Articles: neuralgia.
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Pain management is rapidly changing as the mysteries of how healthy and damaged nervous systems work to communicate pain to the brain become better understood. The role of subcutaneous or intravenous lidocaine in the management of neuropathic pain has been increasingly studied. Patients with a variety of pain have been shown to benefit from this therapy, including patients with cancer, postherpetic neuralgia, second degree burns, strokes, and diabetes. As research and experience grow, so too will the practitioner's ability to successfully use intravenous and subcutaneous lidocaine therapy for their patients with pain.
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To review use of gabapentin as an adjuvant agent to treat neuropathic pain. ⋯ Gabapentin could be an effective adjuvant agent for many neuropathic pain states.
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J Pain Symptom Manage · Aug 1999
Case ReportsMorphine-induced ventilatory failure after spinal cord compression.
We describe a patient who required large doses of parenteral morphine for severe pain secondary to epidural spinal cord compression caused by metastatic cancer. The pain improved suddenly after neurological progression to a complete cord compression. ⋯ The dose of morphine was then physiologically excessive once the neurologic damage was completed and the pain had been relieved. We advise caution in patients receiving high doses of opioids in which a change in disease status or a pain-relieving intervention may produce rapid pain relief.
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J Pain Symptom Manage · Aug 1999
Comparative Study Clinical Trial Controlled Clinical TrialDifferences in the ratios of morphine to methadone in patients with neuropathic pain versus non-neuropathic pain.
The use of methadone in the treatment of cancer pain is becoming more attractive mainly because of its known efficacy, lack of active metabolites, and low cost. Methadone also blocks the n-methyl-D-aspartate (NMDA) receptor, and this property may result in other clinical advantages. ⋯ We found that the ratio of morphine subcutaneous equivalent dose to methadone is between 5 and 7, which is different from previously described dose ratios. However, our study failed to show a difference in the ratios of patients with neuropathic or non-neuropathic pain syndromes.