Articles: pain-management.
-
Int J Obstet Anesth · Jul 1996
Anaesthetic management of labour in two patients with Klippel-Feil syndrome.
Two patients with Type I Klippel-Feil syndrome presented at the antenatal clinic. The first patient, who suffered from sleep apnoea, was delivered of a healthy infant by vacuum extraction. ⋯ In both cases epidural analgesia was employed to allow pain relief during labour. Anaesthetic management of Klippel-Feil syndrome is discussed and the benefits of early anaesthetic assessment and continued involvement of senior anaesthetic and obstetric staff emphasized.
-
Twenty-one patients with primary chronic pain received electroconvulsive therapy (ECT) for concurrent affective symptoms. Twenty of the 21 patients experienced improvement in the level of their pain. ECT can be an effective treatment modality for patients who have chronic pain complicated by affective symptoms.
-
Journal of neurosurgery · Jun 1996
Trigeminal evoked potential-monitored thermorhizotomy: a novel approach for relief of trigeminal pain.
This paper presents a complete method for performing trigeminal thermorhizotomy, guided by neurophysiological data, to relieve tic douloureux. The method involves the use of trigeminal evoked potentials (TEPs) produced by stimulation of the supraorbital, infraorbital, and mental nerves and recorded from electrodes at both the scalp and the trigeminal nerve. To perform the thermorhizotomy, a cannula is modified to produce a concentric bipolar electrode that is suitable for both recording and lesion making. ⋯ Thermolesions are made until the scalp-recorded wave W2 decreases its amplitude by 20% to 50% of the original value or until it is delayed by 0.30 msec. This procedure has the potential to enable extremely precise monitoring of the position of the trigeminal electrode relative to the activated fibers and provides very effective monitoring of the extent of the lesion. The authors have performed this procedure with very satisfactory results in 30 patients with trigeminal neuralgia in the second branch.
-
The author provides practitioners with a summary of recent trends in the management of acute pain in children. This review encompasses pharmacologic techniques as they pertain to two common acutely painful conditions in children: postoperative and procedural pain. ⋯ In the area of procedural pain, current standards for safety guidelines and several recently introduced sedative and analgesic medications are discussed. The author emphasizes that the proper and safe alleviation of acute pain in the pediatric population is not only feasible but is currently the standard of care in the United States.