Chang Gung medical journal
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Review Case Reports
Idiopathic spinal epidural lipomatosis - two cases report and review of literature.
Spinal epidural lipomatosis (SEL), an abnormal localized or tumor-like accumulation of fat in the epidural space, is an infrequent complication of chronic steroid usage and an uncommon cause of spinal cord compression. During the period of 1990 to 2006, we have two cases of medically heath SEL patients without history of steroid administration. Their initial clinical manifestations were low back pain, progressive lower extremities weakness, numbness, followed by rapid deterioration of neurogenic intermittent claudication. ⋯ These 2 patients all underwent laminectomy and removal of epidural fat. Postoperatively, they both showed improvement. We reviewed the literature and discussed the current concept in the management of SEL.
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de Quervain's disease is a condition in which there is pain in the radial styloid process caused by stenosing tenosynovitis of the abductor pollicis longus (APL) or/and extensor pollicis brevis (EPB) tendons in the first extensor compartment of the wrist. In this study we studied variations in the tendons of the EPB in the first extensor compartment and its site of insertion. ⋯ Variation in the number of EPB tendons and site of insertion should be taken into consideration by clinicians and surgeons when performing surgical decompression of the first extensor compartment of the wrist in de Quervain's syndrome. Surgical failure may occur due to overlooking variations in EPB tendons or septation of the first extensor compartment.
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Randomized Controlled Trial
Effect of warm lidocaine on the sensory onset of epidural anesthesia: a randomized trial.
Administration of local anesthetics at body temperature has been reported to shorten the onset time of regional block; however, studies examining the effects of warmed lidocaine on the onset of epidural anesthesia are limited. Here, we ascertain whether warming lidocaine solution to body temperature shortens the time to onset of epidural anesthesia. ⋯ Administration of lidocaine at BT compared to RT shortens the onset time of sensory block in epidural anesthesia with no associated adverse effects.
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Randomized Controlled Trial
Transnasal butorphanol for pain relief after uvulopalatopharyngoplasty - a hospital-based,randomized study.
Nasal spray of analgesic is a novel administration for postoperative pain control. In this study, we assessed the efficacy of transnasal butorphanol (TB) for pain relief following uvulopalatopharyngoplasty (UPPP) in obstructive sleep apnea (OSA) patients, and compared pain alleviation effect to oral mefenamic acid and intramuscular meperidine (M> or =&M). ⋯ Administration of TB can significantly alleviate the wound pain after UPPP in OSA patients. This study also confirmed the safety of TB in patients undergoing oropharyngeal surgery.
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Review
The potential application of granulocyte colony stimulating factor therapy on neuropathic pain.
The precise definition of the International Association for the Study of Pain (IASP) revised in 2008 states that neuropathic pain is a type of pain arising as a direct consequence of a lesion or disease affecting the somatosensory system. This kind of pain is due to long-term dysfunction of the nervous system and is clinically characterized by spontaneous and evoked types of chronic pain, which are involved by various distinct pathophysiological mechanisms in the peripheral and central nervous systems. It is relatively common, with an incidence estimated at 0.6% to 1.5% in the US population. ⋯ Here, we briefly review granulocyte colony stimulating factor (G-CSF) therapy in an animal model of neuropathic pain. Our studies also proved that G-CSF can increase the number of opioid-contained polymorphonuclear cells and significantly relieve neuropathic pain. These studies have led to an increased understanding of the opioids and cytokines -modulating peripheral analgesia effect on neuropathic pain, which opens a new avenue in its treatment.