Der Schmerz
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In 2003 the International Headache Society (IHS) published the second edition of the International Classification of Headache Disorders. Diagnostic criteria for no less than 206 separate headache diagnoses are presented in the parts (I) primary headaches, (II) secondary headaches and (III) cranial neuralgia, central and primary facial pain. ⋯ It is the task of the headache specialist to identify the correct headache diagnose with the smallest effort possible. Both, the differentiation between secondary and primary headaches and the differentiation between the various primary headaches are of equal importance.
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Myalgias of the masticatory muscles are the most frequent noninfectious complaints in the orofacial region. After summarizing the current knowledge on the physiology, etiology, pathophysiology, diagnosis, and differential diagnosis of masticatory muscle pain, we specifically focus on management recommendations. ⋯ Longitudinal short- and long-term studies have revealed that different therapeutic measures are similarly effective. In patients with chronic masticatory myalgias associated with psychosocial impairment, however, additional involvement of a psychotherapist is crucial.
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Randomized Controlled Trial
[Electrical point stimulation (P-STIM) via ear acupuncture: a randomized, double-blind, controlled pilot study in patients undergoing laparoscopic nephrctomyX].
The aim of this study was to determine whether P-STIM-verum in patients undergoing laparoscopic nephrectomies resulted in a lower consumption of analgesics and an improvement of pain scores compared with P-STIM-placebo when administered for acute peri- and postperative pain. ⋯ In this study we were able to demonstrate, that pre- and postoperative P-STIM applied in patients undergoing laparoscopic nephrectomies seems to be an effective, simply applied method with few side-effects for reducing pain and postoperative analgesic consumption.
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The aim of the study is to show whether negative coping style has an impact on post-operative pain reporting and pain-related behaviour. ⋯ High negative coping style may cause a discrepancy between pain reporting and pain-related behaviour. This should be taken into account in the perioperative care of patients.
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Intraspinal drug infusion using implantable pumps and catheter systems is a safe and effective therapy for selected pain patients with severe chronic pain. It improves pain relief, reduces drug-related side effects, decreases the need for oral analgesia and enhances quality of life in a segment of chronic pain patients whose pain has not been controlled with more conservative therapies. ⋯ Careful patient selection and management as well as a multidisciplinary approach are determinants of successful treatment. Current practices for patient selection and management, screening, drug selection, dosing and implantation for intrathecal drug delivery systems are discussed.