Pain practice : the official journal of World Institute of Pain
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Ketamine is a commonly used analgesic agent in the management of both acute and chronic pain. While dose-dependent side effects are well described, allergy to ketamine is extremely rare. ⋯ This case represents a likely immunoglobulin E-mediated type I hypersensitivity reaction to ketamine, supported by elevated tryptase levels and positive intradermal skin testing. The interpretation of these results and likely mechanism of the hypersensitivity reaction are described. The patient and treating team were advised against subsequent use of ketamine, due to the risk of serious adverse systemic reaction with repeat exposure.
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Case Reports
Stellate Ganglion Block for Debilitating Photophobia Secondary to Trigeminal, Postherpetic Neuralgia.
The primary objective of this case report was to demonstrate the therapeutic benefit of stellate ganglion block in trigeminal postherpetic neuralgia. ⋯ The patient demonstrated significant reduction in her VAS pain score and improved functional capacity for approximately 6 months after the intervention. This case report provides evidence that sympathectomy via a stellate ganglion block can treat photophobia secondary to postherpetic neuralgia in the V1 distribution.
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This study aimed to identify the following: (1) the proportion of the defensive high-anxious personality type in a chronic pain population; (2) whether personality type affects the relationships between cognitive factors and disability. ⋯ The interaction between defensiveness and anxiety plays an important role in patients' perceptions of, and outcomes from, chronic pain. Differentiating the defensive high-anxious group revealed different patterns of relationship between a range of cognitive factors and disability. This highlights the necessity of assessing personality characteristics that include defensiveness in order to identify those individuals who may be more vulnerable to cognitive factors influencing their perceptions of disability. If personality type is identified as a predictor of poor adjustment, interventions could be customized to the unique needs of this group (eg. high defensive and anxious individuals).