Journal of pain and symptom management
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J Pain Symptom Manage · Jun 1989
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of neurolytic blocks using phenol and cryogenic block in the management of chronic pain.
This study compared the use of phenol and cryogenic blocks for neurolysis in 28 patients. Patients were assigned randomly to receive peripheral nerve blocks with either phenol or cryoanalgesia. Significantly more patients in the phenol group received 20% or greater relief at 2, 12, and 24 wk than patients in the cryogenic group. Only 27% of patients received significant relief, however, indicating that neurolytic blocks were not particularly effective even though local anesthetic blocks produced significant but temporary pain relief.
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There are many potential causes of dyspnea in the patient with cancer. Ultimately, a sense of increased respiratory effort is common to all of these diverse situations. An organized approach to dyspnea in the cancer patient is presented based on psychophysical principles, and treatment modalities are suggested.
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J Pain Symptom Manage · Jun 1989
Side effects and complications of cervical epidural steroid injections.
Two hundred and four cervical epidural injections of corticosteroids were performed on 142 patients for the treatment of cervical pain over a 1-yr period. Injections were performed at the C7-T1 interspace with 10-15 mL of 0.5% lidocaine containing 1 mg per kg of methylprednisone acetate. ⋯ In addition, two side effects were frequently reported: stiff neck lasting 12-24 hr occurred in 13.2% of patients, and a mild facial flushing with subjective (but not objective) fever lasting about 12 hr occurred in 9.3% of patients. In this large series, the procedure appears safe to use in an outpatient setting.
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J Pain Symptom Manage · Mar 1989
Case ReportsThoracic epidural morphine in the palliation of chest wall pain secondary to relapsing polychondritis.
Relapsing polychondritis is a rare disease of unknown etiology characterized pathologically by degeneration of the chondrocyte and replacement with fibrous connective tissue. The following case report presents the pain management of a 34-yr-old man suffering from intractable pain secondary to relapsing polychondritis. ⋯ Factors in the selection of an implantable narcotic delivery system as well as practical considerations including tolerance and potential side effects of intraspinal narcotics are discussed. Ethical issues surrounding the chronic use of intraspinal narcotics in the setting of chronic benign pain are also discussed.
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J Pain Symptom Manage · Mar 1989
Management of craniofacial pain with transcutaneous electrical nerve stimulation: a clinical protocol.
The use of TENS can be of great value in the management of both chronic and acute craniofacial pain, but established protocols for this application are sparse. This paper discusses a simple protocol for the use of TENS that is based on the author's clinical experience with these types of craniofacial pain.