Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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Comparative Study
[Comparison of phantom limb pain or phantom extremity sensation of upper and lower extremity amputations].
The aim of this retrospective study is to evaluate the upper and the lower extremity amputations with regard to phantom pain, phantom sensation and stump pain. A questionnaire consisting of 23 questions was send to the patients who underwent upper or lower extremity amputation surgery between 1996- 2005. The patients were questioned for the presence of phantom pain and sensations and if they existed for the frequency, intensity, cause of amputation, pre-amputation pain, stump pain, usage of artificial limb. ⋯ The phantom pain was significantly higher in patients who lost dominant hand, experienced pre amputation pain and suffered stump pain. There were no significant differences in regard to phantom pain and sensation between upper and lower extremity amputations. However the presence of preamputation pain, stump pain and amputation of dominant hand were found as risk factors for the development of phantom pain.
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The term adjuvant analgesics describes any drug with a primary indication other than pain, but with analgesic properties in some painful conditions. Adjuvant analgesics often are administered as first-line drugs in the treatment of chronic non-malignant pain. ⋯ Antidepressants, anticonvulsants, neuroleptics, antiarrythmics, antihistaminics, NMDA receptor-antagonists, steroids, muscle relaxants, bisphosphonates, and radiopharmaceuticals are adjuvant agents. This article reviews the evidence supporting the use of adjuvant analgesics for the treatment of pain and emphasizes medical dosages, side effects, and drug interactions.
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Migraine is an episodic headache disorder accompanied by various neurological, gastrointestinal and autonomic changes. In one fifth of the migraineurs, a neurological disturbance (visual, sensory or motor) appears during or before the development of the headache called migraine aura. ⋯ CSD was proposed to be the underlying phenomenon of the migraine aura as it propagates at a similar velocity with visual scotomata and the transient cortical oligemia seen in migraineurs during the aura phase. This data, enabling a better understanding of migraine pathophysiology, will result in new insights into the treatment of other neurological disorders such as cerebrovascular disorders, transient global amnesia, traumatic brain injury, in whose pathophysiology CSD is supposed to take part, beside the treatment of migraine itself.
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Randomized Controlled Trial
The effect of 3-in-1 femoral nerve block with ropivacaine 0.375% on postoperative morphine consumption in elderly patients after total knee replacement surgery.
Total knee replacement (TKR) is one of the most painful orthopedic surgical procedures. This study was aimed to investigate the effect of a single-shot preoperative 3-in-1 femoral nerve block on postoperative pain by using 0.375% ropivacaine, and on the consumption of morphine by using PCA following the TKR surgery. Side effects were also evaluated in this setting. 34 patients were included in this study. ⋯ The morphine requirement was significantly lower in Group R at 12, 18, 24, 48 hr after TKR (p<0.001). Side effects were also lower in this group. Preoperative single-shot 3-in-1 FNB with 40 cc of ropivacaine 0.375% provides better VAS scores, less morphine consumption and fewer side effects in elderly patients when compared to the group with no block.
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The mechanisms responsible for neuropathic pain are not fully understood. Most treatment modalities are ineffective or insufficient for this important clinical condition. Better understanding of pain mechanisms and opioid drug action has widened the indications for opioids in pain therapy of non-malignant pain including neuropathic pain. ⋯ Pain reduction was good throughout the study. Severe side effects did not occur. TDF was effective and well tolerated in the treatment of chronic neuropathic pain of non-malignant origin.