Articles: pain-management.
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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.
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Regional anesthesia · Mar 1991
Case ReportsA new interabdominis approach to inguinal region block for the management of chronic pain.
The use of an indwelling catheter for repeated injections of local anesthetics has been a beneficial addition to our armamentarium for management of chronic pain syndromes. Indwelling catheters take advantage of anatomic planes, and the concept of an interabdomins muscular plane allows placement of a catheter along the course of the ilioinguinal and iliohypogastric nerves. We report the successful treatment of chronic groin pain via an interabdominis indwelling catheter. This is the first report of the use of such an indwelling catheter.
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The following discussion demonstrates a clinical need for a physical education service in a multidisciplinary pain center. Weight loss, and physical and aerobic conditioning are essential aspects of managing pain. By improving patient care and increasing one's pain center attraction, physical education and aerobic research centers can also increase departmental revenues.
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Pain is one of the most original and oldest experiences of humans and is an example of the psychosomatic interconnection and unity of processes in the human organism. For man it is above all a subjective experience and condition. Pain can be divided into acute and chronic pain. ⋯ Chronic pain can be mitigated by psychotherapeutic programmes by means of which we alter the patient's incorrect idea on the origin of pain and help him to gain control over his pain and promote his activity and self-consciousness. It is advisable to engage in therapy also the family and support the formation of self-help groups. In the USA and FRG favourable and stable results are reported with influencing of pain and its therapy by psychological procedures.
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J Pain Symptom Manage · Feb 1991
Clinical Trial Controlled Clinical TrialAuricular transcutaneous electrical nerve stimulation (TENS) reduces phantom limb pain.
The present paper evaluates the efficacy of low frequency, high intensity auricular transcutaneous electrical nerve stimulation (TENS) for the relief of phantom limb pain. Auricular TENS was compared with a no-stimulation placebo condition using a controlled crossover design in a group of amputees with (1) phantom limb pain (Group PLP), (2) nonpainful phantom limb sensations (Group PLS), and (3) no phantom limb at all (Group No PL). ⋯ Ratings of mood, sleepiness, and anxiety remained virtually unchanged across test occasions and sessions, indicating that the decrease in pain was not mediated by emotional factors. Further placebo-controlled trials of auricular TENS in patients with phantom limb pain are recommended in order to evaluate the importance of electrical stimulation parameters such as pulse width and rate, and to establish the duration of pain relief.