Journal of pain and symptom management
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J Pain Symptom Manage · Apr 1992
Case ReportsResponse of central pain syndromes to intravenous lidocaine.
In this study, 8 patients with central pain syndromes, 6 with hemispheric lesions, and 2 with spinal cord lesions were treated with a 1 mg/kg dose of intravenous lidocaine. Patients first received the same volume of normal saline, in single-blind fashion, to monitor placebo effects. Of the 8 patients, 7 responded to lidocaine, and only 1 responded to normal saline. ⋯ In addition, 3 patients had pain relief that lasted for 8-20 wk. These findings, which are in agreement with two previous open-label studies, suggest that a single dose of a local anesthetic, lidocaine, can provide lasting pain relief for patients with central pain syndromes. This analgesic action may be central, and possibly supraspinal, at least in patients with hemispheric lesions.
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J Pain Symptom Manage · Feb 1992
Case Reports Clinical TrialLong-term oral opioid therapy in patients with chronic nonmalignant pain.
In contrast to the use of opioids for the treatment of acute and chronic cancer pain, the administration of chronic opioid therapy for pain not due to malignancy remains controversial. We describe 100 patients who were chronically given opioids for treatment of nonmalignant pain. Most patients experienced neuropathic pain or back pain. ⋯ The most common side effects were constipation and nausea. There were no cases of respiratory depression or addiction to opioids. Our results indicate that opioids can be effective in chronic nonmalignant pain, with side effects that are comparable to those that complicate the treatment of cancer pain.
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J Pain Symptom Manage · Nov 1991
Case ReportsContinuous intrathecal fentanyl infusion for postoperative analgesia.
Following inadvertent dural puncture during epidural catheter placement, a 20 gauge polyethylene catheter was placed in the intrathecal space, and continuous spinal anesthesia with hyperbaric bupivacaine was administered intraoperatively to supplement general anesthesia. Following surgery, a continuous intrathecal fentanyl infusion (0.2 mcg/kg/hr) was administered to provide postoperative analgesia. The child was awake and comfortable throughout this time and required no supplemental analgesic agents. Although epidural catheters are still our preferred method of analgesia, intrathecal fentanyl infusion is one alternative when inadvertent dural puncture occurs.