The Clinical journal of pain
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Three cases of different types of nerve injuries following orthopedic and chest surgery are described. Recovery from these nerve injuries was prolonged and incomplete. By constant awareness of potential nerve damage during operation, it is possible to prevent such injuries.
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Clinical experience with the sphenopalatine ganglion (SPG) block combined with a review of prior studies led to conducting a retrospective evaluation of four patients with chronic pain treated with the SPG block. The review of case reports suggests the usefulness of SPG blocks in the pain management clinic.
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Case Reports
Reflex sympathetic dystrophy and posttraumatic stress disorder. Multidisciplinary evaluation and treatment.
Reflex sympathetic dystrophy (RSD) may co-occur with posttraumatic stress disorder (PTSD). A case study is reported of a challenging adolescent patient who presented to a chronic pain service with RSD and PTSD. A multidisciplinary approach utilizing nerve-block therapy with adjunctive pharmacologic treatment, physical rehabilitation, and behavioral/cognitive psychological therapy was employed to produce a significant reduction in pain as well as a more physically and psychologically functional adolescent. The diagnosis and treatment of each disease is essential for the successful resolution of symptoms.
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This study examined the relationship of pain drawings to somatization in patients with sickle cell disease (SCD). Sixty-nine adult patients with SCD completed a pain drawing in which they shaded in areas of the body in which they experienced pain and also completed the symptom checklist (SCL) 90-R as an index of psychological distress. ⋯ The results suggest that health care professionals who treat SCD patients need to consider pain patterns. In individuals with pain patterns atypical for SCD, the psychological status of the patient may need to be evaluated to facilitate optimal pain management.
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Recent literature indicates a relationship between history of sexual abuse and subsequent psychological and social dysfunction. Less thoroughly examined are the possible abuse-related physical effects. This article examines the prevalence of sexual abuse among 135 chronic pain patients. ⋯ Twenty-eight percent reported child sexual abuse, with history of victimization more significant for women (39%) than men (7%). The abused and nonabused groups of women differed on such variables as marital status, occupation, history of rape and substance abuse, and age of hospitalization. The relationship between sexual abuse and chronic somatic reactions was discussed.