Articles: pain-management.
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Case Reports Clinical Trial
Clinical evaluation of paresthesia steering with a new system for spinal cord stimulation.
The goal was to evaluate, in a clinical study, the predicted performance of the transverse tripolar system for spinal cord stimulation, particularly the steering of paresthesia, paresthesia coverage, and the therapeutic range of stimulation. ⋯ The clinical performance of transverse tripolar stimulation is in accordance with the characteristics predicted by computer modeling. It enables finer control of paresthesia than that achieved by polarity changes in conventional spinal cord stimulation systems.
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The pain associated with burn injury and treatment often is managed poorly. The purpose of this article is to describe available pain-management guidelines and to explain how burn pain can be enhanced by using a guideline-based approach. Data from a retrospective audit are used to highlight several of the common causes of pain mismanagement: including inadequate pain assessment, analgesic-knowledge deficits, and incomplete documentation. ⋯ Guidelines for burn-pain management must be broad in scope to allow for variations in analgesic needs across all patient populations and phases of burn recovery. Guidelines are necessary because studies show that information and education alone have little effect on the quality of pain management. What is effective are guideline-based initiatives that make pain visible and care providers accountable.
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We have performed a prospective, questionnaire-based survey on patients' knowledge of and attitudes towards anaesthetists in Hong Kong. Before their preoperative anaesthetic visit, 120 patients completed a three-section questionnaire. The first section consisted of questions designed to assess patients' knowledge about anaesthetists and their practice. ⋯ Seventy percent of patients recognised that anaesthetists are medical doctors and most realised that they provide anaesthesia for surgical procedures. However, there was scant knowledge of anaesthetists' perioperative role or their role in other aspects of patients care such as pain management, intensive care, resuscitation, research, and teaching. Patients felt it was important to be fully informed about the anaesthetic, and were keen to see their anaesthetist both preoperatively and postoperatively.
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Anesthesia and analgesia · Mar 1998
The effect of electroconvulsive treatment on thermal hyperalgesia and mechanical allodynia in a rat model of peripheral neuropathy.
We tested the ability of electroconvulsive treatment (ECT) to block thermal hyperalgesia and mechanical allodynia in rats with peripheral neuropathy. Repeated ECT (six times daily) significantly reduced thermal hyperalgesia 48 h after the end of the final treatment but had no significant effects on mechanical allodynia. Single ECT had no significant effect on thermal hyperalgesia or mechanical allodynia. Neither single nor repeated ECT had any significant effect on the withdrawal response of sham-operated paws and untreated rats to thermal and mechanical stimuli. The anti-thermal hyperalgesic effect of repeated ECT was reversed by the previous administration of nifedipine (L-type Ca2+ channel blocker). We conclude that, due to effects on the voltage dependent calcium channel, ECT modified one of the pain behaviors induced by nerve injury. ECT may be of use in the treatment of human neuropathic pain. ⋯ We showed that repeated electroconvulsive treatment reduced pain responses to heat stimulation after sciatic nerve injury in rats. This study implies a possible therapeutic effect of electroconvulsive treatment on neuropathic pain.