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At least 199 records · Page 11Linked to original sources
PubMed1983

Calcitonin in the treatment of intractable pain from advanced malignancy.

Clinical details are given of 8 patients who complained of severe pain from metastatic bone disease or from multiple myeloma. Four of the patients were included in a double-blind pilot trial designed to compare the effectiveness of salmon calcitonin (200 i.u. intramuscularly) and placebo given twice daily for 4 days. Two of these patients experienced pain relief and were found to have been given salmon calcitonin; the other 2 had no pain relief and had been given placebo. The other 4 of the 8 patients were treated with salmon calcitonin and also had relief of their pain. It would appear, therefore, that salmon calcitonin may be dramatically effective in the treatment of intractable pain from advanced malignancy and its use warrants further study.

Bone Neoplasms↗
PubMed1993

The use of modulated energy carried on a high frequency wave for the relief of intractable pain.

Ten volunteer patients with chronic neck/shoulder or back pain had been taking analgesics, and using conventional transcutaneous electrical nerve stimulation (TENS) with no significant pain relief. On entry to the trial, they were requested to stop taking their analgesics for two days prior to the study and for two days after starting to use the Liss Bipolar Body Stimulator for 20 min 3-5 times daily. Resumption of medication was then allowed. The stimulator (15,000 Hz carrier wave with a double modulation of 15 and 500 Hz) was connected to two adhesive electrodes placed so that the current field encompassed the trigger points, and used at a current that was just threshold for perception (1-4 mA). A visual analogue pain score was recorded before the study, and each evening of the month's study. The pain showed an overall highly significant rapid reduction of approximately 62% (p < 0.001), and all but two of the patients received substantial benefit throughout the study. We conclude that the Liss Bipolar Body Stimulator usually causes a substantial reduction of pain even in patients not helped by conventional TENS devices.

Back Pain↗
PubMedDate not supplied

Ablation of the brachial plexus. Control of intractable pain, due to a pathological fracture of the humerus.

A case report is presented which illustrates the difficulties in providing control of intractable pain from pathological fractures of the humerus. Relief from large and frequent doses of systemic analgesics was found to be inadequate. Control was achieved using brachial plexus block with bupivacaine combined with absolute alcohol. The decision to partially ablate the plexus is considered to be justified by the improved quality of life which the patient enjoyed.

Brachial Plexus↗
PubMed1980

Stereotactic hypophysectomy for intractable pain secondary to metastatic prostate carcinoma.

Stereotactic radiofrequency transfrontal hypophysectomy was carried out in 7 patients with osseous metastasis from prostatic carcinoma resulting in intractable pain. 86% experienced significant pain relief with 5 of 7 demonstrating marked decrease in medication requirement and improved level of function. The procedure was done under local anesthesia only with no mortality and minimal morbidity. Total destruction of the pituitary gland and the development of diabetes insipidus were shown not to be necessary conditions for pain relief.

Aged↗
PubMed2000

Indication for epidural morphine for the relief of intractable pain in advanced oral cancer: report of four cases.

It can be difficult to manage the pain of advanced oral cancer. We present four patients in whom epidural morphine was used for intractable pain at primary or metastatic sites. For pain supplied by the trigeminal or cervical nerve a small dose of morphine was given through an epidural catheter inserted into the epidural space through C7-Th1. A favourable clinical response was achieved in three. In particular, in one patient who was given continuous morphine using a computerized ambulatory drug delivery system, we achieved excellent efficacy and stable control of pain. We think that the effect of the epidural morphine was decreased in the patient who did not respond because he had previously been treated with high oral doses. The present study confirmed that morphine given epidurally in small doses has a strong and prolonged analgesic action with less toxicity than when given orally.

Adult↗
PubMed1978

Cyclobenzaprine in intractable pain syndromes with muscle spasm.

The effectiveness of cyclobenzaprine hydrochloride, a new tricyclic skeletal muscle relaxant, was shown in patients with long-term intractable pain of cervical and lumbar origin aggravated by skeletal muscle spasm and tenderness. The investigation was double-blind and randomized, comparing cyclobenzaprine hydrochloride (10 mg three times a day) with diazepam (5 mg three times a day) and with placebo. After two weeks of treatment, the 16 patients in the cyclobenzaprine group showed an overall improvement in pain variables as did the 16 patients in the diazepam group. No serious adverse reactions to cyclobenzaprine were observed in the study. However, dry mouth due to cyclobenzaprine's anticholinergic action and mild degrees of drowsiness were encountered more often than with diazepam or placebo.

Adult↗
PubMed1987

Management of intractable pain in cancer patients by implantable morphine infusion systems.

Ten patients underwent implantation of intrathecal morphine catheters with subcutaneous implantation of morphine Infusaid pumps for the treatment of intractable pain of malignant origin from May 1984 to October 1985. All patients exhibited a good initial response to intrathecal morphine and developed some degree of tolerance. All patients with bony metastasis and/or lumbarsacral plexopathy developed rapid tolerance.Depressive illness was noted in all patients undergoing a psychiatric evaluation prior to institution of morphine infusion therapy. Seventy percent of patients treated could be treated on an outpatient basis after pump implantation.Complications included a pump pocket infection requiring the removal of the implanted system. There was no pump failure, respiratory depression, urinary retention, or mortality related to the use of the morphine infusion system. It is recommended that intrathecal morphine infusion be instituted when narcotics have been identified as necessary for pain relief, before the development of significant systemic tolerance.

Humans↗
PubMed1986

Subcortical electrical stimulation for control of intractable pain in humans. Report of 122 cases (1970-1984).

Chronic electrical stimulation of the subcortical area of the brain by implanted electrodes provides satisfactory control of a number of intractable pain syndromes that are refractory to medication. This series of 122 patients who underwent electrode implantation for the control of severe chronic pain was evaluated over a follow-up period of 2 to 14 years. Of the 65 patients with pain of peripheral origin, who were treated with stimulation of the periaqueductal gray region (PAG), 50 obtained successful pain control. Of 76 patients with a deafferentation pain syndrome, 44 obtained control of the dysesthesia with stimulation of the subcortical somatosensory region. Nineteen patients with both leg and back pain received electrodes in the PAG and the somatosensory regions; whereas back pain was relieved by PAG stimulation, dysesthetic leg pain was controlled more effectively by somatosensory region stimulation. The electrical stimulation technique appears to provide long-term pain control safely, with few side effects or complications.

Adult↗
PubMed1982

Continuous epidural morphine treatment for intractable pain in terminal cancer patients.

In patients with intractable cancer pain who failed to respond to conservative and neurosurgical procedures for pain relief, repeated injections of epidural morphine were found to be beneficial. A small dose of morphine (2-4 mg per injection) relieved pain for 6-24 h. A permanent subcutaneous epidural catheter led to successful ambulatory treatment without complications. The implantation of the epidural catheter is a minor surgical procedure, done under local anesthesia and is considered safe even in terminal cancer patients.

Adult↗
PubMed1976

[Assessment and treatment of intractable pain: six months' experience in the relief of pain at the ludwig Boltzmann Institute of Clinical Oncology (author's transl)].

A preliminary report is presented on the results achieved in the assessment and treatment of patients with intractable pain during the first six months experience gained following the appointment of a pain consultant at the Ludwig Boltzmann Institute of Clinical Oncology. Nerve blockade was carried out 106 times in 45 patients suffering from primary or secondary malignant disease and 71 times in 18 patients with other conditions; intrathecal instillation of 96% alcohol was performed once and 2 chordotomies were also performed. One patient needed antidepressive therapy. Major questions relating to this problem are discussed. Gratifyingly satisfactory results were observed in more than two thirds of the patients. These objective findings and the subjective impressions obtained from patients, their relatives and our personnel prompted us to continue with this type of treatment for pain and to increase our efforts in this direction.

Adult↗