Pain physician
-
Complex regional pain syndrome (CRPS) is a pain disorder characterized by sensory, motor, trophic and autonomic dysfunction. The hallmark of the disorder is pain out of proportion of the inciting event. CRPS is difficult for clinicians to manage as there is no gold standard for diagnosis or treatment. ⋯ The immediate pain relief from topical lidocaine allowed the patient to tolerate physical therapy sessions directed at her CRPS. A successful outcome was measured subjectively and objectively by our patient's reduction in symptoms and improvement in ROM and function, respectively. This case study provides preliminary support for improved pain and functional outcome with early adjunct treatment of CRPS with topical lidocaine.
-
Letter Case Reports
Therapeutic success with local botulinum toxin in erythromelalgia.
-
Review Comparative Study
Chronic opioid therapy for chronic non-cancer pain: a review and comparison of treatment guidelines.
Long-term opioid use for chronic non-cancer pain has increased substantially in recent years despite the paucity of strong supporting scientific data and concerns regarding adverse effects and potential misuse. ⋯ There is a growing body of scientific evidence to support opioid use in chronic pain. Future work should focus on continuing to generate good-quality evidence on the long-term benefits of opioid therapy, as well as scientific data to guide drug choice and dosing for specific conditions, populations, and situations.
-
Randomized Controlled Trial
Dexmedetomidine as an adjunctive analgesic with bupivacaine in paravertebral analgesia for breast cancer surgery.
There is little systematic research on the efficacy and tolerability of the addition of adjunctive analgesic agents in paravertebral analgesia. The addition of adjunctive analgesics, such as fentanyl and clonidine, to local anesthetics has been shown to enhance the quality and duration of sensory neural blockades, and decrease the dose of local anesthetic and supplemental analgesia. ⋯ The addition of dexmedetomidine 1 μg/kg to bupivacaine 0.25% in thoracic PVB in patients undergoing modified radical mastectomy improves the quality and the duration of analgesia and also provides an analgesic sparing effect with no serious side effects.