Pain practice : the official journal of World Institute of Pain
-
As a part of aging, hip fractures are becoming more common. The connection between increased pain and a poor outcome has previously been shown. Therefore, even in prehospital situations, analgesic therapy appears to be reasonable. We established a prospective study with 153 patients to evaluate the patients' pain levels during the prehospital phase of treatment and prehospital analgesic therapy. ⋯ Only a minority of patients with hip fractures received prehospital analgesia. The administration of prehospital analgesia was associated with significant pain relief.
-
Tarlov or perineural cysts (TC) are commonly overlooked as a cause of sacral and ischial pain, and urogenital and bowel problems. TC can be seen on MRI, but are often considered asymptomatic. This is especially true for smaller cysts. ⋯ We suggest that electromyography of the sacral nerve roots can be a reasonable tool for the diagnosis of symptomatic TC, as well as for the differentiation from other pathological entities causing sacral and ischial pain. Moreover, using electromyography it was also documented that smaller cysts of < 1 cm can cause nerve damage. Therefore incidence of symptomatic TC may be higher than initially thought.
-
Different minimally invasive procedures are used to treat lumbar disk herniation. It is important to differentiate these techniques due to their specific effects and the disparate technical issues associated with each. This report describes a successful case involving the use of mechanical decompression in conjunction with radiofrequency ablation to treat a patient with pain and neurological deficits due to an extruded disk hernia. ⋯ A 43-year-old male had magnetic resonance imaging (MRI) demonstrating an extruded disk herniation in the left foraminal region, compression at the left spinal nerve root, and obliteration of the left foraminal entrance of the L5-S1 distribution. In the operating room, sufficient disk material was removed using grasping forceps, and then, the Disc-FX system with a Trigger-Flex probe (Elliquence, Baldwin, NY, U.S.A.) was inserted. Modulation of the annulus was performed in bipolar hemo mode, and nucleus ablation was conducted in bipolar turbo mode within a 1.7-MHz frequency range. Among the available minimally invasive techniques, newly developed technologies may become important treatment options if they enable faster rehabilitation, lower rates of recurrence, shorter hospital stays, and reduced medical costs.
-
Letter Case Reports
Dexmedetomidine Infusion may Cause Agitation During Procedural Sedation.