The Clinical journal of pain
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There continues a significant debate over the best contemporary method for treating trigeminal neuralgia. Glycerol injection into the trigeminal cistern has been used in a consecutive series of 200 patients. A total of 80% of the patients have had good or excellent pain relief. ⋯ A recurrence rate of 24% has been the single largest disadvantage of the procedure. Reinjection is usually successful in treatment of recurrence. The combination of efficacy, minimal and temporary neurologic dysfunction, and low complication rate make this procedure, in our opinion, the procedure of choice for the first step, when surgical treatment is required.
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Comparative Study
The subjective experience of acute pain. An assessment of the utility of 10 indices.
Sixty-nine postoperative patients indicated the severity of their pain using eight measures designed to assess pain intensity and two designed to measure pain affect. The utility and validity of the 10 measures were evaluated according to two criteria: (a) the magnitude of the relationship between each scale and a linear combination of the pain measures, and (b) relative rates of incorrect responding. ⋯ The 11-point Box Scale (BS-11) of pain intensity demonstrated the strongest relationship to a linear combination of all of the measures employed and was responded to correctly by each subject in the sample. All else being equal, these results suggest that the BS-11 scale may be the most useful clinical index of pain intensity among postoperative patients.
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Unilateral section of dorsal roots C5 to T1 were performed in rats, and the automutilation behavior was measured by the extent of the limb lesions expressed in arbitrary units. Changes in the scores of automutilation were studied after the injection of four substances: a morphinomimetic (pethidine) and three antibiotics, chloramphenicol, amoxicillin, and doxycycline. Effects were tested on groups of at least eight rats that were compared with another group of eight animals operated on in the same way but injected with distilled water. ⋯ The same effect was found when the animals were injected with chloramphenicol and amoxicillin. On the contrary, doxycycline was found less efficacious. These results are discussed using the hypothesis of autotomy caused by an abnormal painful sensation felt in the deafferented forelimb.
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The continuous subcutaneous infusion of buprenorphine, a new approach to the relief of severe cancer pain, has been carried out using a portable infusion pump. The efficacy of this method was examined in 30 patients by visual analogue scale. ⋯ The minimum effective blood concentration was not detectable by high-performance liquid chromatography. Advantages of this therapy are its simplicity, applicability in many types of cancer, multiple sites of administration, and easier training on the part of health personnel.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized trial of Codetron for pain control in osteoarthritis of the hip/knee.
Patients suffering from pain due to osteoarthritis of the hip and knee participated in a double-blind placebo controlled trial using daily Codetron home care units for 6 weeks over the tibial, saphenous, popliteal and sciatic nerves, and tender points. Seventy-four percent of patients in the real Codetron (Group A) and 28% of the patients in sham Codetron (Group B) improved their pain level more than 25% as measured by visual analogue scale. ⋯ Other functional parameters proved to be insensitive to change in this study. This is highly suggestive of beneficial effect of nonhabituating Codetron as a complementary modality in the therapy of chronic pain conditions such as osteoarthritis.