Articles: pain-management.
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Stereotact Funct Neurosurg · Jan 1989
Transcutaneous electrical nerve stimulation and spinal cord stimulation for pain relief in reflex sympathetic dystrophy.
35 patients with the diagnosis of reflex sympathetic dystrophy in a late stage have been treated with transcutaneous electrical nerve stimulation (TENS). 6 out of the 35 were also submitted to spinal cord stimulation (SCS). The follow-up was from 10 to 36 months. ⋯ In the long run these results are better than those obtained with sympathetic blocks and sympathectomy. TENS and SCS have no effect on osteoporosis or ankylosis.
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Neurosurgical review · Jan 1989
Experience with spinal cord stimulation (SCS) in the management of chronic pain in a traumatic transverse lesion syndrome.
Epidural electrical stimulation of the spinal cord by means of percutaneously implanted electrodes was successfully used in cases of traumatic paraplegia with chronic pain, more particularly if vegetative components predominated. Out of seven patients treated in our clinic six reported a good or very good outcome of the stimulation over follow-up periods up to six years. On account of the good effect on chronic pain the use of this stimulation procedure is indicated and justified before considering any destructive operative measures.
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Anesthesia and analgesia · Dec 1988
Epidural morphine delivered by a percutaneous epidural catheter for outpatient treatment of cancer pain.
Twenty-three outpatients with cancer pain refractory to other methods of pain control were treated with epidural morphine (EM) delivered through a chronically placed percutaneous lumbar epidural catheter. Patients and their families were taught to administer EM at home. ⋯ There were no catheter-related infections or cases of respiratory depression. After 2500 patient treatment days, we have found this method to be a safe and effective method of cancer pain management in outpatients.
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The occurrence of pain was investigated in 118 patients with posttraumatic brachial plexus injuries (BPI). Ninety-five patients were operated upon by the same surgeon. Three to 14 years after BPI and reconstructive surgery, 91% of the patients experienced permanent pain that was severe in 40% and mild in 51% of cases. ⋯ For 57% of patients with pain, a plurimodal medical treatment with tricyclic antidepressants, antiepileptic drugs, and behavioral therapy efficiently reduced pain. For the patients with unbearable paroxystic pain, when medical treatment failed, the destruction of deafferented dorsal horns at the level of avulsion (Nashold procedure) could produce pain relief. In all cases psychosocial management produced early rehabilitation.
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The purpose of this study was to investigate the efficacy of femoral nerve blocks in patients with fractures of the neck of the femur. Thirty-six patients with femoral neck fractures attending the accident department over a three month period received femoral blocks from one of the two authors. ⋯ In all six patients who reported no benefit, the block failed objectively. There were no complications of the procedure.