Pain medicine : the official journal of the American Academy of Pain Medicine
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A previous study of radiofrequency neurotomy of the articular branches of the obturator nerve for hip joint pain produced modest results. Based on an anatomical and radiological study, we sought to define a potentially more effective radiofrequency method. ⋯ The method that we described has the potential to produce complete and reliable nerve coagulation. Moreover, it minimizes the risk of penetrating the great vessels. The efficacy of this approach should be tested in clinical trials.
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Gabapentin is an antiepileptic used for neuropathic pain treatment. Glaucoma can be conceptualized an optic neuropathy associated with characteristic structural damage to the optic nerve and associated visual dysfunction. ⋯ Gabapentin may relieve pain in a painful, blind, glaucomatous eye.
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Case Reports
Successful use of gabapentin in acute pain management following burn injury: a case series.
Pain after burn injury has multiple qualities, including neuropathic and hyperalgesic elements. This element of the burn patients' pain experience is frequently difficult to manage and contributes significantly to their suffering. The onset may be either immediate or delayed. ⋯ Conclusions. This case series introduces the use of gabapentin as a potentially important therapy in the management of neuropathic pain following burn injury. Further research is required to define the use of gabapentin in this specific setting.
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Case Reports
Computed tomography-guided bilateral transdiscal superior hypogastric plexus neurolysis.
This report describes a case of computed tomography (CT)-guided bilateral posteromedian transdiscal approach to the superior hypogastric plexus with neurolysis for treatment of intractable abdominal pain secondary to metastatic prostate cancer. The case is considered in relation to other approaches described in the literature. ⋯ Neurolysis of the superior hypogastric plexus is effective in treating metastatic prostate cancer abdominal pain. While there are significant risks to the CT-guided bilateral transdiscal approach to the superior hypogastric plexus, it may be used effectively as an alternative to navigate anatomic obstacles necessary to perform the neurolysis.
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To identify and characterize methadone-related drug interactions, as well as factors accounting for the variability in manifesting these interactions clinically. ⋯ Drug interactions associated with methadone and their clinical significance are still poorly understood in general. Many tertiary drug information references and review articles report interactions associated with methadone in a general sense, much of which is theoretical and not verified by case reports, much less well-designed clinical trials. The majority of drug interaction reports that do exist were performed in the MMT population, which may differ significantly from chronic pain or cancer pain populations.