Articles: pain-management.
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Ortop Travmatol Protez · May 1991
[Effectiveness of acupuncture analgesia in the treatment of chronic post-traumatic pain syndromes].
The present work is dedicated to the study of the acupuncture analgesia efficiency in ambulatory practice in treatment of chronic post-traumatic pain syndrome as well as the comparative characteristics of the acupuncture analgesia and electric analgesia in treatment of this pathology. There have been analyzed the results of treatment of the pain syndrome after the traumata of the lower limbs by the IRT method (106 patients), compared the terms and the results of the treatment by the above mentioned methods as well as by the separate acupuncture analgesia and electro-analgesia methods. As a result, it should be noted that the IRT method is more effective in treatment of the chronic pain syndrome as compared with the common traditional methods. The electroanalgesia method, in turn, contributes to more rapid pain soothing and restoration of the vegetative and trophic functions than acupuncture.
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The analgesic effects of transcutaneous electrical nerve stimulation (TENS) and vibratory stimulation (VS), used both separately and simultaneously, were compared in 24 patients suffering from chronic pain. We tested the hypothesis that these combined procedures might improve the pain reducing effects obtained with a single type of stimulation, since they make it possible to recruit a larger number of large diameter afferents and/or to increase the discharge frequencies. Four 35-minute treatment sessions (VS, TENS, VS + TENS, Sham stimulation) were run with each patient. ⋯ The assessments took place immediately after any treatment (0h.), and again 4 hours and 24 hours later. The results showed that dual stimulation not only alleviated pain in more cases than either VS or TENS alone, but also had stronger and more long-lasting analgesic effects. On the other hand, all three types of stimulation used produced stronger analgesic effects than those obtained with the sham stimulation.
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Epidural or intrathecal opiate analgesia, combined with bupivacain by means of an implanted pump, represents a possibility for providing good pain management for cancer patients as well as other chronic pain patients. Several indications, for implantation of a percutanously refillable pump are demonstrated in 27 patients. Twenty-four patients were treated with epidural and 3 with intrathecal catheters. ⋯ In the course of 2 years there has been no significant increase in the daily dose of buprenorphin given epidurally to patients with chronic pain. There were no addiction problems with opiates given epidurally or intrathecally by means of implanted pumps. Because of a 13% complication rate, pumps and epidural or intrathecal catheters should only be implanted by an experienced team.