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Tachycardia Following Ganglion Impar Block

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Open Journal of Anesthesiology 2012年第5期2卷 217-218页

作者： E. Ngugi Kinyungu Troy Buck Joseph R. Holtman Department of Anesthesiology Division of Pain Management and Pain Medicine Loyola University Medical Center Maywood USA.

Objective: To understand an unusual complication of a low risk procedure. Design: This article chronicles the side effect of a Ganglion Impar Block. Setting: Loyola University Medical Center Outpatient Chronic pain Clinic. Patients: One. Results: Our patient had tachycardia after a Ganglion Impar Block. Conclusions: An unusual complication of a ganglion impar block can be increased heart rate.

关键词： Ganglion Impar Block Tachycardia

Complex Regional pain Syndrome: Outpatient pain management in the Chronic Setting: A Case Report

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Open Journal of Anesthesiology 2024年第5期14卷 137-144页

作者： Julie Chege Ngugi Kinyungu ITAV pain management Medical School University of Nairobi New York USA ITAV pain management Donald and Barbara Zucker School of Medicine at Hofstra/Northwell New York USA

Background: Complex Regional pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a debilitating condition with high levels of pain and reduced function. Aim: This case report aims to discuss the multimodal approach in the management of a patient who presented with ongoing poorly controlled pain secondary to CRPS from an injury that happened years prior. Case Presentation: A 45-year-old female was involved in a motor vehicle accident where her right leg was injured. She underwent several surgeries and developed CRPS that significantly reduced her mobility and quality of life. She presented to the pain clinic years after her initial injury and a multimodal regimen was started for her resulting in significantly improved function. Conclusion: CRPS can be a severely debilitating condition. While early diagnosis and management are important, ongoing management in the outpatient chronic pain setting is important in maintaining a good level of function.

关键词： Chronic Regional pain Syndrome (CRPS) Multimodal management Chronic pain Sequelae

Radial shock wave therapy in the treatment of chronic constriction injury model in rats： a preliminary study

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Chinese Medical Journal 2014年第5期127卷 830-834页

作者： Fu Miao Cheng Hao Li Duoyi Yu Xiaotong Ji Nan Luo Fang Department of Anesthesiology and pain management Beijing Tiantan Hospital Capital Medical University Beijing 100050 China

Background pain physicians pay close attention to neuropathic pain （NP）,since there is currently no ideal *** shock wave therapy （RSWT） is a noninvasive treatment to chronic pain of soft tissue *** far,there is no information on the use of RSWT for the treatment of *** we observe the effects of RSWT on a NP model induced by chronic constriction injury （CCI） in *** Four different energy densities （1.0,1.5,2.0 and 2.5 bar） RSWT administered as a single session or repeated sessions in rats with NP induced by CCI of the sciatic *** analgesic effect was assessed by measuring mechanical withdrawal threshold （MWT） and thermal withdrawal latency （TWL）.The safety was assessed through calculating sciatic functional index （SFI）.Results MWT and TWL increased after a single session of RSWT from day 1 to day 5 but retumed to baseline levels by day *** repeated sessions of RSWT,both the MWT and TWL were significantly higher than NP group （P ＜ 0.01）for at least 4 *** addition,no significant changes of SFI were observed in any groups after repeated sessions of RSWT and no increased pain or other side effects in any *** A single session of RSWT is rapidly effective in the treatment of CCI,but the efficacy maintained in a short ***,repeated sessions of RSWT have prolonged efficacy.

关键词： radial shock wave therapy extracorporeal shock wave treatment neuropathic pain chronic constriction injury model

DAIRY PRODUCT RESTRICTION AND AGE INFLUENCE IN REDUCING FIBROMYALGIA pain AMONG PATIENTS TREATED WITH AURICULAR ACUPUNCTURE:A DOUBLE BLIND STUDY

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Journal of Integrative Medicine 2014年第3期 313-314页

作者： Wei Ling Huang Medical Acupuncture and pain management Clinic Sao PauloBrazil

Objective: This study is a retrospective double-blind investigation by telephone interview of the effectiveness of auricular acupuncture, in the treatment of patients with fibromyalgia by observing age and gender, influence of dairy product restriction, a numerical analysis of the quantity of pain before and after auricular acupuncture treatment, and the intensity of reduction of pain according to ***: We started with research of over 900 auricular acupuncture patient *** were searched by the clinic’s secretary and 35 of them were selected who had suffered from fibromyalgia and the names and telephone numbers were *** names and numbers were given to a research assistant who had never had contact with any of the patients *** was able to reach 13 of them using a questionnaire to gather the data about pain intensity before and after auricular acupuncture treatment, the influence of dairy product restrictions and correlation with age on pain intensity ***: All the patients were women, and there was an important reduction in the pain intensity after auricular acupuncture treatment mainly when the patient restricted her intake of dairy products, and when they were less than 45 years of age.

关键词： DAIRY PRODUCT RESTRICTION AND AGE INFLUENCE IN REDUCING FIBROMYALGIA pain AMONG PATIENTS TREATED WITH AURICULAR ACUPUNCTURE

Thoracic spinal cord injury and paraplegia caused by intradural cement leakage after percutaneous kyphoplasty: A case report

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World Journal of Clinical Cases 2024年第10期12卷 1837-1843页

作者： Zi Mao Zhi-Hong Xiong Jun-Feng Li Department of pain management The Affiliated Hospital of Yunnan UniversityKunming 650000Yunnan ProvinceChina Department of Medical Administration The Affiliated Hospital of Yunnan UniversityKunming 650000Yunnan ProvinceChina

BACKGROUND Percutaneous kyphoplasty(PKP)is a pivotal intervention for osteoporotic fractures,pathological vertebral compression fractures,and vertebral bone *** its efficacy,the procedure presents challenges,notably complications arising from intradural cement *** and accurate diagnosis,coupled with emergent intervention is imperative to improve patient *** case report illuminates the intricacies and potential complications associated with PKP,emphasizing the critical need for vigilant monitoring,prompt diagnosis,and immediate intervention to mitigate adverse *** SUMMARY A 58-year-old male patient,experiencing a T7 osteoporosis-related pathological compression fracture,underwent PKP at a local *** weeks postprocedure,the patient developed paraplegic and dysuric symptoms,necessitating emergency decompression *** improvement was achieved,marked by the restoration of muscle strength,sensation,and *** PKP Intradural cement leakage following PKP is unusual and potentially *** imaging examinations,urgent evaluation,and the decompression surgery are essential,which help alleviate symptoms associated with spinal damage,markedly improving the overall prognosis.

关键词： Percutaneous kyphoplasty Intradural cement leakage Complication Decompression surgery Case report

management of a large mucosal defect after duodenal endoscopic resection

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World Journal of Gastroenterology 2016年第29期22卷 6595-6609页

作者： Shintaro Fujihara Hirohito Mori Hideki Kobara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Tsutomu Masaki departments of Gastroenterology and Neurology Kagawa University Faculty of Medicine

Duodenal endoscopic resection is the most difficult type of endoscopic treatment in the gastrointestinal tract(GI) and is technically challenging because of anatomical specificities. In addition to these technical difficulties, this procedure is associated with a significantly higher rate of complication than endoscopic treatment in other parts of the GI tract. Postoperative delayed perforation and bleeding are hazardous complications, and emergency surgical intervention is sometimes required. Therefore, it is urgently necessary to establish a management protocol for preventing serious complications. For instance, the prophylactic closure of large mucosal defects after endoscopic resection may reduce the risk of hazardous complications. However, the size of mucosal defects after endoscopic submucosal dissection(ESD) is relatively large compared with the size after endoscopic mucosal resection, making it impossible to achieve complete closure using only conventional clips. The over-the-scope clip and polyglycolic acid sheets with fibrin gel make it possible to close large mucosal defects after duodenal ESD. In addition to the combination of laparoscopic surgery and endoscopic resection, endoscopic full-thickness resection holds therapeutic potential for difficult duodenal lesions and may overcome the disadvantages of endoscopic resection in the near future. This review aims to summarize the complications and closure techniques of large mucosal defects and to highlight some directions for management after duodenal endoscopic treatment.

关键词： Endoscopic mucosal resection Endoscopic submucosal dissection Duodenum Complication Bleeding Perforation Over-the-scope clip Clip Closure Endoscopic full-thickness resection

围术期艾司洛尔的安全性：随机对照试验的系统回顾与荟萃分析

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麻醉与镇痛 2013年第1期9卷 38-53页

作者： Savio K H. Yu Gordon Tait Keyvan Karkouti Duminda Wijeysundera Stuart McCluskey Scott Beattie 安博(译) 杜金(校) Department of anesthesia and pain management University Health Network University of Toronto Toronto Ontario Canada

背景尽管发现β受体阻滞剂能够减少围术期心肌梗死（myocardial infarction，MI）的发生，但是β受体阻滞剂导致的低血压与术后卒中和死亡相关。本系统回顾中我们评估了特异性β1-肾上腺素受体拮抗剂艾司洛尔在非心脏手术中的安全性和... 详细信息

背景尽管发现β受体阻滞剂能够减少围术期心肌梗死（myocardial infarction，MI）的发生，但是β受体阻滞剂导致的低血压与术后卒中和死亡相关。本系统回顾中我们评估了特异性β1-肾上腺素受体拮抗剂艾司洛尔在非心脏手术中的安全性和有效性，通过对术后低血压和心动过缓发生率的分析评估安全性，通过对心肌缺血发生率的分析评估有效性。方法我们在电子数据库中检索在非心脏手术围术期使用艾司洛尔的随机安慰剂对照试验。提取设计、人口统计学、血流动力学变化（有计划的或无计划的）、心肌缺血以及心肌梗死的数据，通过荟萃回归评估其异质性来源。结果我们的研究汇集了研究特点完全匹配的67个试验。研究质量受限于小样本并缺乏分配隐匿性的详细说明。总之，分析证明了无计划低血压的发生率增加[OR2．13；95％可信区间（confidenceinterval，CI），1．48-3．04]，并且与剂量相关（R^2=0．408）。未证实心动过缓的发生率有明显增加（OR1．18；95％CI，0．69-2．02）。剂量滴定表现为对动脉血压和心率均有影响。与安慰剂相比，在7项评估研究中艾司洛尔减少了心肌缺血的发生（OR＆17；95％CI，0.02-0．45）。我们没有评估艾司洛尔对心肌梗死和卒中的发生率的影响，因为在检索研究中这些事件极少发生。结论这篇回顾研究表明艾司洛尔能够安全有效地滴定血流动力学至设定的终点。我们还需要对高危患者的安全性数据进行研究，以建立围术期艾司洛尔的安全性和有效性模型。

关键词：随机对照试验艾司洛尔系统回顾安全性围术期荟萃分析血流动力学变化肾上腺素受体拮抗剂

The role of the brain in pain:lessons learned from neuroimaging

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The role of the brain in pain:lessons learned from neuroimag...

Improvement in Radicular Symptoms but Continued Facet Arthropathy and Axial Back pain Following Rupture of a Facet Joint Synovial Cyst

中华医学会疼痛学分会第八届年会暨CASP成立二十周年

作者： Sean Mackey pain management Division Stanford Systems Neuroscience and pain Lab（SNAPL） Stanford University

＜正＞Background:pain is a complex adaptive neural system that is made up of diverse and multiple interconnected *** elements are adaptive in that they have the capacity to change and learn from *** are some limitations for animal pain models:most tests are for threshold which may not be meaningful for clinical pain;pain models do not capture the complex pain experience that includes

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Neuroscience & Medicine 2018年第1期9卷 46-52页

作者： Bryan J. Kratz Troy Buck Daniel Cramer Department of pain management Loyola University Medical Center Maywood IL USA

Lumbar synovial cysts are benign fluid collections thought to form in a background of facet joint degeneration, allowing for fluid to leak from the joint capsule and form cysts in the synovium. Although often asymptomatic, patients with symptomatic synovial cysts will present with low back pain and possibly an associated radiculopathy. Clinicians can consider conservative management, epidural steroid injection, surgical intervention, or facet joint block with aspiration and rupture. This case describes a 59-year-old male facilities manager with intermittent low back pain for one year with worsening right-sided radicular symptoms secondary to a lumbar facet joint synovial cyst in the context of severe facet arthropathy and microinstability. The patient’s low back pain and radicular symptoms were refractory to conservative treatment. Imaging demonstrated a lumbar synovial cyst and subsequent management included transforaminal epidural steroid injection and facet joint block with cyst aspiration and rupture. The patient’s radicular pain resolved but axial lumbar pain returned after 3 weeks of relief. Follow-up imaging demonstrated decreased cyst size with fluid accumulation and joint space widening. Although the cyst was successfully decompressed with resolution of radicular pain, the underlying facet arthropathy remains contributing to persistent axial low back pain and potential for continued degenerative changes including cyst recurrence.

关键词： Facet Joint Synovial Cyst Lumbar Synovial Cyst Radicular pain Cyst Rupture Low Back pain Non-Surgical management