Pain medicine : the official journal of the American Academy of Pain Medicine
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Case Reports
Behçet's disease (syndrome) with myalgia and its response to intravenous amino acids: a case series.
To present a case series of patients with refractory Behçet's disease who presented with myalgia and with signs such as mouth and genital ulcerations and skin lesions and were treated with intravenous amino acids. ⋯ Physicians treating myalgia should observe for signs of Behçet's disease, such as oral and genital ulcerations, and consider intravenous amino acids if steroids are not effective.
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We report a case of malignancy-related testicular pain successfully treated by placement of spinal cord stimulator electrodes. Effective analgesia was provided by epidural lead placement over the dorsal columns. The rationale for our technique was based on contemporary understanding of spinal cord stimulation mechanism in conjunction with analysis of our patient's anatomical lesion location. ⋯ Testicular pain may be difficult to treat particularly in patients unable to tolerate opioid analgesics. In cases that have failed conservative therapy, a trial of spinal cord stimulation should be explored.
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Lumbosacral radicular syndrome (LRS) is probably the most frequent neuropathic pain syndrome. Three months to 1 year after onset, 30% of the patients still experience ongoing pain. The management of those patients is complex, and treatment success rates are rather low. The beneficial effect of pulsed radiofrequency (PRF) therapy has been described for the treatment of LRS in case reports and in retrospective and prospective studies. Up until now, no neurological complications have been reported after PRF treatment. The current clinical audit has been performed to assess the amount of pain relief after a single PRF treatment. ⋯ PRF treatment can be considered for the management of LRS patients. These results need to be confirmed in a randomized clinical trial.
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Randomized Controlled Trial Comparative Study
Pre-incisional analgesia with intravenous or subcutaneous infiltration of ketamine reduces postoperative pain in patients after open cholecystectomy: a randomized, double-blind, placebo-controlled study.
In literature, there is controversy on the use of ketamine for management of postoperative pain. The aim of the present study was to evaluate the efficacy of pre-incisional intravenous or subcutaneous infiltration of ketamine on postoperative pain relief after open cholecystectomy. ⋯ A 2 mg/kg dose of subcutaneous infiltration ketamine or 1 mg/kg dose of intravenous ketamine given at approximately 15 minutes before surgery provides an adjunctive analgesia during 24 hours after surgery in patients undergoing cholecystectomy surgery.