The Clinical journal of pain
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Case Reports
Ritodrine for Intractable Uterine Pain Due to Extrapelvic Malignant Tumor Metastases: A Case Report.
Effective pain management is an essential component of cancer treatment as approximately 75% of all cancer patients experience excruciating nociceptive pain even at maximum safe doses of nonsteroidal anti-inflammatory drugs and/or opioids. We report a case where ritodrine hydrochloride effectively controlled refractory pain due to uterine metastases from thymic carcinoma. ⋯ Ritodrine relieved the pain caused by uterine contraction due to metastases and enhanced the quality of life.
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Patients with complex regional pain syndrome type 1 might have disturbed autonomic function and increased heart rate fractal dynamics with a resultant impaired baroreflex sensitivity (BRS). We hypothesized that these parameters of impaired cardiovascular regulation might improve with a reduction of pain intensity. ⋯ Increased LF/HF ratios likely indicate that patients had an imbalance of the autonomic nervous system. The increased fractal slope suggests that patients developed strong self-similarity of HR variability. The highly predictable HR variability leads to impaired hemodynamic homeostasis, resulting in decreased BRS. The impaired cardiovascular regulation improved with a reduction of pain. Thus, spectral analysis of HR variability may be useful objectively to follow complex regional pain syndrome type 1 patients, not only for pain management but also for the status of cardiovascular stability.
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The incidence of noncancer pain (NCP) in cancer patients is unknown. An analysis of incidence, severity, impact on quality of life (QoL), and appropriateness of NCP treatment in a cohort of cancer patients referred to a radiotherapy center is reported. ⋯ In a cancer patients' population referred to a radiotherapy center, the NCP incidence was higher than the CP incidence and NCP intensity was only slightly lower than CP. NCP was significantly pharmacologically undertreated and it was related to a decline in QoL.