Pain medicine : the official journal of the American Academy of Pain Medicine
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Muscle hyperalgesia is typically evaluated by pressure algometry applying linear stimulation. Combining linear pressure stimulation with additional minor variations of the pressure in different directions may optimize the detection of pain sensitivity in hyperalgesic muscle. ⋯ Rotational stimulation together with pressure stimulation was more efficient than classical pressure algometry in detecting muscle hyperalgesia.
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This study was designed to describe the efficacy and toxicity of intravenous (i.v.) lidocaine infusions for the treatment of neuropathic pain initially administered at a flat-rate trial dose of 500 mg over 30 minutes. ⋯ The flat-dose trial used under the University of Wisconsin Health protocol for i.v. lidocaine administration did not cause serious adverse events, but few patients who responded to this trial dose tolerated subsequent infusions at the trial rate. Due to the lack of serious adverse events, administering an aggressive trial dose to elicit an analgesic response appears to be rational. If patients show a benefit from the trial dose, the need for reductions in infusion rate of subsequent doses should be anticipated.
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Observational Study
Age- and procedure-specific differences of epidural analgesia in children--a database analysis.
Several audits demonstrated the safety of epidural catheters in children undergoing surgery. Within the present data analysis, we investigated whether older compared with younger children and children with specific types of surgical procedures might report higher pain scores. ⋯ This database analysis demonstrated that older children and children undergoing thoracic or spine surgery reported significant higher pain scores most likely because they received less additional opioids. Therefore, a more "aggressive" pain treatment (including opioids on demand under appropriate monitoring) might further improve postoperative care.