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Ketamine phantom pain

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https://www.readbyqxmd.com/read/27737513/pharmacologic-interventions-for-treating-phantom-limb-pain
#1
REVIEW
Maria Jenelyn M Alviar, Tom Hale, Monalisa Dungca
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 12, 2011. Phantom limb pain (PLP) is pain that arises in the missing limb after amputation and can be severe, intractable, and disabling. Various medications have been studied in the treatment of phantom pain. There is currently uncertainty in the optimal pharmacologic management of PLP. OBJECTIVES: This review aimed to summarise the evidence of effectiveness of pharmacologic interventions in treating PLP...
October 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27402960/perioperative-pain-management-strategies-for-amputation-a-topical-review
#2
Michael L Kent, Hung-Lun John Hsia, Thomas J Van de Ven, Thomas E Buchheit
OBJECTIVE: To review acute pain management strategies in patients undergoing amputation with consideration of preoperative patient factors, pharmacologic/interventional modalities, and multidisciplinary care models to alleviate suffering in the immediate post-amputation setting. BACKGROUND: Regardless of surgical indication, patients undergoing amputation suffer from significant residual limb pain and phantom limb pain in the acute postoperative phase. Most studies have primarily focused on strategies to prevent persistent pain with inclusion of immediate postoperative outcomes as secondary measures...
July 8, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26257422/oral-ketamine-for-phantom-limb-pain-an-option-for-challenging-cases
#3
Sukanya Mitra, Sunita Kazal
No abstract text is available yet for this article.
July 2015: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/25923225/ketamine-a-narrative-review-of-its-uses-in-medicine
#4
Brian M Radvansky, Shawn Puri, Anthony N Sifonios, Jean D Eloy, Vanny Le
One of the most fascinating drugs in the anesthesiologist's armament is ketamine, an N-methyl-D-aspartate receptor antagonist with a myriad of uses. The drug is a dissociative anesthetic and has been used more often as an analgesic in numerous hospital units, outpatient pain clinics, and in the prehospital realm. It has been used to treat postoperative pain, chronic pain, complex regional pain syndrome, phantom limb pain, and other neuropathic conditions requiring analgesia. Research has also demonstrated its efficacy as an adjunct in psychotherapy, as a treatment for both depression and posttraumatic stress disorder, as a procedural sedative, and as a treatment for respiratory and neurologic conditions...
November 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/24224475/phantom-limb-pain-a-systematic-neuroanatomical-based-review-of-pharmacologic-treatment
#5
REVIEW
Zachary McCormick, George Chang-Chien, Benjamin Marshall, Mark Huang, R Norman Harden
OBJECTIVE: Review the current evidence-based pharmacotherapy for phantom limb pain (PLP) in the context of the current understanding of the pathophysiology of this condition. DESIGN: We conducted a systematic review of original research papers specifically investigating the pharmacologic treatment of PLP. Literature was sourced from PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL). Studies with animals, "neuropathic" but not "phantom limb" pain, or without pain scores and/or functional measures as primary outcomes were excluded...
February 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/23703410/intravenous-infusions-in-chronic-pain-management
#6
REVIEW
Boleslav Kosharskyy, Wilson Almonte, Naum Shaparin, Marco Pappagallo, Howard Smith
In the United States, millions of Americans are affected by chronic pain, which adds heavily to national rates of morbidity, mortality, and disability, with an ever-increasing prevalence. According to a 2011 report titled Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research by the Institute of Medicine of the National Academies, pain not only exacts its toll on people's lives but also on the economy with an estimated annual economic cost of at least $560 - 635 billion in health care costs and the cost of lost productivity attributed to chronic pain...
May 2013: Pain Physician
https://www.readbyqxmd.com/read/23590428/effects-of-low-dose-iv-ketamine-on-peripheral-and-central-pain-from-major-limb-injuries-sustained-in-combat
#7
Rosemary C Polomano, Chester C Buckenmaier, Kyung H Kwon, Alexandra L Hanlon, Christine Rupprecht, Cynthia Goldberg, Rollin M Gallagher
OBJECTIVE: Examine response patterns to low-dose intravenous (IV) ketamine continuous infusions on multiple pain outcomes, and demonstrate effectiveness, safety, and tolerability of ketamine administration on general wards. DESIGN: Retrospective case series of consecutive patients given low-dose IV ketamine continuous infusions. SETTING: Walter Reed Army Medical Center, Washington, DC. PATIENTS: Nineteen eligible inpatients with neuropathic pain from major limb injuries sustained in combat with inadequate pain control from multimodal analgesia...
July 2013: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/23426608/postamputation-pain-epidemiology-mechanisms-and-treatment
#8
Eugene Hsu, Steven P Cohen
Postamputation pain (PAP) is highly prevalent after limb amputation but remains an extremely challenging pain condition to treat. A large part of its intractability stems from the myriad pathophysiological mechanisms. A state-of-art understanding of the pathophysiologic basis underlying postamputation phenomena can be broadly categorized in terms of supraspinal, spinal, and peripheral mechanisms. Supraspinal mechanisms involve somatosensory cortical reorganization of the area representing the deafferentated limb and are predominant in phantom limb pain and phantom sensations...
2013: Journal of Pain Research
https://www.readbyqxmd.com/read/23158899/postamputation-pain-studies-on-mechanisms
#9
REVIEW
Lone Nikolajsen
Amputation is followed by both painful and non-painful phantom phenomena in a large number of amputees. Non-painful phantom sensations rarely pose any clinical problem, but 60-80% of all amputees also experience painful sensations (i.e. phantom pain) located to the missing limb. The severity of phantom pain usually decreases with time, but severe pain persists in 5-10% of patients. Pain in the residual limb (i.e. stump pain) is another consequence of amputation. Both stump and phantom pain can be very difficult to treat...
October 2012: Danish Medical Journal
https://www.readbyqxmd.com/read/22531549/the-emergence-of-adolescent-onset-pain-hypersensitivity-following-neonatal-nerve-injury
#10
David Vega-Avelaira, Rebecca McKelvey, Gareth Hathway, Maria Fitzgerald
BACKGROUND: Peripheral nerve injuries can trigger neuropathic pain in adults but cause little or no pain when they are sustained in infancy or early childhood. This is confirmed in rodent models where neonatal nerve injury causes no pain behaviour. However, delayed pain can arise in man some considerable time after nerve damage and to examine this following early life nerve injury we have carried out a longer term follow up of rat pain behaviour into adolescence and adulthood. RESULTS: Spared nerve injury (SNI) or sham surgery was performed on 10 day old (P10) rat pups and mechanical nociceptive reflex thresholds were analysed 3, 7, 14, 21, 28, 38 and 44 days post surgery...
April 24, 2012: Molecular Pain
https://www.readbyqxmd.com/read/22161403/pharmacologic-interventions-for-treating-phantom-limb-pain
#11
REVIEW
Maria Jenelyn M Alviar, Tom Hale, Monalisa Dungca
BACKGROUND: Phantom limb pain (PLP) is pain that arises in the missing limb after amputation and can be severe, intractable and disabling. Various medications have been studied in the treatment of phantom pain. Presently there is uncertainty in the optimal pharmacologic management of PLP.  OBJECTIVES: This review aims to summarize the evidence of effectiveness of pharmacologic interventions in treating PLP. SEARCH METHODS: We searched the Cochrane Pain, Palliative and Supportive Care Review Group (PaPaS) Trials Register, the Cochrane Controlled Trials Register (CENTRAL, The Cochrane Library), MEDLINE and EMBASE up to September 2011 for randomised and quasi-randomised trials comparing pharmacologic treatment with placebo, another active treatment, or no treatment...
December 7, 2011: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/21447079/21-phantom-pain
#12
REVIEW
Andre Wolff, Eric Vanduynhoven, Maarten van Kleef, Frank Huygen, Jason E Pope, Nagy Mekhail
Phantom pain is pain caused by elimination or interruption of sensory nerve impulses by destroying or injuring the sensory nerve fibers after amputation or deafferentation. The reported incidence of phantom limb pain after trauma, injury or peripheral vascular diseases is 60% to 80%. Over half the patients with phantom pain have stump pain as well. Phantom pain can also occur in other parts of the body; it has been described after mastectomies and enucleation of the eye. Most patients with phantom pain have intermittent pain, with intervals that range from 1 day to several weeks...
July 2011: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/20692106/using-mirror-visual-feedback-and-virtual-reality-to-treat-fibromyalgia
#13
V S Ramachandran, Elizabeth L Seckel
Fibromyalgia is a condition characterized by long term body-wide pain and tender points in joints, muscles and soft tissues. Other symptoms include chronic fatigue, morning stiffness, and depression. It is well known that these symptoms are exacerbated under periods of high stress. When pain becomes severe enough, the mind can enter what is known as a dissociative state, characterized by depersonalization - the feeling of detachment from one's physical body and the illusion of watching one's physical body from outside...
December 2010: Medical Hypotheses
https://www.readbyqxmd.com/read/20665361/-prevention-and-therapy-of-prolonged-chronic-pain-after-surgery
#14
REVIEW
Esther Pogatzki-Zahn
Prolonged, chronic pain after surgery is a very common phenomenon that has been underrecognized until recently. A number of risk factors and predictors (including the surgical procedure, age, gender, pre- and postoperative pain, psychosocial factors, genes and pain modulation variables) have been identified in the past years. Together with an increased knowledge about the pathophysiology of chronic pain after surgery, we may be able to develop successful drugs or interventions modifying the disease in subgroups of patients in the near future...
July 2010: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/20661356/early-and-effective-use-of-ketamine-for-treatment-of-phantom-limb-pain
#15
Harsha Shanthanna, Medha Huilgol, Vinay Kumar Manivackam
Treatment for phantom limb pain is difficult and challenging. There is often suboptimum treatment with fewer than 10% receiving lasting relief. Treatments based broadly on other neuropathic pains may not be appropriate for a clinical success. We report a case of phantom limb pain, which proved resistant to multiple analgesics, including opioids and continuous epidural blockade. Treatment with intravenous (IV) ketamine as an alternate day infusion, gave complete remission of phantom limb pain. This demonstrates an early and effective use of a potent NMDA antagonist for treatment of phantom limb pain...
March 2010: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/19266417/-therapy-of-phantom-limb-pain
#16
REVIEW
Andreas Schwarzer, Michael Zenz, Christoph Maier
About 80 % of all extremity amputations suffer from phantom limb pain following the operation. In this context, it is important to differentiate between painful phantom limb sensations, non-painful phantom limb sensations and residual limb pain. The pathophysiology of phantom limb pain is not fully understood. Current research findings ascribe a major pathophysiological role to cortical changes as well as a disturbed body perception. Peripheral and spinal mechanisms appear less relevant in the development of phantom limb pain...
March 2009: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/19027263/-effect-of-ketamine-on-prevention-of-postmastectomy-chronic-pain-a-pilot-study
#17
RANDOMIZED CONTROLLED TRIAL
M Crousier, V Cognet, M Khaled, P-Y Gueugniaud, V Piriou
OBJECTIVE: This pilot study was designed to evaluate the feasibility of a trial to estimate the preventive effect of ketamine on postmastectomy pain syndrome (PMPS). STUDY DESIGN: Double-blind, randomized, placebo-controlled pilot trial. PATIENTS AND METHOD: Thirty six patients scheduled for a radical mastectomy with axillary lymph node dissection were randomized in two groups (n=18 per group). Before skin incision, a bolus (0.5 mg/kg of ketamine or placebo) followed by a continuous infusion (0...
December 2008: Annales Françaises D'anesthèsie et de Rèanimation
https://www.readbyqxmd.com/read/18717513/ketamine-for-acute-and-subacute-pain-in-opioid-tolerant-patients
#18
Shoshana Chazan, Margaret P Ekstein, Nissim Marouani, Avi A Weinbroum
Prolonged acute pain, especially that of oncologic neurological origin, is at times difficult to control; it is seldom entirely alleviated by opioids. We report eight patients with severe pain, three of whom suffered from new onset oncologic metastatic bone pain, others had previous pain syndromes and presented with exacerbation of pain. Pain was associated with hyperalgesia and allodynia phenomena in two patients and with phantom pain in a third one. Tolerance to opioids had developed, and high IV doses of morphine, meperidine or fentanyl, and patient-controlled intravenous and epidural analgesia were insufficient...
May 2008: Journal of Opioid Management
https://www.readbyqxmd.com/read/18349204/chronic-phantom-limb-pain-the-effects-of-calcitonin-ketamine-and-their-combination-on-pain-and-sensory-thresholds
#19
RANDOMIZED CONTROLLED TRIAL
Urs Eichenberger, Frank Neff, Gorazd Sveticic, Steinar Björgo, Steen Petersen-Felix, Lars Arendt-Nielsen, Michele Curatolo
BACKGROUND: Calcitonin was effective in a study of acute phantom limb pain, but it was not studied in the chronic phase. The overall literature on N-methyl-D-aspartate antagonists is equivocal. We tested the hypothesis that calcitonin, ketamine, and their combination are effective in treating chronic phantom limb pain. Our secondary aim was to improve our understanding of the mechanisms of action of the investigated drugs using quantitative sensory testing. METHODS: Twenty patients received, in a randomized, double-blind, crossover manner, 4 i...
April 2008: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/17583431/a-randomised-double-blind-trial-of-the-effect-of-pre-emptive-epidural-ketamine-on-persistent-pain-after-lower-limb-amputation
#20
RANDOMIZED CONTROLLED TRIAL
John A Wilson, Alastair F Nimmo, Susan M Fleetwood-Walker, Lesley A Colvin
Persistent pain has been reported in up to 80% of patients after limb amputation. The mechanisms are not fully understood, but nerve injury during amputation is important, with evidence for the crucial involvement of the spinal N-methyl d-aspartate (NMDA) receptor in central changes. The study objective was to assess the effect of pre-emptively modulating sensory input with epidural ketamine (an NMDA antagonist) on post-amputation pain and sensory processing. The study recruited 53 patients undergoing lower limb amputation who received a combined intrathecal/epidural anaesthetic for surgery followed by a randomised epidural infusion (Group K received racemic ketamine and bupivacaine; Group S received saline and bupivacaine)...
March 2008: Pain
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