Articles: pain-management.
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Journal of neurology · Feb 1986
Long-term effects of spinal cord stimulation in chronic pain syndromes.
A total of 50 patients with chronic pain syndromes were selected for treatment with spinal cord stimulation. Correct positioning of electrodes was obtained in 44 patients, leading to an initial alleviation of pain in 25 patients. ⋯ Only 8 patients had at least some beneficial effect lasting for more than 3 years. The long-term results in patients with more severe psychological disturbances were no worse than those of the other patients.
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Review Comparative Study
The evaluation of therapeutic acupuncture: concepts and methods.
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Applied neurophysiology · Jan 1986
Use of antidromic evoked potentials in placement of dorsal cord disc electrodes.
Intraoperative recordings of somatosensory evoked potentials were made in 16 patients undergoing implantation of a dorsal cord stimulation system. Antidromic recordings, obtained by stimulating through the dorsal cord electrode placed in the epidural space and recording over peripheral nerves in the painful region of the body, and much higher signal-to-noise ratios and could be obtained with greater reliability than standard orthodromic recordings. When the placement of the electrode was adjusted to obtain evoked responses in the painful region, paresthesias referred to that region were obtained in virtually every case. Use of this procedure allows implantation and internalization of the electrodes in a single procedure under general anesthesia, and reduces the necessity of subsequent revisions.
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Scand. J. Gastroenterol. · Dec 1985
Randomized Controlled Trial Clinical TrialCoeliac plexus block versus pancreaticogastrostomy for pain in chronic pancreatitis. A controlled randomized trial.
Seventeen patients with chronic pancreatitis and dilated pancreatic ducts were randomly allocated to coeliac plexus block or pancreaticogastrostomy. The number of patients with pain relief after coeliac plexus block and pancreaticogastrostomy did not differ at discharge. ⋯ Operation decreased pancreatic tissue pressure significantly. This pressure decrease is believed to explain pain relief.
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The results of intraspinal narcotic analgesia (INA) in 43 patients with chronic nonmalignant pain syndromes are reviewed. A protocol has been established to improve proper patient selection and includes three phases of study. ⋯ In those patients qualifying for continuous delivery systems (CDS), 65% had good to excellent relief of pain while 34% were considered failures for a variety of reasons. Apparent tolerance development in many of the patients was, in fact, due to technical problems with the epidural catheter instead.