The Clinical journal of pain
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We examined the relationship between pain distribution and measures of self-reported behavioral functioning, pain intensity, frequency, and quality in 51 patients with chronic pain. Results indicate that patients with more distributed pain report their pain as more disruptive to important areas of functioning and also report their pain as more intense and frequent. These results corroborate previous findings and suggest that pain distribution may be used as a useful clinical marker of disability status in chronic pain patients.
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Fifteen patients with brachial plexus avulsion and five patients with postherpetic pain underwent dorsal root entry zone surgery with intraoperative impedance monitoring. The usual range of initial impedance values recorded in the superficial layers of the normal cord is from 1,000 to 1,500 omega. ⋯ In postherpetic neuralgia, measurements of impedance are abnormally low in the involved area, in which the roots appear macroscopically abnormal. In this study, tissue impedance was correlated with gross pathologic changes in the spinal cord.
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Seventy cancer patients suffering from visceral or somatic pain received continuous epidural methadone (EM) analgesia. Initially, 4 mg of 0.1% methadone was given three times daily. If this dose proved ineffective, it was gradually increased to 8 mg four times daily. ⋯ Four of these patients responded well and continued treatment for an average of 18 days. No serious side effects have been observed with EM. With a proper selection of patients and following strict therapy guidelines, epidural methadone is efficacious in treating cancer pain.