Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2000
Clinical TrialEffect of high-dose lidocaine treatment on superoxide dismutase and malon dialdehyde levels in seven diabetic patients.
We report on the use of intravenous (IV) high-dose lidocaine to relieve diabetic neuropathic pain, and the technique's effects on clinical measures of lipid peroxidation. ⋯ High-dose lidocaine treatment lessens MDA levels, a marker of free-radical-mediated cell damage. This suggests that one of lidocaine's mechanism of action may be its effect on oxygen free radicals, which in turn impacts lipid peroxidation.
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Reg Anesth Pain Med · May 2000
Clinical TrialThe minimum effective concentration of opioids: a revisitation with patient controlled analgesia fentanyl.
Whether patients titrate themselves to an individualized blood or plasma opioid concentration (the so-called minimum effective concentration or [MEC]) has been debated extensively. Nevertheless, there is consistent opinion that during patient controlled analgesia (PCA) patients balance acceptable pain relief against unacceptable side effects. This study sought to characterize fentanyl used by PCA with respect to MEC and factors influencing PCA use. ⋯ This study found evidence to support the concepts of an individual MEC and a therapeutic window of fentanyl used with PCA.
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Reg Anesth Pain Med · May 2000
Case ReportsCalciphylaxis treated with neurolytic lumbar sympathetic block: case report and review of the literature.
Calciphylaxis is a painful complication of end-stage renal disease and secondary hyperparathyroidism. Calcification most commonly affects skin and soft tissue of the lower extremities resulting in excruciatingly painful skin ulcers. Treatment involves correction of hypercalcemia and hyperphosphatemia, parathyroidectomy, and supportive measures. ⋯ The neurolytic LSB provided pain relief and is a treatment modality to be considered in managing the pain associated with calciphylaxis.
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The Internet is increasingly an important resource for both the Pain Medicine physician and the patient. Considerable high-quality information exists within numerous government, university, professional association, and private sites. ⋯ Clinicians may communicate about complex patient management issues via a list-serve, which delivers entire discussions to their E-mail accounts. These multiple resources offer an enriched environment for patient care, education, and research in pain management.