinous mid-back pain with neuralgic characteristics; and lumbar facet joints may refer pain to the back, buttocks, and proximal lower extremities. Because the facet joint is innervated by the medial branches arising from the posterior rami of the spinal nerve at the same level and a level above the joint, LA blocks of these n...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Laura Bertini, M. Baciarello Source Type: journals

Ultrasound and pain in children: A reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Ultrasound guidance has been demonstrated to improve block characteristics in children including shorter block performance time, higher success rates, shorter onset time, longer block duration, less volume of local anesthetic agents and visibility of neuraxial structures.Clinical studies in children suggest that ultrasound guidance has some advantages over more traditional nerve stimulation-based techniques for regional block. However, the advantage of ultrasound guidance on safety over traditional has not been adequately demonstrated in children except ilio-inguinal blocks.There are only a limited number of rand...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Valeria Mossetti, Giorgio Ivani Source Type: journals

Ultrasound and chronic pain: Innovative approachesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Ultrasound (US) is an increasingly used imaging technique in interventional pain management. It allows the identification of soft tissues, vessels and nerves, without exposing patients and personnel to radiation. Imaging can be performed continuously and the fluid injected is visualized in a real time fashion. Possible applications are nerve blocks of the cervical and lumbar zygapophysial joints, stellate ganglion block, intercostal and paravertebral nerve blocks, inguinal nerve blocks, occipital nerve blocks, blocks of painful stump neuromas, caudal epidural injections and injections of trigger/tender points. Du...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Andreas Siegenthaler, Michele Curatolo, Urs Eichenberger Source Type: journals

Pain in arthritisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Under the term arthritis are grouped a large number of diseases characterized by the occurrence of an inflammatory process within the joints; between the different types of chronic arthritis, rheumatoid arthritis (RA) is the prototypical example. With the increasing importance of early diagnosis and treatment, in the last years several subsets of chronic arthritis have been described, starting from the early arthritis (EAs), term that include all the arthritis of recent onset; within the EAs we recognize the undifferentiated polyarthritis (UPA), that does not fulfill the classification criteria for an established...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Roberto Caporali, Lorenzo Cavagna, Carlomaurizio Montecucco Source Type: journals

Fibromyalgia: From treatment to rehabilitationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Fibromyalgia is a clinical syndrome of chronic widespread pain and reduced pain thresholds to palpation. The pathophysiology remains unknown, but there is increasing evidence that peripheral and central sensitization cause an amplification of sensory impulses that may alter pain perception in fibromyalgia patients. Interventions to treat fibromyalgia should aim at different targets simultaneously in order to reduce peripheral and central sensitization. There are both pharmacologic and non-pharmacologic approaches with evidence for effectiveness in the treatment of fibromyalgia and its associated symptoms. Evidenc...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Marta Imamura, David A. Cassius, Felipe Fregni Source Type: journals

Fibromyalgia: The diagnosis and pharmacologic treatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Fibromyalgia (FM) is a chronic condition characterized by widespread pain and diffuse tenderness along with a constellation of ancillary symptoms. The 1990 ACR criteria for classification of FM are important in enhancing much the research of FM. FM is part of a spectrum of functional somatic syndromes. FM is not a homogenous condition and several subtypes of FM had been determined. The best strategy for management of FM is to use a multidisciplinary approach to treatment using both pharmacological and non-pharmacological interventions.Tramadol, tricyclic drugs, mixed reuptake inhibitors and anticonvulsants show e...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Dan Buskila Source Type: journals

Pain and rheumatology: An overview of the problemEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Actually pain is a very important health problem, affecting the majority of people, leading to a significant worsening of patients quality of life and being responsible for a large amount of both medical resources’ expenses and indirect costs. Between the different causes of pain, rheumatic conditions are predominant; in fact diseases such as osteoarthritis (OA), rheumatoid arthritis (RA), fibromyalgia (FM) and extra-articular rheumatisms (EARs) are not only frequently observed, but are also invariably associated with pain occurrence. According to the wide range of rheumatic diseases described, pain expression ...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Carlomaurizio Montecucco, Lorenzo Cavagna, Roberto Caporali Source Type: journals

Pain and physical medicineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The first stage of any physical medicine intervention for a patient with pain is an accurate diagnosis. This allows a decision on the proposed therapy to be made according to the clinical picture. Recent classifications of pain allow us to divide pain management treatment into three specific groups, aimed at: (1) cancer pain, (2) pain (acute, sub-acute or chronic) as a symptom of a specific pathology, and (3) chronic non-malignant pain. In this article, we offer a summary of our clinical experience regarding the drafting of rehabilitation plans for patients with pain who have been referred to us. (Source: Europea...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Elena Dalla Toffola, Maurizio Bejor Source Type: journals

Psychiatry and chronic pain: Examining the interface and designing a structure for a patient-center approach to treatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Chronic pain disorders require comprehensive care. While interdisciplinary approaches are recommended, the role of the psychiatrist is often misunderstood. Psychiatrists should be involved with the care of patients with chronic pain as early as possible to maximize response to treatment and improvements in quality of life. Psychiatrists offer an expertise that specifically addresses important deficiencies in the care of patients with chronic pain: (1) the lack of a detailed formulation, (2) the lumping of all psychopathology, and (3) the failure to effectively utilize a rehabilitation model of treatment. (Source:...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Michael R. Clark Source Type: journals

Spinal cord stimulation: A brief update on mechanisms of actionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Spinal cord stimulation (SCS) originated from the gate control theory by Melzack and Wall some 40 years ago and is now widely practised as a therapy in neuropathic pain of peripheral origin. The physiological mechanisms behind the beneficial effects however are hitherto only fragmentarily known.In this short review the present knowledge is updated with recent data from animal experiments and from clinical observations. SCS used for neuropathic pain and for ischemic seems to utilize fundamentally different mechanisms and in the latter syndromes the primary effect seems to be reduction of tissue ischemia. In neurop...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Bengt Linderoth Source Type: journals

The pharmacological treatment of neuropathic painEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe characteristics of NP symptoms in order to individualise our therapeutic target and then we list the possible therapeutic drugs for these kinds of symptoms. (Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: C. Bonezzi, M. Allegri, L. Demartini, M. Buonocore Source Type: journals

Systemic opioid and chronic painEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Opioid analgesic drugs currently represent the most powerful choice in pain therapy. They elicit their effects by mimicking endogenous substances – opioid peptides – the natural ligands of the opioid receptors. These analgesic drugs interact with specific receptors physiologically present in the central nervous system (CNS) and in the periphery, where they serve different functions. The opioid receptors modulate well-known functions related to nociceptive transmission, but this system is also involved in the regulation of gastrointestinal, endocrine, and autonomic functions. Opioids are being prescribed more ...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Giustino Varrassi, Chiara Angeletti, Cristiana Guetti, Franco Marinangeli, Antonella Paladini Source Type: journals

Long-term intrathecal morphine influence on major compounds of the endocrine system in elderly populationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Long-term intrathecal opioid administration influenced FSH, LH and GH serum levels. Data on this issue are inadequately described in the literature. The finding of endocrine effects of opioid therapy, nonetheless, cannot be ignored, as it may have clinical relevance in both elderly and young population. We believe that during long intrathecal pain treatments with morphine, clinicians should be aware of both immediate and later opioids side effects, and in particular, they should monitor immune and endocrine changes. (Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: William Raffaeli, Boaz Gedaliahu Samolsky Dekel, Melotti Rita, Donatella Righetti, Alessandro Caminiti, Marco Balestri, Donatella Sarti, Fanelli Guido Source Type: journals

Epidural analgesia and laborEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Whilst women vary in their needs and desire for analgesia in labor it must be acknowledged that neuraxial analgesia is the only technique that can completely relieve the pain of labor. However the technique is not without its own inherent complications, both for the mother and for the process of labor and delivery. In this article the techniques for establishing and maintaining neuraxial analgesia in labor are discussed and the advantages and disadvantages of neuraxial analgesia in labor are explored. (Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Geraldine O’Sullivan Source Type: journals

Epidural space and regional anesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Epidural fat provides sufficient cushion for the pulsatile movements of the dural sac, protects nerve structures, facilitates the movement of the dural sac over the periosteum of the spinal column during flexion and extension, and forms a pharmacologic reservoir of lipophilic substances. Root cuffs have a cellular component that affects the passage of substances injected epiduraly or near the intervertebral foramen, depending on the site of injection, preganglionar, postganglionar or ganglionar. We found fat inside root cuffs but not within the dural sac. Fat in this location may have affect kinetics of lipophili...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: José De Andrés, Miguel Angel Reina, Alberto Prats Source Type: journals

Locoregional anesthesia and anticoagulationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Spinal hematoma is a rare and potentially catastrophic complication of spinal or epidural anesthesia. Risk factors include traumatic needle/catheter placement, sustained anticoagulation in an indwelling neuraxial catheter, and catheter removal during therapeutic levels of anticoagulation. Generally, a patient’s coagulation status should be optimized at the time of spinal or epidural needle/catheter placement, and the level of anticoagulation should be monitored during epidural catheterization. Signs of cord compression, such as severe back pain, progression of numbness or weakness, and bowel and bladder dysfunc...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Terese T. Horlocker Source Type: journals

Efficacy of drugs in regional anesthesia: A reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, since many different drugs are available for regional anesthesia, we must choose wisely the one that exhibits the best safety-efficacy profile and that suits the chosen technique and type of anesthesia/analgesia best. (Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Massimo Allegri, Marco G. Delazzo, Paolo Grossi, Battista Borghi Source Type: journals

Evaluation of peripheral nerve injuryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Common etiologies of peripheral nerve injury include penetrating injury, crush, stretch, and ischemia. Management of nerve injury requires familiarity with the relevant anatomy, pathology, pathophysiology, and the surgical principles, approaches and concerns. Surgical repair is done at varying time intervals after the injury, and there are a number of considerations in deciding whether and when to operate. In neurapraxia, the compound muscle action and nerve action potentials on stimulating distal to the lesion are maintained indefinitely; stimulation above the lesion reveals partial or complete conduction block....
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: William W. Campbell Source Type: journals

Neuropathic pain: Peripheral and central mechanismsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Neuropathic pain refers to a specific pain syndrome characterized by pain and sensory abnormalities in body parts that have lost their normal peripheral innervation or sensory representation. They are to be distinguished from other types of pain because of differences in the underlying pathophysiology and treatment. Following a peripheral nerve injury, a cascade of events occurs in primary afferents causing peripheral sensitization. Central sensitization, which is increased responsiveness in central neurons, is usually the result of an increased barrage from the periphery, but may also occur independent of such p...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Troels Staehelin Jensen, Nanna Brix Finnerup Source Type: journals

Acute postoperative pain as a risk factor for chronic pain after surgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Chronic postoperative pain is a major clinical problem. Several risk factors, including younger age, female gender, psychological, and genetic factors, have been identified. Surgery itself is the most important risk factor. Preoperative pain and severe acute postoperative pain are also very consistent risk factors for the development of chronic postoperative pain. Theoretically, a reduction of postoperative pain should reduce the risk of developing chronic postoperative pain. The present article will summarize the epidemiology of chronic pain after various surgical procedures. The emphasis will be on the relation...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Lone Nikolajsen, Cristina E. Minella Source Type: journals

Interindividual variability of drug transporters: Impact on opioid treatment in chronic renal failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Some transmembrane transporters influence the absorption, the tissue distribution and the elimination of opioids, and their genetic variants may be an important factor in therapeutic efficacy and toxicity. Uptake and efflux transporters may facilitate or limit access of opioids to blood–brain barrier (BBB), modulating pain relief. As renal function is crucial in the metabolism and pharmacokinetic profile of any drug, renal failure and end-stage renal disease may alter drug disposition by affecting protein and tissue binding, and reducing systemic clearance of drugs. (Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Guglielmina Nadia Ranzani, Simona De Gregori, Manuela De Gregori, Mario Regazzi, Stefano Govoni Source Type: journals

Analysis of a population of patients who were referred to a second level pain center: Clinical and demographic characteristicsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Pain is the symptom that leads most patients to ask for medical intervention; if not controlled, pain may become a very costly item in the Italian Health Care system. Proper referral to a second level specialist pain center can extensively decrease the duration of a painful condition, prevent the onset of more pain and of the so-called pain syndromes, and also reduce the improper use of analgesic drugs or pain surgery. Patients should be referred to a specialist pain center when their pain is uncontrolled.In this observational study we analyzed the clinical and demographic data of a population referred for the fi...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: C. Bonezzi, E. Pitino, M. Allegri Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Source Type: journals

Unmet needs in drug treatment of chronic severe pain – clinical evidence on current and future conceptsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - August 31, 2009 Category: Anesthesiology Authors: Hans G. Kress Tags: Pain and Patients – Are We Meeting their Needs? New Concepts in Analgesia for Severe Pain Source Type: journals

Novel concepts for analgesia in severe pain – current strategies and future innovationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - August 31, 2009 Category: Anesthesiology Authors: Michael Schäfer Tags: Pain and Patients – Are We Meeting their Needs? New Concepts in Analgesia for Severe Pain Source Type: journals

Patients' and physicians' needs; defining therapeutic gaps in severe chronic painEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - August 31, 2009 Category: Anesthesiology Authors: Marie Fallon Tags: Pain and Patients – Are We Meeting their Needs? New Concepts in Analgesia for Severe Pain Source Type: journals

IntroductionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - August 31, 2009 Category: Anesthesiology Authors: Joan Hester Tags: Pain and Patients – Are We Meeting their Needs? New Concepts in Analgesia for Severe Pain Source Type: journals

Ultrasound in interventional pain managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Ultrasound (US) is an increasingly used imaging technique in interventional pain management. It allows the identification of soft tissues, vessels and nerves, without exposing patients and personnel to radiation. Imaging can be performed continuously and the fluid injected is visualized in a real time fashion. Possible applications are nerve blocks of the cervical and lumbar zygapophysial joints, stellate ganglion block, intercostal nerve blocks, blocks of painful stump neuromas, caudal epidural injections and injections of trigger/tender points. Due to direct nerve visualization, US has a potential applicat...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Michele Curatolo, Urs Eichenberger Source Type: journals

Ultrasound in paediatric anaesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Regional anaesthesia is widely employed for the perioperative pain control also in children. The literature data confirm the very low rate of complications and side effects of regional anaesthesia in children but there are key points for performing a block and placing a catheter in children: there is the need of good knowledge of anatomical and physiological differences; the use of the more recent local anaesthetics increases the therapeutic window and it is mandatory to work with dedicated paediatric tools. Through the use of new techniques like ultrasound we can improve the success of the blocks reduci...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Valeria Mossetti, Giorgio Ivani Source Type: journals

Ultrasounds for regional anesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Regional anesthesia is living a new era due to the introduction of ultrasounds for regional blocks: several anesthesia procedures with inherent risks of complications have greatly improved in the last years thanks to techniques concerning the “visibility” of the procedures. Ultrasound guided blocks are an important advance in quality, effectiveness and, perhaps, safety when performing peripheral blocks. Some of the blocks considered quite difficult to perform with the electroneurostimulator only are in fact made easier by the ultrasounds technique (see for example the interscalene block or the sopraclavi...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Alessandro Albani Source Type: journals

Ultrasound in acute and chronic pain: why is it necessary?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: High success rates are attainable using state-of-the-art multiple electrical nerve stimulation, loss-of-resistance or fluoroscopic guidance techniques in most interventional acute and chronic pain techniques. Nevertheless, ultrasound (US) guidance for regional anesthesia and pain medicine offers compelling advantages in terms of precise location of anatomical structures, controlled needle advancement and local anesthetic deposition. Accurate models are needed to define criteria for the reproducibility of US examination and nerve block. Familiarization with US imaging is quickly becoming necessary as the next...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Guido Fanelli, Marco Baciarello Source Type: journals

Medical use of opioids: what drives the debate? A brief commentaryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article explores the factors that drive the current debate about the use of opioids to relieve the suffering of patients with chronic intractable pain. (Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Jane C. Ballantyne Source Type: journals

Radiofrequency or neuromodulation treatment of chronic pain, when is it useful?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The management of chronic pain is challenging for the patient and the physician. Besides pharmacologic treatment pain therapists dispose of several minimal invasive interventional techniques. When used for the correct diagnosis and under the appropriate conditions, those techniques have been documented to provide pain relief and improve the patient's quality of life. Too often the use of interventional pain management techniques is postponed until all conservative treatment options fail to provide adequate pain relief or cause intolerable side effects. Evidence is starting to accumulate indicating that earli...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Jean Pierre Van Buyten Source Type: journals

Low back pain: state of artEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Diagnosis of low back pain (LBP) is made by exclusion of secondary spinal diseases, identifiable in the first month of pain (acute LBP – ALBP) through the so-called “reds flags”, and only if pain persists over 4 weeks (sub-acute LBP – SALBP) using diagnostic exams. LBP classification is actually based on the localization (LBP and sciatica) and duration of pain: ALBP, SALBP, and chronic (CLBP) when it lasts over 6 months. ALBP prognosis is very good because it is auto-resolving in most of the cases; on the contrary, CLBP has a bad prognosis (very low rate of resolution even with treatment). The stage ...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Stefano Negrini, Claudia Fusco, Salvatore Atanasio, Michele Romano, Fabio Zaina Source Type: journals

Epidemiology and treatment of pain in Italy: part IIEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Pain relief is a branch of Medicine that only recently has developed, its institutional standardization levels and its process standards have not yet been identified. Pain therapy was first introduced by Bonica in 1951, but is still disregarded in many cases, despite the consciousness that the lack of pain control causes evident damage and has a significant effect on well-being perception. The primary need for not suffering from unnecessary pain is undervalued, as a result of a multiplicity of factors. In order to improve this situation, the “Pain-Free Hospital” (PFH) program was instituted, with the spe...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: W. Raffaeli, G. Varrassi, D. Righetti, M.C. Monterubbianesi, J. Andruccioli, D. Sarti, F. Marinangeli, M.L. Ursini, A. Piroli, A. Paladini Source Type: journals

Epidemiology and treatment of pain in Italy: part IEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Chronic pain can be debilitating and often becomes the defining factor in patients' lives. Many trials have been developed to evaluate the extent and quality of pain in specific populations. The most important informations result from the study “Pain in Europe”, published in 2006, that showed a prevalence of pain by 19%; low back pain was the most frequent disease; one third of the interviewed people complained the worst imaginable pain; on average, people lived with chronic pain for 7.7 years. In regard to the treatment of pain in Italy, the same survey shows inadequate treatment in 47% of cases; 42% of...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: G. Varrassi, W. Raffaeli, F. Marinangeli, M.L. Ursini, A. Piroli, A. Paladini, D. Righetti, M.C. Monterubbianesi, J. Andruccioli, D. Sarti Source Type: journals

Acute Pain Service – what it is, why it is and what is next?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: In this article the organization of Acute Pain Service (APS) in Örebro University Hospital will be described in detail. How this organization works and how it is used to improve pain relief and pain relieving methods will also be described. Future ways to improve this organization and postoperative pain will be discussed. (Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Ragnar Bäckström, Narinder Rawal Source Type: journals

Regional anesthesia and pain management: what's newEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Present technological advances allow more accurate needle/catheter placement. Continuous regional analgesia with perineural catheters has been shown to significantly improve outcome. Grossi introduced the “anesthetic line” concept as a guide for approaches to perineural regional anesthesia. Winnie introduced the concept of the brachial plexus sheath that envelops the neural or neurovascular plexus. He discussed similar sheathes applying to the lower extremity. Recent studies support his sheath theory. Anatomical as well as local anesthetic distribution studies support a new concept that has relevant clin...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: William F. Urmey Source Type: journals

Regional anaesthesia and side effects: is it safe?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The availability of new local anaesthetics and the improvement of regional techniques has caused a great increase of central and peripheral blockades for anaesthesia as well as for postoperative pain. The increase of these blockades tends to increase the rate of complications. In a Pubmed research we found more than 400 articles about this topic. In the analysis of the literature we divided two major chapters: severe complications after central blockades and after peripheral nerve blocks. Analysis of the literature showed a lower incidence of serious complications associated with neuroaxial anaesthes...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Massimo Allegri, Paolo Grossi, Federica Ferrari, Battista Borghi Source Type: journals

How to use drugs for pain management: from pharmacokinetics to pharmacogenomicsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The promise of pharmacogenomics (PGx), i.e. the study of the role of inheritance in the individual variation in drug response lies in its potential to further identify the right drug and dosing regimen in every individual patient. Observations on the impact of cytochrome P450 (CYP) 2D6, the μ-opioid receptor μ 1 (OPRM1), UDP-glucuronosyl (UGT) 2B7 isoenzyme, efflux transporter P-glycoprotein (P-gp) and ATP-binding cassette B1 (ABCB1/multiple drug resistence 1 (MDR1) polymorphisms on opioid disposition are provided to illustrate the potential impact of PGx on pain management. PGx are, however, only one ...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: K. Allegaert, J.N. van den Anker Source Type: journals

Impact of genetic variants on pain and analgesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews recent studies of human genetics of pain which implicate polymorphisms in these candidate genes. Associations of COMT and OPRM1 genetic variants were reported with sensitivity to pain, analgesic requirements as well as side effects of pharmacotherapy in either experimental pain settings or in patients suffering from acute or chronic pain. However, attempts to directly link genotypes to pain states remain largely unsuccessful up to date. Studies associating pain or analgesic demands to single nucleotide polymorphisms or haplotypes showed inconsistent results in the majority. There is a need for suff...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Ulrike M. Stamer, Lan Zhang, Frank Stüber Source Type: journals

Pathophysiology of pain: from theory to clinical evidenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Following damage to the nociceptive signalling system or sustained activation of this a series of plastic changes occur. These changes includes development of increased responses to a noxious stimulus (hyperalgesia), pain evoked by low-intensity normally innocuous stimuli (allodynia), persistence after cessation of stimulation (aftersensations), spread of pain to surrounding non-damaged areas and an increase of pain after repetitive stimulation. The nociceptive system serves a warning role in acute pain states, which is necessary for survival. But in chronic pain conditions the noceiceptive system serves no ...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Troels Staehelin Jensen Source Type: journals

Pain and the pharmacogenetics at the fuzzy border between pain physiopathology and pain treatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Nociceptive pain is time limited and severe nociceptive pain normally responds well to treatment with opioids, On the contrary, neuropatic pain is frequently chronic, and tends to have a less robust response to treatment with opioids. The unsolved problem of insufficient pain treatment at clinical level, including both wanted analgesic effects and unwanted side effects, is a stimulus to expand the knowledge on the physiophatology of pain and on the involved molecular mechanisms. In particular, it is important not only to better understand the molecular mechanisms associated to drugs effects but also to chara...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: Stefano Govoni, Mario Regazzi, Guglielmina Nadia Ranzani Source Type: journals

30 years of pain treatment in Italy: past, present and futureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Chronic pain is a situation that bring patients to ask for a medical intervention and can be originated from many different pathologic conditions. Nowadays, recent advancements in pain treatment have made possible to control pain in many patients, allowing them to return to daily activities. Anaesthesiologists are the modern pain specialists, and must know and define the origin of pain in every case: the comprehension of pain mechanisms gives them the possibility for a planned strategy of treatment. In this work we perform a overview about the “state of the art” of pain treatment in Italy analyzing w...
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Authors: M. Allegri, C. Tinelli, G. Sandrini, C. Bonezzi Tags: Editorial Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: European Journal of Pain Supplements)
Source: European Journal of Pain Supplements - October 1, 2008 Category: Anesthesiology Source Type: journals