Pain practice : the official journal of World Institute of Pain
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Case Reports
A Computed Tomography-Guided Demonstration of the Unilateral Distribution of Low-Volume Epidural Injectate.
The primary objective of this case report was to demonstrate the unilateral distribution of the low volume injectate given in the epidural space when paramedian interlaminar approach is utilized under computed tomography guidance. ⋯ There was primarily unilateral distribution of low-volume injectate in the epidural space when paramedian interlaminar approach is utilized.
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Traumatic amputation at the pelvic level is a rare procedure with few studies addressing long-term complications. Painful neuroma formation may form at the site of nerve transection and cause significant impairments in daily living. Ultrasound-guided cryoablation therapy has grown in popularity and should be considered in patients with painful neuromas. This is a case report of complete pain relief in a patient with rare traumatic hip disarticulation with neuroma formation, treated with ultrasound-guided cryoablation. The patient gave consent for publication. ⋯ This case illustrates a rare incidence of painful neuroma formation in a patient with traumatic hip disarticulation. Cryoablation with ultrasound guidance resulted in resolution of all pain. We report, to the best of our knowledge, the first occasion of an ultrasound-guided cryoablation resulting in complete pain relief in a traumatic hip disarticulation neuroma.
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Randomized Controlled Trial Comparative Study
Percutaneous Cervical Nucleoplasty Versus Pulsed Radio Frequency of the Dorsal Root Ganglion in Patients with Contained Cervical Disc Herniation; A Prospective, Randomized Controlled Trial.
Cervical neck pain is often caused by cervical disk pathology and may cause severe symptoms and disability. Surgeons and patients are increasingly aware of postsurgery-related complications. This stimulated the clinical usage of minimally invasive treatments such as percutaneous nucleoplasty (PCN) and pulsed radio frequency (PRF). However, scientific evidence on both treatments is limited. ⋯ Within 3 months, both PCN and PRF show significant pain improvement in patients with contained cervical disk herniation, but none is superior to the other. Both treatment options appear to be effective and safe in regular clinical practice.
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Computerized pneumatic cuff pressure algometry (CPA) using the DoloCuff is a new method for pain assessment. Intra- and inter-rater reliabilities have not yet been established. Our aim was to examine the inter- and intrarater reliabilities of DoloCuff measures in healthy subjects. ⋯ Inter-rater reliability was excellent for PT, PTol, and TSI. Similarly, the intrarater reliability for PT and PTol was excellent, while borderline excellent/good for TSI. Therefore, the DoloCuff can be used to obtain reliable measures of pressure pain parameters in healthy subjects.
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This analysis compared the therapeutic response of pregabalin in patients with neuropathic pain (NeP) who had been previously treated with gabapentin to the therapeutic response in patients who had not received gabapentin previously. ⋯ The findings presented here support the idea that pregabalin may be used successfully to treat patients with NeP who may be refractory, respond inadequately, or are intolerant to gabapentin. These findings highlight the importance of tailoring treatment of NeP based on individual patient response to different treatments, including the trial of multiple agents within the same mechanistic class.