Articles: neuralgia.
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The current study aimed to assess whether local administration of morphine could block the development of hyperalgesia and allodynia in a rat model of osteotomy or bone damage. ⋯ This study shows that local application of a low dose of morphine effectively blocks the development of hyperalgesia and allodynia in a rat model of bone damage through mu-opioid receptor action. These findings provide further evidence that local application of morphine at the time of orthopedic surgery, bone graft, or bone marrow harvesting may reduce the amount of postoperative pain.
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Clinical Trial
[Lidocaine tape (Penles--a dressing tape based on 60% lidocaine--) reduces the pain of postherpetic neuralgia].
The treatment of postherpetic neuralgia (PHN) by topical administration of local anesthetics has a number of drawbacks. Lidocaine tape (Penles) is a 15 cm2 dressing tape based on 60% lidocaine used to anesthetize skin when an intravenous catheter is inserted. This study aims to evaluate the analgesic efficacy of lidocaine tape in patients with PHN by comparing the results with those of surgical drape (Tegaderm). ⋯ Pain score was reduced at measurements taken starting from 1 hour after lidocaine tape application (P < 0.05). Lidocaine tape induced minor side-effects, erythema in a patient and increase in pain in another patient. In conclusion, lidocaine tape is effective for relief of PHN.
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Neuropathic pain accompanies peripheral nerve injury following a variety of insults including metabolic disorders, traumatic injury, and exposure to neurotoxins such as vincristine and taxol. Vincristine, a microtubule depolymerizing drug, produces a peripheral neuropathy in humans that is accompanied by painful paresthesias and dysesthesias (Sandler et al., [1969] Neurology 19:367-374; Holland et al. [1973] Cancer Res. 33:1258-1264). The recent development of an animal model of vincristine-induced neuropathy provides an opportunity to investigate mechanisms underlying this form of neuropathic pain. ⋯ This decrease in microtubule density was due to a significant increase in the cross-sectional area of unmyelinated axons, suggesting swelling of axons. In addition, vincristine-treated axons had significantly fewer microtubules cut in cross-section and significantly more tangentially oriented microtubules per axon compared to controls. These results suggest that vincristine causes disorganization of the axonal microtubule cytoskeleton, as well as an increase in the caliber of unmyelinated sensory axons.
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Spinal cord stimulation is an accepted treatment for neuropathic pain. Technical advances in electrode design and better patient selection have led to better and sustained pain control by these devices. Multilead electrical stimulation is the latest innovation in implantable electrostimulation (Mattrix, Medtronic Minneapolis, USA). ⋯ Dual channel stimulation is cost saving in patients implanted with two electrodes. This is presented in a third patient with an electrode in the thalamus--as pain treatment for cervicobrachialgia and a second in the epidural space--as treatment for the failed back surgery syndrome. These electrodes were connected to the Mattrix stimulator.
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Randomized Controlled Trial Clinical Trial
Efficacy of oxycodone in neuropathic pain: a randomized trial in postherpetic neuralgia.
Although opioid analgesics are used in the management of neuropathic pain syndromes, evidence of their efficacy remains to be established. We evaluated the clinical efficacy and safety of oxycodone in neuropathic pain using postherpetic neuralgia as a model. ⋯ Controlled-release oxycodone is an effective analgesic for the management of steady pain, paroxysmal spontaneous pain, and allodynia, which frequently characterize postherpetic neuralgia.