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Anesthesia Pain Palliative

Thomas Aerden, Koenraad Grisar, Patrick Neven, Esther Hauben, Constantinus Politis
INTRODUCTION: Metastasis to the oral cavity can be located in both the soft and bony tissues and comprise only 1% of all oral malignancies; however, it is clinically significant because it indicates widespread metastatic disease and an unfavorable prognosis. A numb chin is an important presentation of oral metastasis, but other dental and systemic pathology may be involved. PRESENTATION OF CASE: We present the case of a 54-year-old woman who presented with numb chin syndrome 8 years after a diagnosis of primary breast carcinoma...
January 4, 2017: International Journal of Surgery Case Reports
Amanda C Faircloth
Palliative care teams require multidisciplinary support. While this is an emerging area in anesthesia practice, there are many avenues for certified registered nurse anesthetists (CRNAs) to share their unrivaled clinical knowledge. CRNAs may become involved with or consult on palliative sedation, medical management, interventional pain management, terminal wean/extubation, and organ donation. Additionally, CRNAs need to understand the unique needs of this patient population so that they can appropriately care for palliative care patients presenting to the operating room for palliative surgery...
January 2017: Annual Review of Nursing Research
David Arsanious, Spiro Khoury, Edgar Martinez, Ali Nawras, Gregory Filatoff, Hossam Ajabnoor, Umar Darr, Joseph Atallah
UNLABELLED: Hiccups are actions consisting of sudden contractions of the diaphragm and intercostals followed by a sudden inspiration and transient closure of the vocal cords. They are generally short lived and benign; however, in extreme and rare cases, such as esophageal carcinoma, they can become persistent or intractable, up to and involving significant pain, dramatically impacting the patient's quality of life. This case involves a 60-year-old man with a known history of squamous cell carcinoma of the esophagus...
2016: Pain Physician
Jeffrey Gilligan, Jennifer C Shih, Viet L Cai, Joshua A Hirsch, Christopher Rodrigues, Zubin D Irani
UNLABELLED: Radiofrequency (RF) ablation of the lateral sacral plexus has been used for the treatment of sacroiliac joint pain including as an adjunct to other palliative therapies for the treatment of painful osseous metastasis. The treatment goal is targeted ablation of the dorsal lateral branches of S1-S4. Though several techniques have been described, the Simplicity III (Neurotherm, Middleton, MA) system allows for ablation to be achieved with a single RF probe by utilizing a multi-electrode curved RF probe to create a continuous ablation line across all sacral nerves...
2016: Pain Physician
Toshihiko Nakatani
Palliative care prevents and relieves total pain of patients and their families and improves their quality of life. The author describes the work of anesthesiologists in palliative care unit as ward staffs. The need for palliative care units is increasing and new palliative care units are being established throughout Japan. Anesthesiologists are involved in anesthesia, pain management intensive care, emergency medicine and palliative care. The anesthesiologists in palliative care are involved in use of opioid and nerve block for treating physical pain...
March 2016: Masui. the Japanese Journal of Anesthesiology
James R Eiszner, Alfred Atanda, Ashwin Rangavajjula, Mary Theroux
AIM: The purpose of this study was to report our experience with peripheral nerve blockade in pediatric and young adult patients with skeletal dysplasia undergoing knee arthroscopy. BACKGROUND: The incidence of skeletal dysplasia is 1:4000 live births. These patients have biomechanical predispositions to knee joint degeneration, which is often palliated by arthroscopic surgery. Regional anesthesia has been proven to improve the cost and quality of care in adults undergoing arthroscopic knee surgery...
May 2016: Paediatric Anaesthesia
Seshadri Raju, Mark Ward
BACKGROUND: The geriatric population aged 80 years and older with severe manifestations of chronic venous disease face diminishing therapeutic options. Self-applied compression is often not possible because of frailty or arthritis. Significant limb swelling diminishes mobility, affects independent living, and precipitates institutionalization. Limb ulceration and pain diminish quality of life at a time when it is paramount. Cellulitis uniquely poses septicemic risk in this age group. Family caregivers are often able to continue home care if the intensity of care can be reduced...
January 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Armeana Olimpia Zgaia, Alexandru Irimie, Dorel Sandesc, Catalin Vlad, Cosmin Lisencu, Alexandru Rogobete, Patriciu Achimas-Cadariu
BACKGROUND AND AIM: Ketamine is a drug used for the induction and maintenance of general anesthesia, for the treatment of postoperative and posttraumatic acute pain, and more recently, for the reduction of postoperative opioid requirements. The main mechanism of action of ketamine is the antagonization of N-methyl-D-aspartate (NMDA) receptors that are associated with central sensitization. In the pathogenesis of chronic pain and particularly in neuropathic pain, an important role is played by the activation of NMDA receptors...
2015: Clujul Medical (1957)
Giuseppe R Gristina
In the modern medicine a sound evidence is available today supporting the four fundamental principles representing the best scientific and ethical approach to end of life issues: shared decision making process in a doctor-patient relationship centered care; rejection of dying process marked by the suffering and disproportionate treatments; withholding/withdrawing these treatments and palliative sedation as main contributions to suppress the patients' suffering and pain at the end of life; clear-cut difference between these clinical and ethical options and euthanasia...
November 2015: Recenti Progressi in Medicina
Faisal R Jahangiri
This case illustrates the benefits of utilizing intraoperative neurophysiological monitoring (IONM) for preventing injury to sensory/motor pathways of the spinal cord during a cordotomy procedure to relieve pain. Cordotomy has been used effectively in the treatment of visceral pain but comes with a high risk of damaging motor and sensory pathways due to close proximity of lesion. The subject is a 47-year-old female with a pancoast tumor of the left lung, left brachialplexopathy, and severe neuropathic pain syndrome, refractory to medical therapy...
September 2015: Neurodiagnostic Journal
A F Khasanov, V R Trifonov, V Yu Murav'ov, N A Khasanova, A I Ivanov, K A Ivanovskaya
UNLABELLED: Tracheal and bronchial endoscopic stenting can give a quick therapeutic result or delay surgiCal treatment of patients with stenosis. It also can improve quality of life, create conditions for palliative therapy and increase survival of incur- able oncological patients. This paper contains description of our experience in anesthesia for tracheal stenting with re- spiratory support. MATERIALS AND METHODS: 23 patients were investigated retrospectively (15 males, 8females)...
July 2015: Anesteziologiia i Reanimatologiia
Christoph L Lassen, Susanne Aberle, Nicole Lindenberg, Annika Bundscherer, Tobias W Klier, Bernhard M Graf, Christoph H Wiese
BACKGROUND: While anesthesiologist's involvement in palliative care has been widely researched, extensive data on palliative patients under anesthesiological care in the operating room is missing. This study was performed to assess the incidence, demographics, and outcome of palliative patients under anesthesiological care. METHODS: We conducted a single-center retrospective chart review of all palliative patients under anesthesiological care at a university hospital in 1 year...
2015: BMC Anesthesiology
Mumin Hakim, Candice Burrier, Tarun Bhalla, Vidya T Raman, David P Martin, Olamide Dairo, Joel L Mayerson, Joseph D Tobias
Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. The anesthetic management was complicated by the presence of a large mediastinal mass, limited pulmonary reserve, and severe chronic pain with a high preoperative opioid requirement...
2015: Journal of Pain Research
Vérène Praud
The pain resource nurse in oncology works on the wards, upon the teams' request, in situations of complex pain in the context of serious and chronic diseases. She supports and cares for patients providing specific pain relief, in collaboration with an algologist, and is involved in the continuous training of caregivers.
April 2015: Revue de L'infirmière
Geert Maleux, Bart Vertenten, Annouschka Laenen, Liesbeth De Wever, Sam Heye, Paul Clement, Raymond Oyen
BACKGROUND: Cancer-related obstruction of large abdominal and pelvic veins might become symptomatic with clinical signs of lower limb venous congestion. Technical and clinical outcome after interventional treatment is not well studied yet. PURPOSE: To retrospectively assess the technical and clinical outcome of endovascular management of symptomatic cancer-related iliocaval venous obstructive disease. MATERIAL AND METHODS: From 1998 to 2013, 19 patients (15 men, 4 women; mean age, 63...
April 2016: Acta Radiologica
Doralina L Anghelescu, Jennifer M Snaman, Luis Trujillo, April D Sykes, Y Yuan, Justin N Baker
BACKGROUND: Patient controlled anesthesia (PCA) is increasingly used to manage pain in pediatric cancer patients and is important in the treatment of escalating pain at the end of life. The description of the use of opioid PCA in this population has been limited. PROCEDURE: This retrospective chart review of the last 2 weeks of life addressed the following objectives: (1) to describe the patient population treated with opioid PCA; (2) to describe the morphine-equivalent doses (MED) (mg/kg/day); and (3) to describe the pain scores (PS)...
July 2015: Pediatric Blood & Cancer
Jun-Song Yang, Lei Chu, Fu-Tao Xiao, Dong-Jie Zhang, Yang Wang, Liang Chen, Zhen-Yong Ke, Ding-Jun Hao, Zhong-Liang Deng
BACKGROUND CONTEXT: Percutaneous vertebroplasty (PVP) has proven to be a valuable palliative treatment option for patients with medically refractory painful osteolytic metastases of the spine. Percutaneous vertebroplasty of the atlas has been reported in only seven articles and has been performed with different techniques and approaches. PURPOSE: To describe the technique we used to perform PVP of a lytic lesion of the lateral mass of C1 via anterior retropharyngeal approach guided by C-arm fluoroscopy...
March 1, 2015: Spine Journal: Official Journal of the North American Spine Society
Lucy Chu, Pippa Hawley, Peter Munk, Paul Mallinson, Paul Clarkson
INTRODUCTION: Minimally invasive palliative procedures (MIPPs) are sometimes considered step 4 of the World Health Organization's three-step ladder. A case conference has been created at the BC Cancer Agency to facilitate access to MIPPs for advanced cancer patients with severe pain not responding to conventional analgesics. The twice monthly conference discusses referrals for pain control procedures and reviews imaging, with palliative care, musculoskeletal interventional radiology, radiation oncology, medical oncology, and anesthesia experts in attendance...
June 2015: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Michele Anzidei, Beatrice Cavallo Marincola, Mario Bezzi, Giulia Brachetti, Francesco Nudo, Enrico Cortesi, Pasquale Berloco, Carlo Catalano, Alessandro Napoli
PURPOSE: The purpose of this study was to evaluate the feasibility of magnetic resonance-guided focused ultrasound (MRgFUS) ablation for pain palliation and local tumor control in selected patients with unresectable primary pancreatic adenocarcinoma. MATERIALS AND METHODS: After providing dedicated informed consent, 7 patients with histologically proven unresectable pancreatic adenocarcinoma underwent MRgFUS treatment on a dedicated 3-T unit featuring a dedicated ablation system...
December 2014: Investigative Radiology
F Ricotti, K Giuliodori, I Cataldi, A Campanati, G Ganzetti, G Ricotti, A Offidani
Treatment of multiple cutaneous and subcutaneous melanoma metastases is still represents a therapeutic challenge for both dermatologists and oncologists. Electrochemotherapy (ECT) is a promising therapeutic procedure, owing to its ability to improve the penetration of cytotoxic drugs into cancer cells by application of current electric pulses. The aim of our study is to evaluate efficacy, tolerability and long-term efficacy of ECT in the treatment of advanced metastatic melanoma. Thirty patients affected by a total of 654 cutaneous and subcutaneous melanoma metastatic nodules were recruited...
May 2014: Dermatologic Therapy
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