Cases reported "Pain, Intractable"

Filter by keywords:



Filtering documents. Please wait...

1/14. Intrathecal infusion of bupivacaine with or without buprenorphine relieved intractable pain in three patients with vertebral compression fractures caused by osteoporosis.

    BACKGROUND AND OBJECTIVES: At present, there is no reliable method of relieving "refractory" pain in patients with compression fractures of the vertebral bodies caused by osteoporosis. We explored the possibility of relieving this type of pain by intrathecal (i.t.) infusion of bupivacaine with or without buprenorphine. methods: An 18-g nylon i.t. catheter was inserted via a lumbar interspace with its tip positioned at the level of the fractured vertebra from which the maximal pain originated. bupivacaine (2.375-5.0 mg/mL) with (n = 1) or without (n = 2) buprenorphine (0.015 mg/mL) was infused through the i.t. catheter from an external electronic pump. The infusion began in the operating room at a basic rate of 0.1-0.2 mL/h, with optional bolus doses (0.1 mL, 1-4 times/h) via patient controlled analgesia. The daily dose of i.t. bupivacaine was adjusted to provide satisfactory pain relief [visual analogue scores (VAS) = 0-2 on a scale of 0-10]. RESULTS: Satisfactory pain relief was obtained with daily doses of i.t. bupivacaine ranging from 10 to 70 (mean approximately 25) mg and buprenorphine from 0.02 to 0.2 (mean = 0.15) mg. The duration of i.t. treatment was 37, 387, and 407 days, respectively. Two patients terminated the i.t. treatment when it was no longer needed. Treatment was discontinued in the third patient because of death caused by irreversible heart failure. The 2 surviving patients were still free of pain 1,074 and 1,476 days after termination of the i.t. treatment. No severe complications occurred. CONCLUSIONS: Continuous intrathecal infusion of bupivacaine, with or without buprenorphine, appeared to be an effective method for the long-term treatment (months to > 1 year) of "refractory" pain from vertebral compression fractures, in this small group of patients.
- - - - - - - - - -
ranking = 1
keywords = group
(Clic here for more details about this article)

2/14. Effects of stereotactic lesions of the pulvinar and lateralis posterior nucleus on intractable pain and dyskinetic syndromes of man.

    In a series of 18 patients suffering from intractable pain or different types of dyskinetic syndromes, 28 stereotactic lesions of the pulvinar, associated with six lesions of the laterlis posterior nucleus, have been performed. The evaluation of long-term results in intractable pain reduces the therapeutic benefit of the stereotactic pulvinolysis. Concerning dyskinetic syndromes, the pulvinar does not seem to play an important role in spasticity, while its role in other dyskinetic syndromes can be questionable.
- - - - - - - - - -
ranking = 2406.3908685097
keywords = nucleus
(Clic here for more details about this article)

3/14. Use of intravenous valproate sodium in status migraine.

    patients with migraines have typically been given one group of medications for abortive treatment and another for preventative. In the acute situation when the patient has severe nausea it is difficult to administer medications. Intravenous medications would avoid this problem but are limited to the opiates and dihydroergotamine. The following cases demonstrate the acute treatment of migraine with intravenous valproic acid (Depacon). The oral form of valproic acid has been used as a prophylactic agent, but the intravenous form may provide an alternative for abortive care as well. The ease of administration and lack of side effects are also important considerations. Double-blind studies will help clarify the situation.
- - - - - - - - - -
ranking = 1
keywords = group
(Clic here for more details about this article)

4/14. Typical carcinoid tumor of the larynx occurring with otalgia: a case report.

    Neuroendocrine neoplasms of the larynx comprise a rare group of tumors that have a controversial history with regard to their classification. The world health organization categorizes these tumors as typical carcinoids, atypical carcinoids, small-cell neuroendocrine carcinomas, and paragangliomas. Atypical carcinoids and small-cell neuroendocrine carcinomas are the more common. Only 13 cases of typical carcinoid have been reported. Local excision is sufficient for typical carcinoids and paragangliomas, but atypical carcinoids require neck dissection because of their tendency to metastasize. Small-cell neuroendocrine carcinomas are not cured by local excision, and these patients have the worst prognosis (5-year survival: 5%); their treatment is limited to chemo- and radiotherapy. Because of these variations in tumor behavior and treatment, it is essential that otolaryngologists and pathologists to be able to correctly identify the specific type of tumor in order to optimize patient treatment and survival. We report a case of typical carcinoid and review the pertinent literature on this subject.
- - - - - - - - - -
ranking = 1
keywords = group
(Clic here for more details about this article)

5/14. Chronic stimulation of the Kolliker-Fuse nucleus region for relief of intractable pain in humans.

    Chronic electrical stimulation in the periventricular or periaqueductal gray matter regions and the thalamic somatosensory relay nuclei (ventralis posteromedialis and ventralis posterolateralis) provides long-term pain relief in about 50% of patients with intractable pain refractory to other conservative and/or surgical measures. To enhance the success of electrical stimulation in relief of pain, alternative brain and brain-stem targets have been sought. A series of laboratory studies indicated that the Kolliker-Fuse nucleus and the parabrachial region may provide appropriate alternatives to the "classic" targets. This report describes six patients with intractable chronic pain of nociceptive or central origin, in whom an electrode was stereotactically implanted in the region of the Kolliker-Fuse nucleus. Kolliker-Fuse nucleus stimulation alone or in combination with stimulation in the periaqueductal/periventricular gray matter region or the somatosensory thalamic nuclei provided excellent pain relief in three of the six patients.
- - - - - - - - - -
ranking = 3368.9472159135
keywords = nucleus
(Clic here for more details about this article)

6/14. Effect of dorsal column stimulation on pain-induced intracerebral impulse patterns.

    Evoked electrical potentials were recorded via intracerebral electrodes in a patient with stump and phantom limb pain who had a previously implanted dorsal column stimulator. When pain was elicited by peripheral stimulation it was found that positive deflections appeared in the ventrolateral nucleus of the thalamus at time latencies corresponding to the propagation velocities of A delta- and C-fibres. Dorsal column stimulation completely eliminated the C-fibres. Dorsal column stimulation completely eliminated the C-fibre deflection and partially eliminated the A delta-fibre deflection.
- - - - - - - - - -
ranking = 481.27817370193
keywords = nucleus
(Clic here for more details about this article)

7/14. Pain reduction by electrical brain stimulation in man. Part 1: Acute administration in periaqueductal and periventricular sites.

    Acute studies performed in five patients indicate that electrical stimulation of the brain could be a powerful tool for the reduction or control of intractable pain. While chronic or spontaneous pain could be relieved by stimulation of the periaqueductal gray matter, the accompanying side effects render it impossible to stimulate this site regularly. On the other hand, stimulation of medial thalamic sites, particularly medial to the nucleus parafascicularis, yielded good relief of chronic pain at parameters which did not cause many undesirable side effects. The same parameters also produced inhibition of acute pain in two of the five patients.
- - - - - - - - - -
ranking = 481.27817370193
keywords = nucleus
(Clic here for more details about this article)

8/14. Treatment of diabetic neuropathy with pentoxifylline: case report.

    Diabetic neuropathy includes a heterogenous group of neuropathic syndromes associated with diabetes mellitus. One form of diabetic neuropathy is distal symmetric polyneuropathy, which is characterized at a late stage by intractable pain. This pain is generally refractory to present modalities of therapy except for narcotics. pentoxifylline offers a new approach to therapy, reducing the blood viscosity and improving perfusion of ischemic microcirculation. A case report will be presented of intractable painful peripheral neuropathy responding dramatically to pentoxifylline therapy.
- - - - - - - - - -
ranking = 1
keywords = group
(Clic here for more details about this article)

9/14. narcissism and the development of chronic pain.

    Thirteen patients were selected for study from a population of patients undergoing routine psychiatric evaluation in a Pain Clinic. These patients demonstrated consistent character traits (traits typically seen in the narcissistic personality) and appeared to be vulnerable to the development of a chronic pain syndrome. The psychological characteristics of these patients are discussed and compared with a control group of patients with chronic pain. The development aspects of the syndrome are emphasized. Implications for treatment are suggested from the clinical material.
- - - - - - - - - -
ranking = 1
keywords = group
(Clic here for more details about this article)

10/14. Thalamic stimulation for neuropathic pain.

    Eighteen patients with neuropathic pain underwent thalamic electrode implantation. Satisfactory initial pain relief ensued in 14, and their electrode systems were internalized for long-term use. Twelve of the 14 continue to obtain either complete or partial pain relief by regular stimulation. One of the other two patients has had a complete remission of pain, apparently spontaneously, and the other had to have the electrodes removed after it retracted from his thalamus on two occasions. The electrodes have been placed in the sensory nucleus of the thalamus where stimulation evokes paresthesias in the painful part of the body. Technical problems consisting of our inability to locate the target in two patients and our failure to fix the electrode adequately in one prevented us from employing the treatment in three patients. The fourth patient had temperature dysesthesia which was not altered during 2 weeks of stimulation.
- - - - - - - - - -
ranking = 481.27817370193
keywords = nucleus
(Clic here for more details about this article)
| Next ->


Leave a message about 'Pain, Intractable'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.