Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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Randomized Controlled Trial
[Concomitant use of strong and weak opioids in the management of chronic cancer pain].
Our aim was to search whether the addition of Tramadol affected treatment when a dose increase was needed before increasing the transdermal fentanyl (TDF) dose in cancer patients using TDF would have any advantages. ⋯ We found in our study that when TDF and tramadol are used together, TDF need is reduced and the pain management protocol is better tolerated by patients. Based on the results of our study, we suggest concomitant use of strong and weak opioids.
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If migraine does not manifest itself in the form of headache but in some other atypical symptoms with a headache, it is labeled a Migraine Variant. Many migraine variants have been redefined and included in the 2004 International Classification of Headache Disorders classification. These include hemiplegic migraine, basilar-type migraine, childhood periodic syndromes, retinal migraine, complicated migraine, ophthalmoplegic migraine and vertiginous migraine. ⋯ Migraine Variants are important to recognize in clinical practice. Most variants respond well to treatment with antimigraine prophylaxis. If diagnosed correctly, treatment response is always satisfying.
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The development of intracranial subdural hematoma after spinal anesthesia is a rare and serious complication that can be fatal if untreated. Needle puncture to the dura mater can cause leakage of cerebrospinal fluid, and lead to stretching and rupture of the meningeal blood vessels with resultant bleeding. A 24-year-old patient, with a completely normal history and laboratory analysis, has got a L4-5 level spinal anesthesia well done at first try, using a Quinke 25 G needle and 12,5 mg bupivacaine heavy. ⋯ Emergency cranial computerized tomography was obtained and acute fronto-temporo-parietal subdural hematoma was reported. After spinal anesthesia, continued atypical headache and presence of tinnitus must alert against an underlying subdural hematoma. Early diagnosis can be made by history of the patient combined with neurological and radiological imaging methods.
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The head and neck regions are the most common sites of the human body to be involved in chronic pain conditions. Neuropathic pain is a chronic pain condition, and refers to all pain initiated or caused by a primary lesion or dysfunction or transitory perturbation in the peripheral or central nervous system (CNS). ⋯ These treatments may include endodontic treatment and extraction of the tooth or teeth in the region. In this review, only post-traumatic peripheral pain neuropathies seen after dental treatments will be discussed.