Articles: pain-management.
-
J Coll Physicians Surg Pak · Jan 2023
Case ReportsAbdominal Wall Abscess Secondary to Spilled Gallstones 20 Years after Laparoscopic Cholecystectomy.
This case report describes an intra-abdominal and abdominal wall abscess formation in a 53-year male. The abscess developed 20 years after an uncomplicated laparoscopic cholecystectomy. He presented to multiple clinics with complaints of abdominal swelling and pain and had been prescribed multiple courses of antibiotics in the preceding six months before a definitive diagnosis was made. ⋯ Early postoperative complications including abscess formation usually come to attention; however, the importance of late complications should not be undervalued, especially when an abscess develops in a patient with a history of recent or remote cholecystectomy. Thorough investigation, consideration of possible diagnosis related to abscess formation post-cholecystectomy, and timely action is the key to management. Key Words: Abdominal wall abscess, Laparoscopic cholecystectomy, Complications, Retained gallstones.
-
J Coll Physicians Surg Pak · Jan 2023
Case ReportsChallenging Pain Management in a Patient with Trigeminal Neuralgia Secondary to Multiple Sclerosis.
Patients suffering from multiple sclerosis (MS) often develop neuropathic pain. Trigeminal neuralgia (TN) is the most common type in these patients. The pain is characterised by recurrent, unilateral, brief, electric shock-like episodes, abrupt in onset and termination, and limited to the distribution of one or more divisions of the trigeminal nerve, which is difficult to treat when compared to classical TN. ⋯ However, due to severe side effects she had to quit its use. The patient was then successfully treated with an intravenous infusion of lidocaine and remained pain-free without any other pain medications. Key Words: Trigeminal neuralgia, Multiple sclerosis, Lidocaine.
-
Randomized Controlled Trial
The efficacy of ultrasound-guided anterior quadratus lumborum block for pain management following lumbar spinal surgery: a randomized controlled trial.
Quadratus lumborum block (QLB) is a fascial plane block. There is no randomized study on the efficacy of QLB for lumbar surgery. We evaluated the efficacy of QLB for postoperative pain management and patient satisfaction after lumbar disc herniation surgery (LDHS). ⋯ We found that the QLB is effective for pain control following LDHS.
-
Observational Study
Interaction between Dexamethasone, Ropivacaine, and Contrast Media Used in Interventional Pain Treatment: Considerations in Safety.
Background and Objectives: Although epidural steroid injections are used as an effective treatment, this technique is associated with rare but serious ischemic complications, especially when particulate steroids are used. However, recent studies have reported that even if non-particulate steroids are used, particulates are formed by the interaction with some local anesthetics (LA), causing ischemic complications. This observational study evaluated commonly used combinations of non-particulate steroids and LA with contrast media via microscopic analysis and analyzed the chemical properties of each mixture to identify the correlation of particulate formation. ⋯ Conclusions: The combination of ropivacaine and dexamethasone, a non-particulate steroid, mainly used in epidural injections, forms particulates. However, when mixed with contrast media, particulates are dissolved because of changes in pH and factors affecting particulate formation. In fluoroscopy-guided injections, the use of contrast media could resolve particulate formation.