Masui. The Japanese journal of anesthesiology
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Neuropathic pain, as a chronic intractable pain, is well known to be difficult in prevention, diagnosis and treatment. Especially, neuropathic pain from different causes has each characteristics for prevention, diagnosis and treatment. These include post-herpetic pain, persistent chronic pain following traffic accident, pain after peripheral nerve injury in venipuncture, phantom limb pain originating from dysfunction of the primary motor cortex, pain from failed back surgery syndrome, and diabetic neuropathy, and are helpful for understanding prevention, diagnosis and treatment of neuropathic pain.
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To prevent peripheral nerve injury and neuropathic pain resulting from venipuncture, medical students and medical workers should be educated about the following points in clinical practice. First, the medial aspect of the antecubital fossa should not be punctured, to prevent injury to the median and medial anterobrachial cutaneous nerves. Second, the symptoms and signs of neuropathic pain resulting from venipuncture should be taught, to recognize the onset of neuropathic pain. Third, pharmacotherapy for the management of neuropathic pain should be taught to treat neuropathic pain resulting from venipuncture.
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Use of conventional sedatives is restricted in order to evaluate consciousness levels in patients undergoing intracranial surgery. However, patients can become agitated and delirious as a result of insufficient doses of sedatives, and as a consequence require physical restriction. Dexmedetomidine (DEX) provides a cooperative form of sedation, allowing patients easy transition from sleep to wakefulness. The clinical characteristics make it possible to perform neurological assessments. We evaluated the effect of DEX for sedation in patients undergoing cerebral aneurysm surgery. ⋯ DEX is beneficial for sedation in patients undergoing cerebral aneurysm surgery because it provides adequate sedation with less physical restriction.