Articles: pain-measurement.
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Spinal cord stimulators (SCS) are used to treat various chronic pain states. Establishing patient outcomes in terms of pain control, opioid medication use, and overall satisfaction is vital in maintaining SCS's role in clinical practice. ⋯ Retrospective review of patients with spinal cord stimulators revealed OME reduction at 1 year for those patients in the FBSS and CRPS groups; patient satisfaction at 1 year and NRS score reduction at 6 months and 1 year were statistically significant for all groups.
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The complex regional pain syndrome (CRPS) still represents an incompletely etiologically understood complication following fractures of the distal radius. The incidence of CRPS following fractures of the distal radius varies between 1 % and 37 %. Pathophysiologically, a complex interaction of inflammatory, somatosensory, motor and autonomic changes is suspected, leading to a persistent maladaptive response and sensitization of the central and peripheral nervous systems with development of the corresponding symptoms. ⋯ Among the types of apparatus used for diagnostics, 3‑phase bone scintigraphy and temperature measurement have a certain importance. A multimodal therapy started as early as possible is the most promising approach for successful treatment. As part of a multimodal rehabilitation the main focus of therapy lies on pain relief and functional aspects.
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Case Reports Comparative Study
Outcome of a Specific Compartment Fasciotomy Versus a Complete Compartment Fasciotomy of the Leg in One Patient With Bilateral Anterior Chronic Exertional Compartment Syndrome: A Case Report.
Chronic exertional compartment syndrome of the leg is a debilitating lower extremity condition in which increased intracompartmental pressure impedes blood flow to the involved compartments of the distal lower extremity, resulting in ischemia and pain. Owing to the lack of success with conservative management, most surgeons perform complete release fasciotomy as the preferred method of fasciotomy to avoid an unsuccessful release or outcome. Studies have been performed regarding the outcomes of complete compartmental release versus specific compartmental release, but no study has been performed comparing complete fasciotomy and compartment-specific fasciotomy in a single patient. ⋯ In general, the range of motion, circumferential measurements, and functional outcome measure scores were better for the specific compartmental fasciotomy leg than for the complete fasciotomy leg during the recovery period. The overall functional outcomes were the same for both surgical approaches, with the specific fasciotomy leg returning to baseline function 13 to 23 days before the complete fasciotomy leg. The outcomes remained unchanged 18 months after surgery.
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Evidence exists that analgesics are underutilized, delayed, and insufficiently dosed for emergency department (ED) patients with acute abdominal pain. For physicians practicing in a Canadian paediatric ED setting, we (1) explored theoretical practice variation in the provision of analgesia to children with acute abdominal pain; (2) identified reasons for withholding analgesia; and (3) evaluated the relationship between providing analgesia and surgical consultation. ⋯ Pediatric emergency physicians self-reported rates of providing analgesia for acute abdominal pain scenarios were higher than previously reported, and appeared unrelated to request for surgical consultation. However, an unwillingness to provide opioid analgesia, belief that analgesia can obscure a surgical condition, and failure to take self-reported pain at face value remain, suggesting that the need exists for further knowledge translation efforts.