Current pain and headache reports
-
We describe the various side effects occurring in dialysis sessions and indicate measures for their prevention and/or treatment. Next, we analyze dialysis headache in terms of incidence, prevalence, criteria for its inclusion in the classification of the International Headache Society, and factors related to its triggering, ie, bradykinin and nitric oxide (NO), which have increased plasma levels during dialysis. ⋯ A similarity is particularly detected in terms of the role of NO as the last link in the chain of events that precedes the onset of headache, which is preceded by a latency period of 3 to 4 hours, much longer than the few seconds needed to inactivate NO. A hypothesis is raised to explain this phenomenon, opening new perspectives for the study of the pathophysiology of headaches, including primary headaches.
-
Most patients with cancer pain achieve good analgesia using traditional analgesics and adjuvant medications; however, an important minority of patients (2% to 5%) suffers from severe and refractory cancer pain. For these individuals, spinal analgesics (intrathecal or epidural) provide significant hope for pain relief over months or years of treatment to help improve quality of life. ⋯ A variety of opioids, local anesthetics, clonidine, ketamine, and other analgesics are available for the spinal route of administration and should be titrated to clinical effect or intolerable side effect. This article discusses the appropriate selection of patients for spinal analgesics, reviews current recommended infusion systems and current spinal analgesics, discusses possible complications, and includes practical suggestions for patient management.
-
High-altitude headache (HAH) is an important public health problem because many of the millions of visitors to locations high above sea level get significant headaches each year. Headache is the most common symptom of acute exposure to high altitude. ⋯ This article describes the clinical picture of AMS and CMS. The clinical characteristics of HAH are presented, its pathophysiology is discussed, and the acute and preventive treatment options are reviewed.
-
Curr Pain Headache Rep · Aug 2007
Review Case ReportsAdvances in radiation therapy for oncologic pain.
Pain is a feared component of cancer for a patient. The patient's prior experience with cancer pain will affect how he or she deals with ongoing and acute onset new pain. ⋯ New technologies are rapidly becoming available that will allow more specific and accurate targeting, while limiting the dose that is received by normal tissues and thus minimizing the potential for tissue toxicity. How new techniques and technologies are incorporated into the management of cancer pain will require a better understanding of the disease process being treated.
-
Successful management of pain in the cancer patient requires careful assessment of the components of the pain complaint and accurate diagnosis of the cause of pain. Symptomatic management of pain involves pharmacotherapeutic strategies that focus on opioid use. ⋯ Failure to continuously monitor opioid use generally results in overtreatment or undertreatment of pain. The cognitive and psychomotor effects of long-term opioid therapy are not well-defined and merit further study.