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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The nervus intermedius (NI) appears to be the main conduit for the associated symptoms of cluster headache (CH) and perhaps for the pain as well. Subtle injury of the facial nerve and NI might initiate mechanisms responsible for CH. Five patients with chronic CH unresponsive to medication underwent surgical decompression of the root exit-entry zone of the facial nerve, and in two patients the trigeminal nerve root was also decompressed. In two patients, the pain syndrome was markedly relieved for as long as two years. In one patient, initial improvement was obscured by narcotic addiction. In two patients, the operation was a failure. The NI was identified as a separate bundle in only one of five patients and decompressions may not have affected that component of the facial nerve.
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PMID:Surgical decompression of the facial nerve in the treatment of chronic cluster headache. 396 15

The authors have attempted to make clear that recovery is a lifelong process. In its early phases, clients are working primarily to achieve relief from guilt and pain created by their addiction. As recovery progresses, however, there is a movement from a relief mentality to a true experience of delight (Enright 1980). The goals of treatment have been achieved when this shift is evident: when one is living comfortably, responsibly and joyfully without cocaine or other drugs. The authors' experience indicates that treating cocaine addicts in cocaine-specific groups is useful in that the homogeneity facilitates group identification and the educational component of treatment. However, the content of the groups and nature of the recovery process are not drug specific or unique. The emergence of C.A., which is based on the same 12 steps as A.A., also illustrates this. What is being treated is addictive disease, not alcoholism or cocaine addiction. Regardless of the chemical, the essentials of treatment are the same: The language of recovery is universal.
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PMID:Cocaine recovery support groups and the language of recovery. 398 1

This new program of pain medication provides more even pain relief, avoiding the peaks and valleys of the traditional injections. Patients remain lucid, slightly euphoric, and pain free--even from deep pain. The family is capable of coping and treating the patient in their home, without having to contend with anger, hostility, and frustration. The patients are cooperative, not as demanding, and for the most part, are able to verbalize freely about their impending death to family members and friends in such a manner that when death does occur, it is peaceful . We have not encountered any addiction/habituation problems. We have not experienced any failures as long as the patient could take the oral medication. With continuous examination and evaluation, we have avoided any adverse drug reactions by tailoring the cocktail to the patient's needs and responses on a continuous basis. When changing from injections or other medications to the cocktail program, or when changing from one cocktail to another, the patient is assured that the old medication is available on demand. Should a patient become anxious or fearful that his cocktail will not always work, he is assured that there are others that will. A pain-free patient relieves the anxiety of the family, an important and welcome fact to be considered. By monitoring such factors as dosage, volume, taste, texture, and color, as well as offering other flavoring (cinnamon, lemon, cherry), we have not experienced any patient refusal. Once on the program, their self-respect is regained and their personal pride and sense of well-being are reestablished.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A new series of oral medications for chronic (cancer) pain relief. 614 39

As the consultation-liaison psychiatrist for a large burn service, the author investigated the undermedication for pain. This phenomenon could not be adequately explained by the staff's insensitivity, by mistaken ideas about analgesics, or by fears of iatrogenic addiction. For both patients and staff, the pain served to maintain self-object differentiation and to provide reassurance that the patient was alive. Developmental observations and psychoanalytic theory support this unconscious need for pain.
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PMID:Undermedication for pain on a burn unit. 614 70

The use of narcotic analgesics have been avoided by clinicians in patients with chronic pain syndromes. Uncertainty as to the etiological cause of chronic pain, development of addiction and habituation and associated psychological and behavioral symptoms found in chronic pain states which are not amenable to narcotic medications are the major reasons narcotics are not prescribed. This communication describes the long-term use of low dose narcotic analgesics as a treatment component of a comprehensive pain management program and addresses the questions of whether or not narcotic efficacy is maintained in long-term use, improvement of patients' function is continued and side effects develop as a result of this treatment.
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PMID:Long-term use of narcotic analgesics in chronic pain. 615 61

The cases of a 43 years old-man with gout and a 24 years-old woman with severe back pain who developed dextro-propoxyphene addiction during pain treatment are reported. They had severe edema and fibrosis of skin, subcutaneous tissue and muscle involving the upper and lower limbs. ESR was elevated, CPK and LDH were normal. EMG in proximal muscles showed decreased duration and voltage of potentials, excess of short polyphasics and increased recruitment (BSAP), with positive waves and fibrillations; distal muscles had fasciculations, fibrillations, positive waves, normal voluntary potentials, decreased recruitment. Lymphography indicate delayed progression of contrast media and obstruction in the thighs. Muscle biopsy on fresh-frozen section and histochemistry showed extensive connective tissue proliferation with intense acid and alkaline phosphatase activity in the perimysial and endomysial area, infiltration of lymphocytes near and around small vessels and capillaries. There were perifascicular and type II fiber atrophy. After discharge the patients returned to propoxyphene addiction and the symptoms who subsided during drug withdrawal come back again. New admission, new drug withdrawal and they were discharged free of symptoms and pathologic changes.
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PMID:[Myopathy caused by propoxyphene: report of 2 cases with muscle histochemistry]. 616 47

One hundred and eighty patients (American Society of Anesthesiologists rating 1-2) received one of three oral analgesics--ciramadol (Wy. 15705) 20 mg, ciramadol 60 mg or codeine 60 mg--on a double-blind random basis for the relief of pain 24-48 hours after major general surgical, gynaecological or orthopaedic operations. All three analgesics proved equally effective and caused mild sedation only. No patient showed signs of clinical cardiorespiratory depression, and other side-effects were infrequent. Ciramadol may therefore prove a useful clinical alternative to conventional oral analgesics provided its lack of respiratory depressant properties and addiction potential in monkeys can be substantiated in humans.
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PMID:Ciramadol--a new synthetic analgesic. A double-blind comparison with oral codeine for postoperative pain relief. 635 86

Since buprenorphine has been reported to be effectively analgesic yet free of addiction potential, two single-dose, double-blind, parallel studies were conducted to compare its analgesic activity and safety with those of morphine. The patients in each study consisted of patients experiencing moderate to severe postoperative pain. They were treated with an intramuscular injection of either 0.2 or 0.4 milligram of buprenorphine (Study I) or 0.15 or 0.30 milligram of buprenorphine (Study II) compared with 5.0 or 10.0 milligrams of morphine in both instances. Patients were interviewed prior to drug treatment and at 10, 20 and 30 minutes, and one, two, three, four, five and six hours postdose to determine pain intensity and relief. The degree of sedation, vital signs and side effects were evaluated. Buprenorphine generally appeared comparable to morphine in the onset and duration of action and in side effect liability.
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PMID:Comparison of analgesic activity of buprenorphine hydrochloride and morphine in patients with moderate to severe pain postoperatively. 647 20

Chronic pain is distinguished from persistent pain and it is proposed that chronic pain involves addiction to the endogenous opioid system. Even when the organic lesions responsible for pain are removed, chronic pain can be maintained as an internal state preventing the withdrawal or abstinence syndrome associated with endorphins and enkephalins.
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PMID:Chronic pain: an addiction. 649 94

Electrical stimulation of the brainstem abolishes pain, while continued stimulation induces tolerance to the analgesic effect. Analgesic drugs producing tolerance also induce physical dependence, suggesting that the phenomenon of tolerance is associated with addiction. There is evidence that the neural mechanism for stimulation-produced analgesia is related to the release of opiate substances within the brain. We therefore propose that repeated or protracted brain stimulation elicits dependence upon the endorphins released by electrical stimulation of the neurons themselves. To investigate this possibility, rats were given repetitive bursts of analgesic electrical brain stimulation for two hours. Immediately thereafter, they were injected with the opiate antagonist, naloxone. Behaviors associated with low grade opiate withdrawal were observed. These data suggest that prolonged analgesic stimulation can result in naloxone-precipitated behaviors similar to the behaviors exhibited during opiate withdrawal.
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PMID:Opiate withdrawal behavior after focal brain stimulation. 654 76


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