Journal of pain and symptom management
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J Pain Symptom Manage · Apr 1992
Case ReportsResponse of central pain syndromes to intravenous lidocaine.
In this study, 8 patients with central pain syndromes, 6 with hemispheric lesions, and 2 with spinal cord lesions were treated with a 1 mg/kg dose of intravenous lidocaine. Patients first received the same volume of normal saline, in single-blind fashion, to monitor placebo effects. Of the 8 patients, 7 responded to lidocaine, and only 1 responded to normal saline. ⋯ In addition, 3 patients had pain relief that lasted for 8-20 wk. These findings, which are in agreement with two previous open-label studies, suggest that a single dose of a local anesthetic, lidocaine, can provide lasting pain relief for patients with central pain syndromes. This analgesic action may be central, and possibly supraspinal, at least in patients with hemispheric lesions.
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J Pain Symptom Manage · Feb 1992
Case Reports Clinical TrialLong-term oral opioid therapy in patients with chronic nonmalignant pain.
In contrast to the use of opioids for the treatment of acute and chronic cancer pain, the administration of chronic opioid therapy for pain not due to malignancy remains controversial. We describe 100 patients who were chronically given opioids for treatment of nonmalignant pain. Most patients experienced neuropathic pain or back pain. ⋯ The most common side effects were constipation and nausea. There were no cases of respiratory depression or addiction to opioids. Our results indicate that opioids can be effective in chronic nonmalignant pain, with side effects that are comparable to those that complicate the treatment of cancer pain.
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J Pain Symptom Manage · Nov 1991
Childbirth in Kuwait: the experiences of three groups of Arab mothers.
The aims of the present study were to characterize the childbirth experiences of three groups of Arab mothers delivering in Kuwait and to evaluate the use of visual analog scales (VAS) for assessing their pain (N = 301). Kuwaiti, Palestinian, and Bedouin women who were expected to have an uncomplicated vaginal delivery were studied. 73% of the women described their maximum labor pain as "unbearably painful," and more than one-half reported that they were "very frightened" or "terrified." The deliveries of Bedouin mothers were remarkable for the absence of pain behaviors; yet their VAS reports indicated that they experienced no less pain. Painful menstruation and fear of childbirth emerged as risk factors for a painful labor. Among the issues discussed are the validity of the VAS data, the difficulties of managing Bedouin mothers' pain, and the importance of excluding physical factors before cultural differences in pain perception are assumed.