The Clinical journal of pain
-
Comment Letter Randomized Controlled Trial Comparative Study
Comparison of ketamine plus midazolam versus ketamine for sedation in children during lumbar puncture.
-
Randomized Controlled Trial Multicenter Study
Tramadol in neuropathic pain after spinal cord injury: a randomized, double-blind, placebo-controlled trial.
To assess the efficacy and safety of tramadol for relieving neuropathic pain after spinal cord injury (SCI). ⋯ Tramadol might be tried for neuropathic pain after SCI after the use of gabapentin/pregabalin, and tricyclic antidepressants have been found to be insufficient. Titration should be slow and individual, to minimize the risk of adverse events.
-
To investigate the expression of capsaicin receptor [transient receptor potential vanilloid type-1 (TRPV1)] in the peritoneum of women with chronic pelvic pain (CPP). ⋯ TRPV1 may play an important role in the maintenance and perpetuation of symptoms in women with CPP. In view of the immunoreactivity detected for TRPV1, the endometriotic lesion may have the ability to interfere with nociception or with the inflammatory peritoneal environment in women with CPP. Further studies are needed to elucidate the participation of TRPV1 in CPP and its association with endometriosis.
-
Case Reports
Obstructed catheter connection pin discovered during intrathecal baclofen pump exchange.
We report a case of catheter obstruction due to complete narrowing of the lumen of a connecting pin, and catheter disconnection in a patient undergoing intrathecal Baclofen pump exchange. The patient underwent intrathecal baclofen pump implantation for treatment of lower extremity spasticity and hypertonia secondary to congenital tetraplegia. Intrathecal baclofen dose escalation occurred over the course of treatment (73 mo) from 80 to 708 mcg/d representing a 189% increase in dose. ⋯ Upon further examination, the lumen of the connection pin positioned between the pump catheter and intrathecal catheter was completely obstructed. Postsurgically, the patient's intrathecal baclofen dose was substantially reduced from 708 to 527 mcg/d (25.6% reduction) to control hypotonicity and to reestablish an Ashworth score of 2. We discuss intrathecal baclofen therapy and a unique complication associated with a catheter connecting pin.