PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Intractable Pain”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources
PubMed2003

Spinal cord stimulation for intractable vulvar pain. A case report.

BACKGROUND: Vulvodynia is a complex pain syndrome with few effective treatments. We present a case of complex persistent vulvar pain effectively managed with spinal cord stimulation. CASE: A 21-year-old woman had a long history of burning vulvar pain exacerbated by exercise and sexual intercourse. Her symptoms began after termination of pregnancy and were not improved by diet changes or medical therapy. A partial vulvar vestibulectomy with Bartholin gland excision was performed, without an improvement. After referral to a pain management specialist, the patient had temporary relief of symptoms following bilateral hypogastric plexus blocks. With these favorable but temporary results, a permanent spinal cord stimulator was implanted, with sustained symptom relief. CONCLUSION: Spinal cord stimulation may offer a new treatment for women with intractable neuropathic vulvar pain.

Adult↗
PubMed1982

Intractable facial pain associated with a ganglioglioma of the cervicomedullary junction: report of a case.

A 6-year-old child with a brain stem tumor presented with the unusual complaint of intractable facial pain resembling trigeminal neuralgia in the absence of other symptoms or signs referable to the 5th cranial nerve. The radiological evaluation included a computed tomographic scan with intravenous contrast administration, which demonstrated an enhancing intramedullary lesion extending from the obex to C-4. After radiation and chemotherapy had failed to achieve symptomatic relief, the tumor, later proven to be a ganglioglioma, was radically removed with the ultrasonic aspirator. Postoperatively the patient experienced full pain relief.

Brain Neoplasms↗
PubMed1983

Experiences of depression and illness behavior in patients with intractable chronic pain.

Studied the relationships between depth of depression, anaclitic and introjective depressive experiences, and dimensions of illness behavior in 37 chronic pain patients. Depth of depression and degree of introjective depressive experiences showed similar positive covariation with a broad range of illness behavior: Namely, hypochondriasis, disease conviction, affective inhibition, affective disturbance, and irritability. The findings suggest that depression characterized by feelings of guilt, worthlessness, and self-doubt, rather than themes of abandonment, is associated differentially with disturbances in the illness behavior of chronic pain patients.

Adult↗
PubMedDate not supplied

Continuous intrathecal meperidine for severe refractory cancer pain: a case report.

The control of severe cancer pain may be problematic despite advances in pain management. Patients with severe intractable pain and/or intractable side effects may require aggressive interventional pain management strategies including the administration of medications by the continuous intrathecal route and/or neurosurgical procedures. Various medications, including opioids, local anesthetics, and alpha-2 agonists may be used intrathecally for the control of cancer pain. Failure of the intrathecal route may require the additional use of neurosurgical procedures such as cordotomy for pain control. We describe a case of severe cancer pain refractory to conventional intrathecal medications and cordotomy that was successfully managed by the addition of meperidine to the intrathecal regimen.

Adult↗
PubMed1990

A controlled study of psychotherapy and amitriptyline used individually and in combination in the treatment of chronic intractable, 'psychogenic' pain.

This paper reports an investigation into the efficacy of flexible dosage amitriptyline (AMI) and brief psychotherapy individually and together in the treatment of chronic 'psychogenic' pain. The patients included in the study were drawn from those referred to a pain clinic and were randomly assigned to 1 of 4 groups: (1) AMI + psychotherapy (N = 26), twelve 45 min weekly sessions; (2) AMI + support (N = 26), six 15 min fortnightly sessions; (3) placebo tablet + psychotherapy (N = 26), twelve 45 min weekly sessions; (4) placebo tablet + support (N = 24), six 15 min fortnightly sessions. Outcome was assessed on categorical and continuous variables administered immediately post treatment. The results indicate that amitriptyline is effective in increasing the patients' activity level and the reduction of pain intensity. Psychotherapy increases pain intensity, but tends to improve productivity. There also appears to be a role for the use of amitriptyline in combination with psychotherapy, but their interaction is a complex one. Baseline factors associated with withdrawal from treatment are reported, as well as those associated with a positive response to amitriptyline and psychotherapy respectively. Our findings offer tentative guidelines for choosing between therapies and also underline the importance of assessing more than one outcome variable in evaluating outcome. The importance of carrying treatments out in the context of a multidisciplinary pain clinic is emphasised.

Adult↗
PubMed2004

Mastectomy and reconstruction--an unusual solution to intractable breast pain.

Breast pain is a common complaint which usually subsides with simple reassurance or sometimes medication. This paper describes the case of a 41-year-old woman suffering from severe non-cyclical breast pain that had proved resistant to a battery of medical treatments. The pain was so disabling that it drove the patient to contemplate suicide. At the patient's request, a bilateral subcutaneous mastectomy with immediate implant reconstruction was performed, resulting in a complete resolution of the pain. Non-cyclical breast pain is less common than cyclical breast pain and tends to be more difficult to treat. This case suggests that mastectomy may be an appropriate option of last resort in the treatment of severe intractable breast pain.

Adult↗
PubMed1992

Testicular denervation. A new surgical procedure for intractable testicular pain.

Chronic testicular pain has many different aetiologies. Identification and treatment of an underlying problem resolve the issue in most cases. However, a proportion of patients with chronic testicular pain have no demonstrable aetiological factor and pose a difficult treatment problem. All of these patients are initially treated by non-surgical measures. Various operations advocated in the literature for non-responders include epididymectomy, scrotal orchiectomy and inguinal orchiectomy, all of which have a significant failure rate. We describe a hitherto unreported operative procedure in a series of 4 patients, with immediate and lasting relief of their pain.

Adult↗
PubMed1987

Clearance of continuous intravenous morphine for severe cancer pain.

Four cancer patients with intractable pain received continuous morphine infusions in doses of 15-275 mg/h for a time period ranging from 4 to 27 days. Serum morphine concentrations were determined periodically following adjustments in infusion rates. As doses were changed and continued at static hourly rates, serum morphine concentrations were relatively constant 20 hours and beyond the time of the respective change, thus suggesting morphine elimination half-lives of less than or equal to 4 hours. High doses did not influence the time required to achieve steady-state concentrations. Steady serum morphine concentrations corresponded with hourly morphine doses in a parallel manner. High interpatient variabilities in clearances and steady-state serum morphine concentrations were noted. These data suggest that at morphine infusions up to 275 mg/h elimination pathways permit handling of increasing concentrations of morphine without nonlinear blood level increases. Also, marked interpatient and intrapatient variations in patient dose requirements were noted.

Female↗
PubMed1988

Pancreaticogastrostomy: the preferred operation for pain relief in chronic pancreatitis.

We present the results of surgery in 53 patients with intractable pain due to chronic pancreatitis associated with pancreatic duct dilatation. Using a limited mucosal to mucosal anastomosis over a silastic T tube the main pancreatic duct was drained in 33 patients into a Roux-en-Y jejunal loop (pancreaticojejunostomy, PJ) and in 20 patients into the stomach (pancreaticogastrostomy, PG). There was one postoperative death in the PJ group and none in the PG group. All patients were followed up for a minimum of four years. There was significantly greater pain relief in the PG group both at 1 (P less than 0.01) and 4 years (P less than 0.05) after surgery. We argue that PG is the operation of choice to relieve intractable pain in most patients with chronic pancreatitis associated with duct dilatation.

Adult↗