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A Severe Case of Complex Regional Pain Syndrome I (Reflex Sympathetic Dystrophy) Managed with Spinal Cord StimulationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of a severe form of a rapidly progressive complex regional pain syndrome type I developing after a right shoulder injury managed with spinal cord stimulation (SCS). After failed conservative treatments, a rechargeable SCS system was implanted in the cervical spine. Allodynia and dystonia improved but the patient subsequently developed similar symptoms in lower right extremity followed by her lower left extremity. The patient became wheelchair bound. A second rechargeable SCS with a paddle electrode was implanted for the lower extremity coverage. The patient's allodynia and skin lesions improved significant...
Source: Pain Practice - October 26, 2009 Category: Anesthesiology Authors: Bernard Canlas, Thomas Drake, Eric Gabriel Source Type: journals

Pelvic Girdle Pain and Low Back Pain in Pregnancy: A ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article will focus on the diagnosis and management of PGP and PLBP, with discussion of terminology, epidemiology, risk factors, pathophysiology, and prognosis. (Source: Pain Practice)
Source: Pain Practice - October 26, 2009 Category: Anesthesiology Authors: Era Vermani, Rajnish Mittal, Andrew Weeks Source Type: journals

Occipital Nerve Stimulator Lead Pathway Length Changes with Volunteer Movement: An In Vitro StudyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Internal pulse generators in sites other than the buttock, including infraclavicular or low abdomen, may be associated with lower lead migration risk. There are many considerations when selecting insertion sites and lead pathways for occipital nerve stimulation. Implanters and patients may consider these results when contemplating surgical approaches to this challenging form of peripheral nerve stimulation. (Source: Pain Practice)
Source: Pain Practice - October 26, 2009 Category: Anesthesiology Authors: Terrence L. Trentman, Jeff T. Mueller, Deepesh M. Shah, Richard S. Zimmerman, Brie M. Noble Source Type: journals

The Role of OROS® Hydromorphone in the Management of Cancer PainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The vast majority of cancer patients experience pain, and treatment with opioids offers the most effective option for pain management. Long-lasting opioid formulations are usually used as cancer pain management strategies. This review surveys the available literature on the only available once-daily sustained-release formulation of hydromorphone, and its use in cancer pain management. Sustained-release (SR) formulations have a more consistent opioid plasma concentration, thereby minimizing the peaks and troughs associated with immediate-release opioid formulations. OROS® hydromorphone (Jurnista[trade], Janssen Pharmaceuti...
Source: Pain Practice - October 26, 2009 Category: Anesthesiology Authors: Jackie Gardner-Nix, Sebastiano Mercadante Source Type: journals

4. Cervical Radicular PainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cervical radicular pain is defined as pain perceived as arising in the arm caused by irritation of a cervical spinal nerve or its roots. Approximately 1 person in 1,000 suffers from cervical radicular pain. In the absence of a gold standard, the diagnosis is based on a combination of history, clinical examination, and (potentially) complementary examination. Medical imaging may show abnormalities, but those findings may not correlate with the patient's pain. Electrophysiologic testing may be requested when nerve damage is suspected but will not provide quantitative/qualitative information about the pain. The presumed causa...
Source: Pain Practice - October 5, 2009 Category: Anesthesiology Authors: Jan Van Zundert, Marc Huntoon, Jacob Patijn, Arno Lataster, Nagy Mekhail, Maarten van Kleef Source Type: journals

The Vertebral Artery is Unlikely to be the Sole Source of Vascular Complications Occurring during Stellate Ganglion BlockEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion: Arterial vessels other than the vertebral artery that also supply the anterior spinal cord and brain stem pass directly anterior to the transverse processes at the most common sites of the SGB. It is anatomically possible, therefore, that accidental injection or induced spasm of these vessels and not the vertebral arteries is responsible for some cases of seizure, hematoma, or other vascular complications during SGB. (Source: Pain Practice)
Source: Pain Practice - September 14, 2009 Category: Anesthesiology Authors: Marc A. Huntoon Source Type: journals

Ultrastructural Changes in Axons Following Exposure to Pulsed Radiofrequency FieldsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study, PRF is applied to the afferent axons of the sciatic nerves of rats. A standard radiofrequency (RF) electrode and RF generator is used to apply the RF signal output to the sciatic nerve using standard PRF parameters that have been successfully used in clinical practice. The ultrastructure of the treated axons is observed after 10 days by electron microscopy. A control, sham application is simultaneously applied to the contralateral sciatic nerve to provide a statistical differential comparison. It is found that the internal ultrastructural components of the axons show microscopic damage after PRF exposure, in...
Source: Pain Practice - September 14, 2009 Category: Anesthesiology Authors: Serdar Erdine, Ayhan Bilir, Eric R. Cosman, Eric R. Cosman Jr. Source Type: journals

Sacral Neuromodulation for the Treatment of Chronic Functional Anorectal Pain: A Single Center ExperienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: This study showed that sacral neuromodulation can be a successful treatment for functional anorectal pain not responding to other treatments. Improvement obtained during test stimulation is a good predictor (diagnostic) for sustained success of permanent sacral neuromodulation. ▪ (Source: Pain Practice)
Source: Pain Practice - September 3, 2009 Category: Anesthesiology Authors: Bas Govaert, Jarno Melenhorst, Maarten van Kleef, Wim G. van Gemert, Cor G. Baeten Source Type: journals

Is Chronic Pain Associated With Somatization/Hypochondriasis? An Evidence-Based Structured ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Somatization is commonly associated with chronic pain and may relate to pain levels. (Source: Pain Practice)
Source: Pain Practice - September 2, 2009 Category: Anesthesiology Authors: David A. Fishbain, John E. Lewis, Jinrun Gao, Brandly Cole, R. Steele Rosomoff Source Type: journals

Incidence and Severity of Epidural Fibrosis after Back Surgery: An Endoscopic StudyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Epiduroscopy demonstrates that the prevalence of severe epidural fibrosis after FBSS is substantially higher than is generally reported in MRI evaluations. Severe epidural fibrosis is an underlying pathology in most patients with FBSS. (Source: Pain Practice)
Source: Pain Practice - September 2, 2009 Category: Anesthesiology Authors: Hemmo A. Bosscher, James E. Heavner Source Type: journals

Development and Psychometric Evaluation of the Pain Impact InventoryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The initial tests showed that the PII seems to be a psychometrically sound instrument for measuring the impact of pain on daily life from a multidimensional perspective. (Source: Pain Practice)
Source: Pain Practice - September 2, 2009 Category: Anesthesiology Authors: Ulf Jakobsson Source Type: journals

Additional Validation of the Pain Medication Questionnaire in a Heterogeneous Sample of Chronic Pain PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The present study represents the next stage in the development of a psychometrically sound, self-report screening tool used for assessing the potential pain-medication-misuse risk. A revised Pain Medication Questionnaire (PMQ) was initially designed to successfully evaluate such risk. A subsequent series of two additional studies further documented the clinical utility of the PMQ. A new shortened version of the PMQ was developed, and its psychometric properties, along with its predictive accuracy in identifying risk for medication misuse, were evaluated. Results revealed that the new version maintained the strong psychomet...
Source: Pain Practice - September 2, 2009 Category: Anesthesiology Authors: Amanda K. Buelow, Robbie Haggard, Robert J. Gatchel Source Type: journals

Low-dose ketamine as an adjunct to routine pain practice: are we ready yet?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Pain Practice)
Source: Pain Practice - September 1, 2009 Category: Anesthesiology Authors: Dmitri Souzdalnitski, Nalini Vadivelu, Keun Sam Chung Tags: LETTERS TO THE EDITOR Source Type: journals

Spinal cord stimulation for control of low back pain after multiple corrective surgeries for severe scoliosis: report of a caseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Pain Practice)
Source: Pain Practice - September 1, 2009 Category: Anesthesiology Authors: Bernard R. Canlas, Antonio N.B. Yap, Berlin Y. Fernando, Jose Martin S. Paiso Tags: LETTERS TO THE EDITOR Source Type: journals

Continuous pain score meterEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Pain Practice)
Source: Pain Practice - September 1, 2009 Category: Anesthesiology Authors: John R. Grothusen Tags: LETTERS TO THE EDITOR Source Type: journals

Intrathecal Therapy: What Has Changed With the Introduction of ZiconotideEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Administering drugs into the intrathecal space is becoming more popular in the treatment of patients with intractable pain or intolerable side effects of systemic analgesic treatments. Although morphine and ziconotide are the only intrathecal analgesics currently approved by regulatory authorities in the U.S. (Food and Drug Administration) and Europe (national-level approval by individual countries for morphine and European Agency for the Evaluation of Medicinal Products approval for ziconotide), a wide variety of opioid and non-opioid drugs are being used in this way. There is no official guidance concerning the selection...
Source: Pain Practice - September 1, 2009 Category: Anesthesiology Authors: Hans G. Kress, Karen H. Simpson, Paolo Marchettini, Ann Ver Donck, Giustino Varrassi Tags: REVIEW ARTICLES Source Type: journals

Intrathecal Ziconotide for Neuropathic Pain: A ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this article is to review the published literature on ziconotide for the treatment of neuropathic pain. Relevant publications were identified through searches of all years of 6 databases, which included PubMed, EMBASE, and CINAHL. Search terms used were ziconotide, SNX-111, MVIIA, Prialt, and neuropathic pain. Publications were included if ziconotide was intrathecally administered (either alone or in combination with other IT agents) to treat neuropathic pain of any etiology and if pain assessment was an outcome measure. Data extracted included study design, IT drug doses, pain outcome measures, and advers...
Source: Pain Practice - August 3, 2009 Category: Anesthesiology Authors: Richard L. Rauck, Mark S. Wallace, Allen W. Burton, Leonardo Kapural, James M. North Source Type: journals

Chronic Migraine: A Prospective Descriptive Clinical Study in a Headache Center PopulationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study describes the pain characteristics of the chronic migraine, including duration, intensity, quality, aggravation by activity, associated features in a headache clinic. One hundred twenty-one chronic migraine patients were evaluated. A total of 79% patients were female, and the mean age was 43.6 years, ranging from 19.0 to 54.2 years. The pain characteristics were predominantly unilateral; either side attacks (43.8%), strictly left-side (19%), or right side (19%). Headache character was reported as throbbing (67%), aching (14%), stabbing (10%), and pressure (9%). Of the associated autonomic features, lacrimation w...
Source: Pain Practice - July 19, 2009 Category: Anesthesiology Authors: Yeşim Yetimalar Beckmann, Yaprak Seçil, Ayşen İnceoğlu Kendir, Mustafa Başoğlu Source Type: journals

IL-6 Levels in Migraine Patients Receiving TopiramateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, we found high IL-6 levels in migraine patients both with and without TPM therapy, suggesting that high IL-6 levels during pain-free periods could be a conditioning factor, making patients more vulnerable to pain attacks in chronic migraine. Further studies investigating the possible mechanism of TPM in migraine are needed. (Source: Pain Practice)
Source: Pain Practice - July 18, 2009 Category: Anesthesiology Authors: Abdulkadir Koçer, Ramazan Memişoğullari, Fusun Mayda Domaç, Atilla İlhan, Emel Koçer, Şefika Okuyucu, Burcu Özdemir, Hatice Yüksel Source Type: journals

Spinal Epidural Abscess as a Result of Dissemination from Gluteal Abscess Secondary to Intramuscular Analgesic InjectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Spinal epidural abscess is a collection of suppurative material that forms between the dura mater and the ligamentum flavum. If not recognized early and treated correctly, it can lead to life-threatening sepsis. Here we report the case of a female patient, 51 years of age, with difficulty walking and bilateral leg pain after having had degenerative discogenic pain for many years. The patient had occasionally received intramuscular non-steroidal anti-inflammatory drug injections. The current report is that of an unusual case of epidural abscess that formed following multiple dose of intramuscular non-steroidal anti-inflamma...
Source: Pain Practice - July 18, 2009 Category: Anesthesiology Authors: Mehdi Sasani, Ozlem Aydin, Ahmet Levent Aydin, Tunc Oktenoglu, Ali Fahir Ozer, Omur Ercelen Source Type: journals

Intrathecal Drug Therapy for Cancer Pain: Time for a Boost!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Pain Practice)
Source: Pain Practice - July 18, 2009 Category: Anesthesiology Authors: Marc A. Huntoon Source Type: journals

Effect of Rectal Diclofenac in Reducing Postoperative Pain and Rescue Analgesia Requirement after Cardiac SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Rectal diclofenac suppository with tramadol provides adequate pain relief after cardiac surgery, and also reduces tramadol consumption and side effects commonly associated with tramadol. (Source: Pain Practice)
Source: Pain Practice - July 18, 2009 Category: Anesthesiology Authors: Naresh Dhawan, Shambhunath Das, Usha Kiran, Sandeep Chauhan, Akshay K Bisoi, Neeti Makhija Source Type: journals

Reversal of Sleep-Disordered Breathing with Opioid WithdrawalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a 30-year-old woman with excessive daytime sleepiness and sleep-disordered breathing for the past 4 years. Medical history was complicated by chronic osteomyelitis, periorbital abscess, and chronic facial pain requiring methadone for pain control for the last 4 years. In this case, ASV, though effective, was not tolerable due to chronic facial pain, and successful withdrawal of methadone at our pain rehabilitation center resolved the sleep-disordered breathing and improved daytime sleepiness. This is to our knowledge the first case report of resolution of sleep-disordered breathing and improvement in daytime sle...
Source: Pain Practice - June 24, 2009 Category: Anesthesiology Authors: Kannan Ramar Source Type: journals

Pain Responder Analysis: Use of Area Under the Curve to Enhance Interpretation of Clinical Trial ResultsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study applied an area-under-the-curve (AUC) analysis to responder profiles in a clinical trial of pregabalin for the treatment of fibromyalgia (FM). Data were from a 14-week, randomized, placebo-controlled trial of pregabalin (300, 450, or 600 mg/day) for the treatment of FM in patients meeting American College of Rheumatology criteria for FM and with a baseline pain score of at least 40 mm on the 100-mm pain visual analogue scale. Pain was evaluated in a daily diary by patients using an 11-point numeric rating scale (0 = no pain, 10 = worst possible pain). Response profiles on pain improvement scores and their differ...
Source: Pain Practice - June 21, 2009 Category: Anesthesiology Authors: Joseph C. Cappelleri, Andrew G. Bushmakin, Gergana Zlateva, Alesia Sadosky Source Type: journals

The Danish Barriers Questionnaire-II: Preliminary Validation in Cancer Pain PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The DBQ-II seems to be a reliable and valid measure of the barriers to pain management among Danish cancer patients. (Source: Pain Practice)
Source: Pain Practice - June 21, 2009 Category: Anesthesiology Authors: Ramune Jacobsen, Claus Møldrup, Lona Christrup, Per Sjøgren, Ole Bo Hansen Source Type: journals

Intrathecal Ziconotide for Complex Regional Pain Syndrome: Seven Case ReportsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ziconotide is a nonopioid analgesic currently indicated as monotherapy, but frequently used in combination with opioids, for the management of severe chronic pain in patients for whom intrathecal (IT) therapy is warranted and who are intolerant of, or whose pain is, refractory to other treatments. There is a paucity of information regarding ziconotide use in patients with complex regional pain syndrome (CRPS). Seven cases in which IT ziconotide was used in patients with CRPS were analyzed. All patients (4 male, 3 female; age range, 14 to 52 years) had experienced inadequate pain relief with multiple conventional and interv...
Source: Pain Practice - June 7, 2009 Category: Anesthesiology Authors: Leonardo Kapural, Kristi Lokey, Michael S. Leong, Sharon Fiekowsky, Michael Stanton-Hicks, Anne J. Sapienza-Crawford, Lynn R. Webster Source Type: journals

Pontine Hemorrhage Following a Recently Implanted Intrathecal Drug Delivery SystemEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: This case emphasizes several important points. First, changes in neurologic and mental status after initiating intrathecal drug therapy may be related to new or pre-existing pathology and not due to intrathecal medications. Second, consideration should be given to central nervous system imaging before intrathecal pump insertion in patients with widely metastatic malignancies. Finally, cerebral spinal fluid hypotension from dural puncture may have contributed to the timing of the hemorrhage in this patient. (Source: Pain Practice)
Source: Pain Practice - June 4, 2009 Category: Anesthesiology Authors: David M Rosenfeld, Terrence Trentman, Naresh P. Patel Source Type: journals

Paracoccygeal Corkscrew Approach to Ganglion Impar Injections for Tailbone PainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article presents a new, paracoccygeal approach whereby the needle is inserted alongside the coccyx and the needle is guided through three discrete steps with a rotating or corkscrew trajectory. Compared with some of the previously published techniques, this paracoccygeal corkscrew approach has multiple potential benefits, including ease of fluoroscopic guidance using the lateral view, ability to easily use a stylet for the spinal needle, and use of a shorter, thinner needle. While no single technique works best for all patients and each technique has potential advantages and disadvantages, this new technique adds to t...
Source: Pain Practice - June 4, 2009 Category: Anesthesiology Authors: Patrick M. Foye, Shounuck I. Patel Source Type: journals

Clinical Characteristics, Pharmacotherapy and Healthcare Resource Use among Patients with Fibromyalgia Newly Prescribed Gabapentin or PregabalinEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Results suggest a high comorbidity and medication use burden in FM patients in this study. Further evaluation is warranted to clarify differences in resource utilization/costs observed with these two anticonvulsants. (Source: Pain Practice)
Source: Pain Practice - June 4, 2009 Category: Anesthesiology Authors: Mugdha Gore, Alesia Beth Sadosky, Gergana Zlateva, Daniel J Clauw Source Type: journals

Does Pain Cause the Perception of Fatigue in Patients with Chronic Pain? Findings from Studies for Management of Diabetic Peripheral Neuropathic Pain with DuloxetineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A major issue in pain literature is whether an etiological association between pain, sleep, and vitality exists. We utilized data from clinical trials of duloxetine for management of diabetic peripheral neuropathic pain (DPNP) to investigate these associations. Data were pooled from 3 double-blind, randomized, placebo-controlled, 12-week trials of patients without mood disorder (N = 1,139). After excluding 442 patients who reported maximum vitality at baseline, experienced treatment-emergent somnolence, asthenia or fatigue, or were taking sedating concomitant medications or duloxetine 20 mg/day, 697 were included in the an...
Source: Pain Practice - June 4, 2009 Category: Anesthesiology Authors: David A. Fishbain, Jerry A. Hall, Richard C. Risser, Jill S. Gonzales Source Type: journals

Spinal Cord Stimulation as a Novel Approach to the Treatment of Refractory Neuropathic Mediastinal PainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the first successful use of a spinal cord stimulator in the treatment of refractory neuropathic mediastinal, esophageal, and anterior neck pain following esophagogastrectomy. (Source: Pain Practice)
Source: Pain Practice - May 30, 2009 Category: Anesthesiology Authors: Oren T. Guttman, Adam Hammer, Boleslav Korsharskyy Source Type: journals

New and Low-Cost Auto-Algometry for Screening Hypertension-Associated HypoalgesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The data obtained from this study indicate that the auto-algometer as described here can detect hypoalgesia associated with hypertension. (Source: Pain Practice)
Source: Pain Practice - May 28, 2009 Category: Anesthesiology Authors: Andrea Viggiano, Nicola Zagaria, Maria Beatrice Passavanti, Maria Caterina Pace, Antonella Paladini, Caterina Aurilio, Michele Adolfo Tedesco, Francesco Natale, Raffaele Calabrò, Marcellino Monda, Elena De Luca Source Type: journals

The Use of Cerebral Oximetry as a Monitor of the Adequacy of Cerebral Perfusion in a Patient Undergoing Shoulder Surgery in the Beach Chair PositionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the use of cerebral oximetry as a monitor of the adequacy of cerebral perfusion in a 63-year-old woman who underwent arthroscopic rotator cuff surgery in a beach chair under general anesthesia. During positioning, a decrease in blood pressure was accompanied by a decrease in cerebral oxygen saturation (SctO2) and was treated with phenylephrine. When spontaneous ventilation resumed, an increase in end-tidal carbon dioxide was accompanied by an increase in SctO2. Cerebral oximetry may prove useful as a guide monitor and manage nonsupine patients. (Source: Pain Practice)
Source: Pain Practice - April 6, 2009 Category: Anesthesiology Authors: Gregory W. Fischer, Toni M. Torrillo, Menachem M. Weiner, Meg A. Rosenblatt Source Type: journals

Ductal Endoscopy of the Breast: More Painful at the Luteal Phase?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Pain during ductal endoscopy of the breast is influenced by a host of factors: some immutable (such as history of lactation) and others variable (day of menstrual cycle). The latter (ie, avoidance of the luteal phase) may be targeted for the minimization of pain. (Source: Pain Practice)
Source: Pain Practice - March 26, 2009 Category: Anesthesiology Authors: George C. Zografos, Flora Zagouri, Theodoros N. Sergentanis, Vassiliki Oikonomou, Maria Fotou, Aphrodite Nonni, Effstratios Patsouris Source Type: journals

Acute Pain and Availability of Analgesia in the Prehospital Emergency Setting in Italy: A Problem to be SolvedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: There is a high prevalence of pain among patients receiving prehospital emergency treatment in Italy and treatment for acute pain during emergency treatment of trauma patients is inadequate. All emergency vehicles, without distinction, should carry opioids and other analgesic drugs (NSAIDs and paracetamol) and there should be no geographic differences in the availability of pain medications. (Source: Pain Practice)
Source: Pain Practice - March 26, 2009 Category: Anesthesiology Authors: Franco Marinangeli, Cristiano Narducci, Maria Laura Ursini, Antonella Paladini, Alberto Pasqualucci, Antonio Gatti, Giustino Varrassi Source Type: journals

Effects of Intravenous Small Dose Ketamine and Midazolam on Postoperative Pain Following Knee ArthroscopyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Ketamine improved the postoperative pain patient satisfaction, increased the maximal sensory level, and was associated with lower sedation scores in the first 15 minutes after administration. Group I was also associated with decreased total meperidine consumption and delayed the time to first recue analgesic administration. Coadministration of ketamine and midazolam did not provide any further benefit over ketamine alone. (Source: Pain Practice)
Source: Pain Practice - March 26, 2009 Category: Anesthesiology Authors: Buket Cagla Ozbakis Akkurt, Kerem Inanoglu, Aydiner Kalaci, Selim Turhanoglu, Zeynel Asfuroglu, Feray Tumkaya Source Type: journals

Evaluation of Epidurographic Contrast Patterns with Fluoroscopic-Guided Lumbar Interlaminar Ventral Epidural InjectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The data showed excellent spread of contrast into the nerve root and the ventral epidural space in all patients. There were no inadvertent vascular or neural complications. LIVE approach can be an alternative way to achieve targeted ventral epidural injection. (Source: Pain Practice)
Source: Pain Practice - March 26, 2009 Category: Anesthesiology Authors: Young K. Choi, Joseph D. Barbella Source Type: journals

Cell Types Obtained from the Epidural Space of Patients with Low Back Pain/RadiculopathyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The findings provide a foundation for future studies of cells obtained from similar patients with the goal of furthering the understanding of the pathogenesis of LBP/RP. (Source: Pain Practice)
Source: Pain Practice - March 11, 2009 Category: Anesthesiology Authors: James E. Heavner, Hemmo A. Bosscher, Mitchell S. Wachtel Source Type: journals

Demographic Characteristics of Patients with Severe Neuropathic Pain Secondary to Failed Back Surgery SyndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Patients suffering from chronic pain of neuropathic origin following FBSS often fail to obtain adequate relief with conventional therapies (eg, medication, nondrug therapies) and suffer greater pain and lower HRQoL compared with patients with other chronic pain conditions. Neuropathic FBSS patients may require alternative and possibly more (cost-) effective treatments, which should be considered earlier in their therapeutic management. (Source: Pain Practice)
Source: Pain Practice - March 6, 2009 Category: Anesthesiology Authors: Simon Thomson, Line Jacques Source Type: journals

Mazes, Conflict, and Paradox: Tools for Understanding Chronic PainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article presents an argument for framing chronic pain within a complex adaptive systems (CAS) paradigm. The first aim of this article is to demonstrate how chronic pain can be framed as a CAS and how paradox, one of the core characteristics of a CAS, exists within the chronic pain experience. The second aim is to illustrate how paradox exists at multiple levels within the health care encounter and ongoing experience of chronic pain. Finally, the article will use the example of interactions at the patient/clinician level to illustrate how health care workers' efforts to deal with issues emergent from the range of parad...
Source: Pain Practice - March 4, 2009 Category: Anesthesiology Authors: Cary A. Brown Source Type: journals

Percutaneous Lumbar Discectomy Using the Dekompressor® System under CT-ControlEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In recent years, new minimally invasive therapies for the treatment of radicular pain associated with contained disc herniation have been introduced. These techniques have changed the field of interventional pain management. In a prospective, nonrandomized case study, we treated patients using the Dekompressor® system guided by computed tomography instead of fluoroscopy. Pain scores, analgesic usage, and activities of daily living were assessed via structured telephone interviews 6 and 12 months after the procedure. Sixty-four patients were treated at 76 lumbar levels. Follow-up data after 12 months were obtained for all ...
Source: Pain Practice - March 3, 2009 Category: Anesthesiology Authors: Peter Lierz, Kenneth M. Alo, Peter Felleiter Source Type: journals

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptively Administered Intravenous Parecoxib: Effect on Anxiety Levels and Procedural Pain During Epidural Catheter Placement for Surgical Operations or for Chronic Pain TherapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The levels of anxiety have been investigated in several medical procedures and early, in the study of pain. The higher the expectation of pain and the anxiety are, the higher the intensity of the pain. Parecoxib seems to exert positive influence on pain and anxiety levels of interventional procedure. Further studies are needed to elucidate the actual mechanisms that are involved. (Source: Pain Practice)
Source: Pain Practice - March 3, 2009 Category: Anesthesiology Authors: Athina Vadalouca, Eleni Moka, Anna Chatzidimitriou, Ioanna Siafaka, Panayiota Sikioti, Erifilli Argyra Source Type: journals

Depression in Chronic Pain Patients: Prevalence and MeasurementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study aimed to: (1) determine prevalence of depression in patients referred to specialist pain services using the Structured Clinical Interview (SCID) diagnostic interview, (2) compare results on the Beck Depression Inventory II (BDI-II) with the SCID to determine the utility of the BDI-II as a screening tool in this population. Thirty-six participants were recruited, mainly women, with a mean age = 47.83 years (standard deviation = 12.85 years), who were heterogeneous with regard to their pain. All completed the BDI-II and SCID. The SCID diagnosed 26 (72%) cases of depression. BDI-II scores showed 31 (86%) that repor...
Source: Pain Practice - March 3, 2009 Category: Anesthesiology Authors: Helen Poole, Susie White, Chantal Blake, Peter Murphy, Ros Bramwell Source Type: journals

Combined Ultrasound and Nerve Stimulation-Guided Thoracic Epidural Catheter Placement for Analgesia Following Anterior Spine Fusion in ScoliosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Anterior spine fusion by thoracotomy is indicated for the treatment of idiopathic scoliosis. Although epidural (EP) analgesia represents the most effective way to provide adequate analgesia after thoracotomy, scoliosis patients have substantial anatomic variations that make EP catheter placement more difficult and often contraindicated. This case report describes a safe, effective technique for placing a thoracic EP catheter in a young patient undergoing anterior spine fusion surgery by thoracotomy. The procedure was guided by both ultrasound (US) and electrical stimulation of the Tuohy needle and catheter. The combination...
Source: Pain Practice - March 3, 2009 Category: Anesthesiology Authors: Pierre Pandin, Lionel Haentjens, Jean Corentin Salengros, Jeam Quintin, Luc Barvais Source Type: journals

Peripheral Subcutaneous Stimulation for the Treatment of Intractable Postherpetic Neuralgia: Two Case Reports and Literature ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a novel treatment approach for intractable PHN utilizing percutaneous peripheral nerve stimulation. Two cases are described in which an 80-year-old man and a 67-year-old woman with intractable PHN, lasting 2 and 10 years, respectively, were effectively treated with implantation of two octapolar leads in the lateral thoracic region. These cases suggest that peripheral nerve stimulation may offer an alternative treatment option for intractable pain associated with PHN especially in the elderly where treatment options are limited because of existing comorbidities. (Source: Pain Practice)
Source: Pain Practice - February 17, 2009 Category: Anesthesiology Authors: Irene Kouroukli, Dionissios Neofytos, Venetiana Panaretou, Vassilios Zompolas, Dimitrios Papastergiou, Georgios Sanidas, Theonymfi Papavassilopoulou, Loukas Georgiou Source Type: journals

Citalopram Enhances B Cell Numbers in a Murine Model of Morphine-Induced ImmunosuppressionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study, CTP had no effect on either total cell counts or lymphocyte populations in the thymus. However, in the spleen, total splenocyte numbers in all CTP-treated animals displayed an increasing trend over saline-treated animals. Interestingly, although more cells were found in the spleen, distribution of splenic lymphocyte populations did not differ between treatments. Despite no increase in total cell number, a high dose of CTP (30 mg/kg) resulted in a significantly higher B cell population in the lymph nodes, while T cell and NK cell numbers were not different. CTP did not significantly reverse morphine-induced w...
Source: Pain Practice - February 15, 2009 Category: Anesthesiology Authors: Thao Nguyen, Jeffery Kramer, Ricardo Vallejo, George Stanton, Byron A. Heidenreich, Ramsin Benyamin, Laura A. Vogel Source Type: journals

Current Understandings on Complex Regional Pain SyndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The mechanisms underlying complex regional pain syndrome (CRPS) have been increasingly studied over the past decade. Classically, this painful and disabling disorder was considered to emerge from pathology of the central nervous system. However, the involvement of additional peripheral disease mechanisms is likely, and recently these mechanisms have also attracted scientific attention. The present article provides an overview of the current understandings regarding pathology of the autonomic and somatic nervous system in CRPS, as well as the roles of neurogenic inflammation, hypoxia, and the contribution of psychological f...
Source: Pain Practice - February 10, 2009 Category: Anesthesiology Authors: Marissa de Mos, Miriam C. J. M. Sturkenboom, Frank J. P. M. Huygen Source Type: journals

Long-term opioid therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Pain Practice)
Source: Pain Practice - February 9, 2009 Category: Anesthesiology Authors: Laxmaiah Manchikanti, Ramsin M. Benyamin Source Type: journals

Response to drs. manchikanti and benyaminEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Pain Practice)
Source: Pain Practice - February 9, 2009 Category: Anesthesiology Authors: Jianguo Cheng, Nagy Mekhail Source Type: journals

Reliability of a Continuous Pain Score Meter: Real Time Pain MeasurementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study has successfully established the test[ndash]retest reliability of the CPSM. The real-time continuous pain measurement may provide more detailed information on a subjects' pain perception compared to a single VAS, in particular during an interval of pain stimuli. (Source: Pain Practice)
Source: Pain Practice - February 9, 2009 Category: Anesthesiology Authors: Elisabeth M. Boormans, Paul J. van Kesteren, Roberto S. Perez, Hans A. Brölmann, Wouter W. Zuurmond Source Type: journals