Articles: neuralgia.
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The antiepileptic drug gabapentin has begun to be used successfully in some cases of neuropathic pain. Its mechanism of action is still unknown, but seems to be related to a positive effect on the synthesis and liberation of the neurotransmitter GABA. ⋯ Gabapentin should be borne in mind in the treatment of this type of pain, particularly when the usual treatment cannot be given or is insufficient to control pain, especially in elderly patients in whom there is often reduced tolerance of drugs.
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This report details the course of a 77-year-old patient suffering mild pain from operated tongue cancer and excruciating, intractable pain from thoracic (T6-T8) post-herpetic neuralgia (PHN), The mouth pain was treated with nonopioid analgesics, as the patient had personal objections to opioid treatment. All the components of the pain from his PHN (continuous burning pain, intermittent lancinating stabbing pain, and tactile allodynia) were successfully treated with an Intrathecal Infusion of buprenorphine (0.03 mg/ml) and bupivacaine (4.75 mg/ml) administered via an externalized intrathecal catheter with the tip located at T9-T10 intervertebral disc. The treatment started three months after the appearance of the herpetic eruption and lasted 294 days until the patient died of malnutrition and the progression of his tongue cancer. ⋯ The patient could ambulate without support while on 90-100 mg/day of intrathecal bupivacaine. During a series of high-pressure oxygen treatments in a pressure chamber to treat an infection at the site of his tumor, the intrathecal infusion was interrupted. Thus, repeated observation of the intervals of severe pain and of analgesia were possible.
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J Assoc Physicians India · Apr 1998
Comparative Study Clinical TrialHerpes zoster and post-herpetic neuralgia--a clinical trial of aspirin in chloroform for anodyne.
Pain associated with Herpes Zoster (HZ) and Post-herpetic Neuralgia (PHN) has been a challenging task to manage with ease. Topical aspirin dissolved in chloroform is an effective means of reducing pain due to HZ and PHN in most patients. The locus of pain origin and analgesia induced by topical aspirin is supposed to be at cutaneous free nerve ending pain receptors. ⋯ Most of the patients experienced relief of pain within 1-5 minutes after the aspirin-chloroform application. Maximum relief was achieved in about 30-40 minutes and persisted for 5-6 hrs. In the beginning 3-4 applications were required but frequency decreased gradually as the pain abated.