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At least 379 records · Page 21Linked to original sources
PubMed1984

Thermocoagulation of the dorsal root entry zone for the treatment of intractable pain.

The authors report the results of DREZ thermocoagulation in 35 patients since March 1980. This technique was applied not only in patients with deafferentation pain after brachial plexus avulsion, but also for postamputation phantom limb pain and pain caused by injury to the spine and spinal cord, by peripheral nerve lesions, and by multiple sclerosis. Independent of etiology, the duration of the pain syndrome, and the quality and projection of the pain, the overall results have been satisfactory and long-lasting.

Brachial Plexus↗
PubMed1976

Peripheral nerve stimulation in the treatment of intractable pain.

Peripheral nerve stimulating devices were implanted for pain control in 33 patients with a variety of disabling chronic pain conditions, which had persisted despite usual medical and surgical therapy. The implants were placed on major nerves innervating the area of the patient's pain. Records were obtained of each patient's stated relief from pain produced by nerve stimulation, along with assessments of narcotic withdrawal, ability to return to work, sleep pattern, and relief from depression. Based on these five criteria 17 patients were judged to be treatment failures, while eight patients had excellent results, and seven had intermediate results. Twelve of the failures were in patients with either low back pain with sciatica, or pain from metastatic disease. The most dramatic successes occurred in patients with peripheral nerve trauma. The incidence of complications has been low, and two patients have used the stimulator for 5 years without adverse effects. Techniques of peripheral stimulator implantation, possible mechanisms of action, and conclusions regarding peripheral nerve stimulation in the treatment of chronic pain are discussed.

Adolescent↗
PubMed1987

Treatment of intractable pain.

The mechanism of acute pain is believed to be mainly a neurophysiological event involving the transmission along A delta and fibers to the neuraxis and then via discrete paths to higher cortical levels. This incoming signal can undergo modification at a levels, either by other incoming signals, or by descending inhibition. In its refractory form chronic pain probably represents a complex balance of a nociceptive stimulus and its interaction with the co-existing psychological state, and behavioral factors. To successfully treat chronic pain it is necessary to direct therapy at the tissue damage (if any), the psychological state of the patient, and the environment in which the pain complaint is made, This often needs a multidisciplinary therapeutic environment to effect change.

Analgesics, Opioid↗
PubMed1977

The management of intractable pain in patients with advanced malignant disease.

The Brompton mixture is a highly effective, flexible, safe and convenient means to control chronic pain of malignant disease. The mixture is a solution containing morphine, the dose of narcotic varying with the need for analgesia, and is given regularly, usually every 4 hours, with a phenothiazine. The main aims of therapy are prevention of pain rather than treatment, an unclouded sensorium and a normal effect. Terminally ill cancer patients were given the Brompton mixture and a phenothiazine in an attempt to control their pain. The mixture was administered to patients in 3 hospital environments: 1) a palliative care unit, 2) general wards and 3) private rooms. Pain was measured in 92 patients with the McGill-Melzack pain questionnaire. The Brompton mixture controlled pain in 90 per cent of patients in the palliative care unit and in 75 to 80 per cent of patients in the wards or private rooms. The differences in pain scores between patients in the palliative care unit and the other groups were significant. The mixture produced substantial decreases in the 3 major dimensions of pain: 1) sensory, 2) affective and 3) evaluative. Comparison of these results with data obtained in an outpatient pain clinic showed that the Brompton mixture was strikingly more effective than the traditional methods of managing cancer pain.

Aged↗
PubMed1990

[Administration of morphine into the cerebral ventricles in chronic intractable pain].

The study evaluated the effect of intraventricular morphine administration on chronic pain associated with malignant diseases in five subjects. To facilitate repeated application of the analgesic a reservoir was fixed subcutaneously on the calvaria with the catheter tip place in the lateral ventricle. The described approach made it possible to reduce substantially the dosage and to protract the action of morphine, as compared with intramuscular administration. No serious complications developed when the described mode of application was used. Because of the technically unpretentious procedure, the simple administration into the reservoir and the significant analgetic effect this method can be used in patients with malignant pain even in advanced stages of the disease.

Adult↗