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Chronic intractible pain

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https://www.readbyqxmd.com/read/29449944/dexmedetomidine-use-during-epiduroscopy-reduces-fentanyl-use-and-postoperative-nausea-and-vomiting-a-single-center-retrospective-study
#1
Takashi Suzuki, Ryota Inokuchi, Kazuo Hanaoka, Machi Suka, Hiroyuki Yanagisawa
Objectives: Minimally invasive epiduroscopy has recently been reported as an effective treatment procedure for chronic and intractable low back pain. However, no study has determined safe anesthetics for monitored anesthesia care during epiduroscopy. We aimed to compare and evaluate conventional monitored anesthesia care drugs with dexmedetomidine. Methods: A retrospective study including all patients who underwent epiduroscopy at the JR Tokyo General Hospital from April 2011 to March 2016 was designed...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29395154/botulinum-toxin-injection-for-childhood-constipation-is-safe-and-can-be-effective-regardless-of-anal-sphincter-dynamics
#2
Claire Zar-Kessler, Braden Kuo, Jaime Belkind-Gerson
BACKGROUND: Childhood constipation is common. Previously, internal anal sphincterotomy has been used for hypertensive/non-relaxing sphincters; however, recent benefit has been shown with Botulinum Toxin (BT) injections. The aim is to investigate BT, including response duration, symptom association and effectiveness in relation to sphincter dynamics. METHODS: Retrospective study of 164 children receiving sphincter BT for severe constipation unresponsive to medication management...
December 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29391827/development-and-implementation-of-an-inpatient-multidisciplinary-pain-management-program-for-patients-with-intractable-chronic-musculoskeletal-pain-in-japan-preliminary-report
#3
Naoto Takahashi, Satoshi Kasahara, Shoji Yabuki
Introduction: Multidisciplinary pain management is a useful method to treat chronic musculoskeletal pain. Few facilities in Japan administer a multidisciplinary pain management program, especially an inpatient program. Therefore, we implemented a multidisciplinary pain management program in our hospital based on biopsychosocial factors guided by the recommendations of the International Association for the Study of Pain. The purpose of this study is to describe our inpatient pain management program for Japanese patients, which uses the biopsychosocial method of pain self-management...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29390501/space-time-acupuncture-for-intractable-cough-after-lupus-nephropathy-a-case-report-and-literature-review
#4
Taipin Guo, Zukun Chen, Xiantao Tai, Zili Liu, Miansheng Zhu
RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29384450/deep-brain-stimulation-of-the-ventral-striatal-area-for-post-stroke-pain-syndrome-a-magnetoencephalography-study
#5
Raghavan Gopalakrishnan, Richard C Burgess, Donald A Malone, Scott F Lempka, John T Gale, Darlene P Floden, Kenneth B Baker, Andre G Machado
Post-stroke pain syndrome (PSPS) is an intractable disorder characterized by hemiparesis associated with unrelenting chronic pain. While traditional analgesia have largely failed, integrative approaches targeting affective-cognitive spheres have started to show promise. Recently, we demonstrated that deep brain stimulation (DBS) of the ventral striatal area significantly improved the affective sphere of pain (Lempka et al. 2017) in PSPS patients. Here, we examine whether electrophysiological correlates of pain anticipation were modulated by DBS that could serve as signatures of treatment effects...
January 31, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29357330/ultrasound-guided-genicular-nerve-block-for-knee-osteoarthritis-a-double-blind-randomized-controlled-trial-of-local-anesthetic-alone-or-in-combination-with-corticosteroid
#6
Doo-Hwan Kim, Seong-Soo Choi, Syn-Hae Yoon, So-Hee Lee, Dong-Kyun Seo, In-Gyu Lee, Woo-Jong Choi, Jin-Woo Shin
BACKGROUND: Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions regarding RF ablation. Although GNB has been recently performed together with corticosteroid, the analgesic effects of corticosteroids for treating chronic pain remain controversial...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29333355/bilateral-peripheral-nerve-field-stimulation-for-intractable-coccygeal-pain-a-case-study-using-dual-lead-intercommunication
#7
Michelle Granville, Patrick T Brennan, Robert E Jacobson
Coccygeal pain is a difficult chronic pain problem with mixed response to various treatments. This is a report of a case of coccygeal pain that after failing various conservative and interventional procedures over five years was evaluated with a temporary peripheral sacral fascial lead followed by implantation of bilateral sacral paramedian leads for peripheral nerve field stimulation (PNFS). This resulted in marked pain control and resumption of full activity. The visual analog scale (VAS) pain score improved from eight pre-implant to one after implant and has remained at that level in follow-up...
November 9, 2017: Curēus
https://www.readbyqxmd.com/read/29324503/%C3%AE-asarone-alleviated-chronic-constriction-injury-induced-neuropathic-pain-through-inhibition-of-spinal-endoplasmic-reticulum-stress-in-an-liver-x-receptor-dependent-manner
#8
Yulong Gui, Aiyuan Li, Jie Zhang, Guan Li, Xia Ruan, Qulian Guo, Wangyuan Zou
BACKGROUND: Neuropathic pain is an intractable and complex disease. Recent studies have shown a close relationship between endoplasmic reticulum (ER) stress and neuropathic pain. Here, we investigated the effect of α-asarone, an ER stress inhibitor, on chronic constriction injury (CCI)-induced neuropathic pain. METHODS: Two parts were included in this study. In part 1, rats were assigned to 7 groups: the sham group, the sham + α-asarone 20 mg/kg group, the CCI group, the CCI + vehicle group, the CCI + α-asarone 5 mg/kg group, the CCI + α-asarone 10 mg/kg group, and the CCI + α-asarone 20 mg/kg group...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29276227/constant-current-vs-constant-voltage-systems-for-temporal-spinal-cord-stimulation-for-intractable-pain
#9
Mayu Ooi, Fujio Yanamoto, Hitoaki Sato, Yumiko Takao, Masako Okada, Moritoki Egi, Satoshi Mizobuchi
Although spinal cord stimulation (SCS) is a useful treatment for chronic intractable pain, the optimal method of stimulation has not yet been established. In this prospective, crossover study, we compared the efficacy of using a constant current (CC) system with that of a constant voltage (CV) system for temporal SCS. Twenty patients were enrolled and divided into two groups. For 10 patients, a CV system was applied on Days 1-5, followed by the use of a CC system on Days 6-10. For the other 10 patients, a CC system was applied for the first five days, followed by a CV system for the subsequent five days...
December 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29245352/effect-of-multiple-intra-articular-injections-of-polynucleotides-on-treatment-of-intractable-knee-osteoarthritis-a-case-report
#10
Jong-Uk Mun, Hyung Rae Cho, Young Soon Choi, Young Uk Kim
RATIONALE: Knee osteoarthritis (KOA) is a chronic joint degenerative disease. Intra-articular injection (IAI) of hyaluronic acid (HA) is widely used to treat KOA. However, some HA injections have no effect at all. Polynucleotides (PN) are recently noted as a valid substitute for HA. PATIENT CONCERNS: A 61-year-old female was admitted to the pain center with symptoms of pain over the knee and warmth feeling with stiffness in the left knee. The patient reported chronic severe pain in the left knee area despite 6 times IAI of HA...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29230247/wireless-neuromodulation-for-chronic-back-pain-delivery-of-high-frequency-dorsal-root-ganglion-stimulation-by-a-minimally-invasive-technique
#11
Bart Billet, Roel Wynendaele, Niek E Vanquathem
Objective: To evaluate the analgesic effect of a dorsal root ganglion (DRG) stimulation technology utilizing high-frequency pulse rates to treat intractable chronic back and leg pain. Methods: This case study presents the outcomes, with a novel, wireless, minimally invasive miniature neurostimulator system in a case of chronic back pain. The subject was implanted bilaterally with a Freedom 4A quadripolar electrode array at the L2 dorsal root ganglion. Stimulation was applied using 10 kHz pulse rate and 30 μs pulse width...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29206315/intrathecal-trialing-of-continuous-infusion-combination-therapy-with-hydromorphone-and-bupivacaine-in-failed-back-surgery-patients
#12
Ryan J Galica, Salim M Hayek, Elias Veizi, Matthew T McEwan, Sivakanth Katta, Omar Ali, Nida Aziz, Nidhi Sondhi
OBJECTIVES: Intrathecal (IT) trial is a prognostic interventional pain management procedure employed to determine the potential success of treating intractable pain with an implantable infusion device system. There is a dearth of data regarding trials with continuous infusion of combination therapy (e.g. opioid combined with local anesthetic). The objective of the this study was to determine the overall outcomes of continuous infusion IT trials and factors influencing long-term success of IT therapy in patients with chronic intractable pain post-laminectomy...
December 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29198673/pain-control-glucose-control-and-quality-of-life-in-patients-with-chronic-pancreatitis-after-total-pancreatectomy-with-islet-autotransplantation-a-preliminary-report
#13
J Solomina, J Gołębiewska, M R Kijek, A Kotukhov, P J Bachul, L Basto, K Gołąb, E Konsur, K Cieply, N Fillman, L-J Wang, C C Thomas, L H Philipson, M Tibudan, A Dębska-Ślizień, J Fung, A Gelrud, J B Matthews, P Witkowski
BACKGROUND: Total pancreatectomy (TP) is offered as a last treatment option for pain relief in patients with chronic pancreatitis. Concurrent islets autotransplantation (TP-IAT) may improve glucose control. METHODS: We analyzed results in 20 recent patients who underwent TP-IAT at The University of Chicago. The median observation period was 28 months (2-38). Data were collected prospectively then analyzed retrospectively. RESULTS: The number of patients requiring opioids daily for pain control decreased from 16 (80%) prior to surgery to 2 (13%) 1 year after, with only 1 (6...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29190962/wu-tou-decoction-attenuates-neuropathic-pain-via-suppressing-spinal-astrocytic-il-1r1-traf6-jnk-signaling
#14
Chao Wang, Xiangying Kong, Chunyan Zhu, Chunfang Liu, Danni Sun, Qionghong Xu, Zhiyun Mao, Qingxia Qin, Hongchang Su, Danqiao Wang, Xiaoliang Zhao, Na Lin
Neuropathic pain (NP) caused by nerve injuries continues to be an intractable challenge due to inadequate therapeutic strategies. Recent study demonstrated glia-induced neuro-inflammation in the spinal cord, especially the activation of astrocytes, plays an essential role in the development of NP, which opens new avenues for NP treatment. In this study, we explored the anti-hyperalgesia properties of Wu-tou decoction (WTD) and showed that WTD potently attenuates mechanical allodynia and heat hyperalgesia in lumbar 5 (L5) spinal nerve ligation (SNL)-induced NP without noticeable side effect or affecting basal pain perception of mice...
November 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29161336/efficacy-of-electrical-stimulation-of-the-occipital-nerve-in-intractable-primary-headache-disorders-a-systematic-review-with-meta-analyses
#15
Robert T Cadalso, John Daugherty, Caron Holmes, Saravanan Ram, Reyes Enciso
AIMS: To determine the efficacy of occipital nerve stimulation (ONS) in reducing the intensity, duration, and frequency of medically intractable primary headaches. METHODS: A systematic review was carried out by searching three electronic databases: the Cochrane Library, MEDLINE via PubMed, and Web of Science. Randomized controlled trials (RCTs) and case series were eligible for inclusion. RCTs were assessed for quality of evidence by using the Cochrane Risk of Bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tools...
November 21, 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/29111493/lateral-cutaneous-nerve-entrapment-syndrome-lacnes-a-previously-unrecognized-cause-of-intractable-flank-pain
#16
R C Maatman, N E Papen-Botterhuis, M R M Scheltinga, R M H Roumen
BACKGROUND AND AIMS: Chronic abdominal pain may occasionally be due to terminal endings of intercostal nerves (ACNES, abdominal cutaneous nerve entrapment syndrome) that are entrapped in the abdominal wall. Spontaneous neuropathic flank pain may also be caused by involvement of branches of these intercostal nerves. Aim is to describe a series of patients with flank pain due to nerve entrapment and to increase awareness for an unknown condition coined Lateral Cutaneous Nerve Entrapment Syndrome (LACNES)...
October 27, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29104252/pharmacological-regulation-of-neuropathic-pain-driven-by-inflammatory-macrophages
#17
REVIEW
Norikazu Kiguchi, Daichi Kobayashi, Fumihiro Saika, Shinsuke Matsuzaki, Shiroh Kishioka
Neuropathic pain can have a major effect on quality of life but current therapies are often inadequate. Growing evidence suggests that neuropathic pain induced by nerve damage is caused by chronic inflammation. Upon nerve injury, damaged cells secrete pro-inflammatory molecules that activate cells in the surrounding tissue and recruit circulating leukocytes to the site of injury. Among these, the most abundant cell type is macrophages, which produce several key molecules involved in pain enhancement, including cytokines and chemokines...
November 1, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28993994/efficacy-and-factors-determining-the-outcome-of-dorsal-root-entry-zone-lesioning-procedure-drezotomy-in-the-treatment-of-intractable-pain-syndrome
#18
Nontaphon Piyawattanametha, Bunpot Sitthinamsuwan, Pramote Euasobhon, Nantthasorn Zinboonyahgoon, Pranee Rushatamukayanunt, Sarun Nunta-Aree
BACKGROUND: Chronic pain is a disabling condition that adversely affects patient quality of life. The dorsal root entry zone lesioning procedure (DREZotomy) is a modality used to treat intractable pain caused by insults to neural structures. This study aimed to investigate the efficacy of and the factors that determine the outcome of microsurgical DREZotomy (MDT). METHOD: All consecutive patients who underwent MDT for treatment of intractable pain during September 2008 to December 2016 were enrolled...
December 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28993112/hospitalization-due-to-acute-exacerbation-of-chronic-pain-an-intervention-study-in-a-university-hospital
#19
Daniel W Wheeler, Sara Kinna, Andrew Bell, Peter J Featherstone, David J Sapsford, Sam P Bass
BACKGROUND AND AIMS: Hospitalization as a result of acute exacerbation of complex chronic pain is a largely hidden problem, as patients are often admitted to hospital under a variety of specialities, and there is frequently no overarching inpatient chronic pain service dedicated to their management. Our institution had established an inpatient acute pain service overseen by pain physicians and staffed by specialist nurses that was intended to focus on the management of perioperative pain...
October 6, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28955294/real-time-classification-of-non-weight-bearing-lower-limb-movements-using-emg-to-facilitate-phantom-motor-execution-engineering-and-case-study-application-on-phantom-limb-pain
#20
Eva Lendaro, Enzo Mastinu, Bo Håkansson, Max Ortiz-Catalan
Phantom motor execution (PME), facilitated by myoelectric pattern recognition (MPR) and virtual reality (VR), is positioned to be a viable option to treat phantom limb pain (PLP). A recent clinical trial using PME on upper-limb amputees with chronic intractable PLP yielded promising results. However, further work in the area of signal acquisition is needed if such technology is to be used on subjects with lower-limb amputation. We propose two alternative electrode configurations to conventional, bipolar, targeted recordings for acquiring surface electromyography...
2017: Frontiers in Neurology
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