Articles: pain-management.
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This paper is an overview of the results of computer modeling of spinal cord stimulation, started ten years ago at the University of Twente, The Netherlands. Results are given of the analysis of various geometrical factors, including spinal anatomy, which influence the effect of spinal cord stimulation on nerve fiber recruitment and paresthesia coverage. ⋯ Two new electrode types are presented: the narrow bi-/tripole and the transverse tripole. The latter also enables adjusting the body area affected with paresthesia by means of a dual channel pulse generator giving simultaneous pulses, thereby limiting surgical interventions for electrode repositioning.
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Int J Clin Exp Hypn · Jan 1998
Case ReportsHypnotic pain control: some theoretical and practical issues.
Pain management programs assist patients to use their behavioral and cognitive skills for the purpose of rendering their experience of pain as more tolerable in some way. Hypnotic procedures may be included in this perspective. Thus, hypnosis may be best conceived as a set of skills to be deployed by the individual rather than as a state. ⋯ In this article, the authors present a minimal and atheoretical definition of hypnosis, and they list the basic properties of hypnosis that may be used in the treatment of pain. For a number of reasons, it is suggested that undertaking hypnosis as though the individual were indeed being placed into a special trance state may in some cases promote an effective outcome. However, it should be acknowledged that there may be instances when the relevant skills may be more effectively engaged at the expense of a strict special trance state by targeting the specific skills that are to be used for therapeutic benefit.
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Study Design. This is a retrospective study on 102 patients subjected to implantation of a spinal cord stimulation system for nonmalignant chronic pain management. The study was conducted through an extensive questionnaire and telephone interviews by a neutral third party. ⋯ Psychological screening contributed to the success of the procedure. Conclusions. With proper medical and psychological screening and with demonstrated initial pain relief, spinal cord stimulation remains an effective modality in the long-term management of severe chronic pain.
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The aim of the present study was to evaluate the efficacy of EMLA cream (containing a eutectic mixture of local anaesthetics) in controlling pain due to arteriovenous fistula cannulation in teenagers undergoing chronic haemodialysis. The study was conducted in two phases, one prospective, the other a blind randomized trial, at the Paediatric Haemodialysis service of the Paediatrics Department of Padua University, Italy. ⋯ Results showed that: (1) the visual analogue scale calls for an adequate training period; and (2) the EMLA cream might be effective in controlling cannulation-related pain but emotional factors, such as uncontrolled fear and stress, can interfere with the global efficacy of the analgesic approach. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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Z Arztl Fortbild Qualitatssich · Jan 1998
Review[Indications and limits of nerve block techniques].
Repetitive nerve blocks as a monotherapeutic treatment are loosing importance in the therapy of chronic pain. Such invasive methods for pain reduction are just one strategy in the interdisciplinary and multimodal planning of pain therapy. ⋯ Furthermore, it is necessary for the physician to know the typical complications of the invasive treatment and to be able to manage them. It is recommended to document the pain course.