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Buprenorphine for the Management of Intractable Pain in Skin Ulcers Associated With Calcific Uremic Arteriolopathy. 丁丙诺啡治疗钙性尿毒症动脉病变相关皮肤溃疡难治性疼痛。
Pain medicine case reports Pub Date : 2024-09-01
Savannah Whitfield, Daniel Sanchez Pellecer
{"title":"Buprenorphine for the Management of Intractable Pain in Skin Ulcers Associated With Calcific Uremic Arteriolopathy.","authors":"Savannah Whitfield, Daniel Sanchez Pellecer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Calcific uremic arteriolopathy, or calciphylaxis, is a rare and severe condition marked by calcification of small-to-medium blood vessels, causing tissue ischemia and necrosis. The pain is excruciating, emanating from tender lesions, severely impacting movement and touch. No approved treatment exists, making effective pain management vital for improving quality of life and outcomes.</p><p><strong>Case report: </strong>A woman with end-stage renal failure and calciphylaxis-related ulcers on the inferior pannus, left medial thigh, and right gluteus experienced refractory pain despite opioid therapy. Palliative care initiated adjustive buprenorphine, yielding remarkable and sustained pain relief.</p><p><strong>Conclusions: </strong>This case emphasizes the urgent need for better treatment options for calciphylaxis, particularly in pain management. The success of adjunctive buprenorphine highlights the debilitating condition, ensuring comprehensive pain management.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"223-227"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Target Crosshair Method for Fluoroscopic-Guided Greater Trochanteric Bursa Injections. 透视引导下大转子法囊注射的目标十字准线方法。
Pain medicine case reports Pub Date : 2024-09-01
Trishul Kapoor, Richard Rosenquist, Jijun Xu
{"title":"A Target Crosshair Method for Fluoroscopic-Guided Greater Trochanteric Bursa Injections.","authors":"Trishul Kapoor, Richard Rosenquist, Jijun Xu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Trochanteric bursitis is one of the most common causes of lateral hip pain. Although fluoroscopic-guided greater trochanteric bursa injections (FGTBIs) are commonly performed, literature describing techniques and methods focused on accuracy and precision is scarce.</p><p><strong>Objectives: </strong>In this case report, we describe an innovative target crosshair method (TCM) to help improve FGTBI procedural accuracy and precision under fluoroscopic guidance.</p><p><strong>Study design: </strong>The design of this study is a retrospective chart review in the form of a technical methodology report.</p><p><strong>Setting: </strong>This study was completed at a large tertiary academic medical center.</p><p><strong>Methods: </strong>The TCM utilizes anteroposterior (AP) and lateral fluoroscopic views of the proximal femur in order to draw a vertical line (AP) at the level of the junction of the femoral neck, trochanteric fossa, and greater trochanter (GT), and a horizontal line (craniocaudal) along the lateral hip designating the posterior half of the GT.</p><p><strong>Results: </strong>Three patients with body mass indexes ranging from 35-40 successfully underwent FGTBI using the TCM for greater trochanteric syndrome causing lateral hip pain. All patients experienced > 70% analgesic relief for 4 to 6 months. There were no adverse events reported by any of the patients.</p><p><strong>Limitations: </strong>The limitations of this study include the inability to generalize results due to a small sample size and the inherent nature of the study design as a retrospective chart review. The primary intention of this study is to describe a novel technical method.</p><p><strong>Conclusions: </strong>The TCM results in an accurate path for skin and subcutaneous tissue local anesthetic injection and a final needle tip landing site for corticosteroid injection regardless of patient body habitus.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"205-208"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dorsal Root Ganglion Stimulation as a Treatment for Chronic Refractory Groin Pain: A Case Series. 刺激背根神经节治疗慢性难治性腹股沟痛：一个病例系列。
Pain medicine case reports Pub Date : 2024-09-01
Madhur Batra, Christopher J Mallard
{"title":"Dorsal Root Ganglion Stimulation as a Treatment for Chronic Refractory Groin Pain: A Case Series.","authors":"Madhur Batra, Christopher J Mallard","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Complex regional pain syndrome (CRPS) can be a debilitating source of pain and is characterized by a combination of sensory, motor, vasomotor, and autonomic abnormalities. Neuromodulation can serve as a therapeutic intervention for groin CRPS.</p><p><strong>Case report: </strong>Two patients with refractory CRPS in the groin and perineum underwent bilateral dorsal root ganglion (DRG) stimulation at L1 and S2. Both patients had reduction (> 70%) in their pain with lasting (> 6 months) relief.</p><p><strong>Conclusions: </strong>CRPS can lead to changes in phenotype and function of the DRG. Stimulation of the DRG can block the passage of impulse trains where peripheral and central pathways of pain are modulated, resulting in improved symptoms and quality of life. Groin and perineal pain, refractory to conventional interventions, can be successfully treated with DRG stimulation.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"229-231"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Wireless Cervical Peripheral Nerve Stimulation for Treating Occipital Neuralgia-Induced Neuropathic Pain. 颈外周神经无线刺激治疗枕神经痛致神经性疼痛。
Pain medicine case reports Pub Date : 2024-09-01
Alaa Abd-Elsayed, Clara Nemr, Max Y Jin, Matthias Wiederholz
{"title":"Wireless Cervical Peripheral Nerve Stimulation for Treating Occipital Neuralgia-Induced Neuropathic Pain.","authors":"Alaa Abd-Elsayed, Clara Nemr, Max Y Jin, Matthias Wiederholz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Peripheral neuropathy is a leading cause of chronic pain and can result in cephalalgia when upper cervical nerves or their branches are injured. This condition often shows resistance to typical treatment methods used for long-term pain management. Peripheral nerve stimulation (PNS) is an effective way to treat neuropathic pain; however, there's limited literature available regarding the wireless modality at the cervical level.</p><p><strong>Case report: </strong>This was a retrospective case series involving 3 patients who received wireless PNS at the C2-C3 level for treating occipital neuralgia and/or axial neck pain. Average Visual Analog Scale scores decreased by 63.9% after trial (P < 0.001) and 78.3% (P < 0.001) at one-year postpermanent implantation.</p><p><strong>Conclusions: </strong>Our study adds to the growing evidence supporting wireless PNS as an efficacious intervention at the cervical level for patients with occipital neuralgia-induced neuropathic pain who fail conventional management.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"217-222"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intraoperative Findings of Pathologic Calcification Surrounding an Intrathecal Pain Pump: A Case Report. 术中发现鞘内疼痛泵周围的病理性钙化1例。
Pain medicine case reports Pub Date : 2024-09-01
Chris Burton, Alexis Hanson, Matthew Valeriano
{"title":"Intraoperative Findings of Pathologic Calcification Surrounding an Intrathecal Pain Pump: A Case Report.","authors":"Chris Burton, Alexis Hanson, Matthew Valeriano","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pathologic calcification is a common complication of surgically implanted devices, increasing the incidence of subsequent infection. Most literature describing this phenomenon occurs with cardiac implanted devices. Documented reports of this complication, specifically in the setting of intrathecal pain pump (ITP) and spinal cord stimulator (SCS) implants, are minimal, with presumably low incidence.</p><p><strong>Case report: </strong>We present a case of a 58-year-old healthy man with a history of motorcycle accident status post L4-S1 fusion complicated by post-laminectomy syndrome. In February 2023, the patient required replacement of his ITP pump and SCS as both were at the end of life. During the replacement procedure, milky fluid was present with extensive calcifications along the ITP pocket and surrounding the catheter, as well as a small amount around the SCS implantable pulse generator.</p><p><strong>Conclusions: </strong>This case illustrates the potential effect on the administration of intrathecal medication and neuromodulation if pathologic calcification occurs.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"199-203"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cyclic Vomiting Syndrome as a Migraine Variant in Adults: A Case Report. 周期性呕吐综合征作为一种成人偏头痛变体：一例报告。
Pain medicine case reports Pub Date : 2024-09-01
Karim Borei, Mohammad Obadah Nakawah
{"title":"Cyclic Vomiting Syndrome as a Migraine Variant in Adults: A Case Report.","authors":"Karim Borei, Mohammad Obadah Nakawah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cyclic vomiting syndrome (CVS) is a complex medical disorder characterized by debilitating attacks of nausea and vomiting lasting hours to days. CVS often acts as a migraine precursor or variant in the pediatric population, but its relationship with migraine in adults is not well established.</p><p><strong>Case report: </strong>Here, we report a case of adult-onset CVS with recurrent attacks of nausea, vomiting, and malaise for several years causing significant morbidity and work loss. Atypical migraine was suspected, and the disorder was controlled with effective antimigraine therapy.</p><p><strong>Conclusions: </strong>Our study contributes to the increasing body of evidence that underscores CVS as a migraine variant. This recognition enhances our comprehension of CVS and guides the development of more efficacious treatment approaches.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"213-215"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sclerotherapy for Management of Intrathecal Pump Seroma Formation: A Case Series. 硬膜疗法治疗鞘内泵血肿：一个病例系列。
Pain medicine case reports Pub Date : 2024-09-01
Grant Allbritten, Joshua Bigham, Michael E Harned, Christopher J Mallard
{"title":"Sclerotherapy for Management of Intrathecal Pump Seroma Formation: A Case Series.","authors":"Grant Allbritten, Joshua Bigham, Michael E Harned, Christopher J Mallard","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Intrathecal drug delivery systems (ITDDS) are an option for the treatment of chronic pain syndromes or spasticity that are refractory to other conservative measures; however, they are not without complications. Seroma formation is one of the possible complications following implantation of an ITDDS.</p><p><strong>Case report: </strong>We present 3 separate cases of patients with recalcitrant seroma formation at their IT pump sites that were successfully treated with doxycycline pleurodesis.</p><p><strong>Conclusions: </strong>Pump site seroma formation is a possible complication following implantation of an ITDDS. Typically, these are self-limiting, but if not addressed can result in complications which include pain, infection, and difficulty filling. We propose a case series of 3 patients who suffered from recurrent seroma formation following ITDDS implantation that were successfully treated with doxycycline-based sclerotherapy.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"237-239"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Diagnosis of Fentanyl-Induced Chest Wall Rigidity: A Case Report. 芬太尼致胸壁僵直1例。
Pain medicine case reports Pub Date : 2024-09-01
Christopher McElrath, Ivan Chew, Thao Lam
{"title":"The Diagnosis of Fentanyl-Induced Chest Wall Rigidity: A Case Report.","authors":"Christopher McElrath, Ivan Chew, Thao Lam","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Fentanyl is a widely used opiate drug because of its rapid-acting sedative and analgesic effects. Fentanyl is often used for procedural sedation due to its favorable pharmacokinetics.</p><p><strong>Case report: </strong>We report the case of a woman who developed the uncommon complication of fentanyl-induced chest wall rigidity or wooden chest syndrome following the administration of low-dose fentanyl during an elective pain procedure in the absence of commonly described risk factors. Her clinical presentation included total body muscle rigidity along with difficulty with ventilation. Her condition was ultimately reversed with prompt administration of intravenous naloxone.</p><p><strong>Conclusions: </strong>Our case reveals that fentanyl-induced chest rigidity is a rare but important adverse event that can potentially occur to any patient. An understanding and awareness of this phenomenon is necessary for all health care providers who may utilize fentanyl for procedural sedation in their practices.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"209-211"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effective Sufentanil Intrathecal Pump Treatment in a Patient With Refractory Complex Regional Pain Syndrome: A Case Report. 舒芬太尼鞘内泵有效治疗难治性复杂局部疼痛综合征1例。
Pain medicine case reports Pub Date : 2024-09-01
Azem A Chami, William C Upshaw, Sahar Shekoohi, Alan D Kaye
{"title":"Effective Sufentanil Intrathecal Pump Treatment in a Patient With Refractory Complex Regional Pain Syndrome: A Case Report.","authors":"Azem A Chami, William C Upshaw, Sahar Shekoohi, Alan D Kaye","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Many treatments for severe complex regional pain syndrome (CRPS) are ineffective as patients may still experience pain even after various therapeutic approaches. Therefore, it is important to consider novel and creative treatment options for patients suffering from unremitting refractory pain.</p><p><strong>Case report: </strong>We report the case of a patient with severe CRPS, which proved to be refractory to numerous conventional treatments. CRPS is a disease that causes chronic pain, typically in distal extremities.</p><p><strong>Conclusions: </strong>Treatment for CRPS includes pharmacotherapy, sympathetic nerve block, and/or various surgical procedures. However, some patients may receive little benefit from these treatments with persistent severe pain despite undergoing treatment. Thus, novel treatments have been attempted to lessen CRPS-mediated pain. We present a case where one of these unconventional therapeutic approaches was utilized involving the administration of sufentanil through an intrathecal pump providing effective pain reduction in a patient with CRPS.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 6","pages":"233-236"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Subcutaneous Botulinum Toxin Type-A Injections for the Treatment of Central Neuropathic Pain in a Patient With Multiple Sclerosis - A Case Report. a型肉毒毒素皮下注射治疗多发性硬化症患者中枢神经性疼痛1例报告。
Pain medicine case reports Pub Date : 2024-07-01
Christian Nicolosi, Christina Draganich, George Marzloff
{"title":"Subcutaneous Botulinum Toxin Type-A Injections for the Treatment of Central Neuropathic Pain in a Patient With Multiple Sclerosis - A Case Report.","authors":"Christian Nicolosi, Christina Draganich, George Marzloff","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BACKGROUND: Neuropathic pain is a common, but difficult-to-treat, condition affecting the quality of life of many. It is prevalent in patients with multiple sclerosis (MS), an autoimmune chronic inflammatory disease of the central nervous system. Treatments, such as gabapentin, pregabalin, tricyclic antidepressants, serotonin, and norepinephrine reuptake inhibitors, are insufficient. As a result, botulinum neurotoxin type A (BoNT-A) has been explored for its effects on pain control with neuropathic pain. \u0000\u0000CASE REPORT: </strong>We present a 59-year-old woman with chronic neuropathic pain and MS. She presented to us with allodynia in the lateral portion of her left trunk, radiating into her breast to the nipple. The patient reported improvement in pain after subcutaneous injections of BoNT-A over the area of pain. \u0000\u0000CONCLUSIONS: In the present case report, we highlight the effectiveness of subcutaneous BoNT-A for the treatment of refractory central neuropathic pain in MS.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 5","pages":"179-184"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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