Masui. The Japanese journal of anesthesiology
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Continuous infusion of fentanyl for postoperative pain management is performed commonly. But the usage of traditional syringe pump or infusion pump sometimes makes medical staff confusing for its difficulties of handling. We have simplified the postoperative pain management system using the single-use continuous infusion device and the protocol for administration of fentanyl. ⋯ It is concluded that good postoperative pain management is possible with single use infusion device safely.
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Pain of the leg ulcer significantly decreases patients' QOL, and pain control is an important treatment as the ulcer treatment. Continuous epidural block is often selected, but we can not provide enough continuous epidural block because of oral anticoagulant treatment and infection because of long-term indwelling catheter. ⋯ We obtained approvals not only from patients but also from plastic surgeons and dermatologists. We suggest that continuous popliteal block can be a usual method of the general pain control procedure.
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For more than 20 years morphine for spinal analgesia in patients with refractory cancer pain has been one of the cornerstones for the management of chronic, medically intractable pain. In general, most types of cancer pain are treatable following the guideline of Cancer Pain Relief well established by the WHO. However, some patient are unable to tolerate pain only following the guideline and often suffer with side-effects from high doses of opioid and from prescribed multiple adjuvant drugs. ⋯ Intrathecal drug application is cost effective and can significantly improve the quality of life in selected patients with limited life expectancy. However, an intensive training of physicians, careful patient selection, awareness of specific complications, and arrangement of social back-up medical system are essential to commence intrathecal morphine application using implantable access port. This article introduces the basic idea of intrathecal morphine therapy with implantable access port (not pumps) as cost effective, alternative therapy for cancer patient suffering from intractable pain.