Articles: pain.
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Our experience in treating 10 patients with intractable pain with paraplegia employing percutaneous epidural or dorsal column stimulation is presented. Initial and long-term results in this group are contrasted with those of 9 patients with intractable post-amputation or post-traumatic neuroma pain. The successful results of neurostimulation treatment of peripheral nerve pain contasts with the disappointing results in the treatment of paraplegic pain.
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The effect of local nerve blockade on the relief of postoperative pain is reported in a series of 167 patients who underwent surgery of the arm, knee or foot. In 80% of cases analgesics were not required within 4 hours postoperatively, and in 39% analgesics were not required within 8 hours. Conventional methods of postoperative pain relief are not always effective. Local nerve blockade can be used to provide complete analgesia after limb surgery and is therefore of great value to postoperative care.
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Transcutaneous electrical nerve stimulation (TENS) was evaluated as a postoperative analgesic. Patients undergoing lumbar spine operations, hip surgery, and gynecological laparotomies were studied. ⋯ Results from 46 experimental patients demonstrated that TENS could reduce the demand for postoperative narcotics in a group of patients who had not used narcotic analgesics before operation. No significant benefit was observed for patients who had used narcotics prior to operation.