Acupuncture for Acute Postoperative Pain Relief in a Patient with Pregnancy-Induced Thrombocytopenia – a Case Report

2005 ◽  
Vol 23 (2) ◽  
pp. 83-85 ◽  
Author(s):  
Susmita Oomman ◽  
David Liu ◽  
Mike Cummings

A 39 year old woman, scheduled for elective caesarean section in her second pregnancy, developed thrombocytopenia. Therefore, at the time of surgery, spinal anaesthesia and non-steroidal analgesic drugs were avoided and she was given a standard general anaesthetic procedure including fentanyl 100μg and morphine 10mg. In the early postoperative period she received tramadol 100mg and a further 10mg of morphine. These drugs did not control her pain, but caused side effects - in particular nausea and retching. Acupuncture to LI4 and PC6 on the right side produced dramatic pain relief within minutes.

2017 ◽  
Vol 2 (20;2) ◽  
pp. sE33-sE52 ◽  
Author(s):  
Chi-Wai Cheung

Background: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. Objectives: To evaluate the use of oral oxycodone for acute postoperative pain management. Study Design: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. Methods: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015. The search terms used were “oral strong opioids,” “postsurgical,” “postoperative,” “post-surgical,” and “postoperative.” Treatment interventions were compared for analgesic efficacy, rescue medication use, side effects, recovery, length of hospital stay, and patient satisfaction. Results: There were 26 clinical trials included in the review. Oral oxycodone showed superior postoperative analgesic efficacy compared with placebo in patients undergoing laparoscopic cholecystectomy, abdominal or pelvic surgery, bunionectomy, breast surgery, and spine surgery. When compared with intravenous opioids, oral oxycodone provided better or comparable pain relief following knee arthroplasty, spine surgery, caesarean section, laparoscopic colorectal surgery, and cardiac surgery. One study of dental postsurgery pain reported inferior pain control with oral oxycodone versus rofecoxib. (withdrawn from the US market due to cardiac safety concerns). In many studies, the demand for rescue analgesia and total opioid consumption were reduced in the oxycodone treatment arm. Patients receiving oral oxycodone experienced fewer opioid-related side effects than those on other opioids, and had a similar occurrence of postoperative nausea and vomiting as patients on placebo. Furthermore, oral oxycodone did not prolong hospital stay and was associated with lower drug costs compared with epidural and intravenous analgesics. Oxycodone administered as part of a multimodal analgesic regimen produced superior pain relief with fewer side effects and a reduced hospital stay. Limitation: There is a limited number of randomized double blinded studies in individual surgical operations, thus making it more difficult to come up with definitive conclusions. Conclusion: Oral oxycodone appears to offer safe and effective postoperative analgesia, and is a well-accepted and reasonable alternative to standard intravenous opioid analgesics. Key words: Postoperative, pain, analgesia, oral oxycodone, opioid


2017 ◽  
Vol 16 (1) ◽  
pp. 178
Author(s):  
W.Z. Pawlak ◽  
L. Svensson ◽  
P.F. Jensen

AbstractBackgroundSymptoms from disseminated cancer can develop very slowly. This could be very difficult to distinguish those symptoms from chronic disabilities and nuisances in patients with chronic non-malignant pain.ObjectiveIn this report, the case of a woman with both nonmalignant pain and cancer is presented.Case reportA 54 years old woman was referred by a general practitioner to Multidisciplinary Pain Center. The diagnosis was chronic non-malignant neck pain on the basis of degenerative columnar disease. The patient was also suffering from osteoporosis. During the first visit in the Center, the patient complained of shooting pains in the neck and had tingling sensations in the fingers – most of his right hand. Moreover, the patient experienced shooting pains in the hips, lower back and spine. The multidisciplinary treatment with medication, physical therapy, TENS and cognitive behavioral therapy was offered. Paracetamol together with gabapentin was used. The patient experienced relief of pain. The doses of gabapentin was escalated up to 2400 mg daily without significant side effects. Afterwards, the dose was gradually increased to 3600 mg daily and the patient experienced fatigue, mild headache and dizziness. These symptoms were initially interpreted as side effects of gabapentin. However, the tingling sensations in the fingers were almost disappeared. The doses of gabapentin was reduced, but without relief of symptoms. Within 2 weeks, the patient developed partial paresis of the right upper limb and aphasia. The patient was urgently referred to the neurologic inpatient clinic. CT- and MR-scans showed multiple cerebral metastases. Under the diagnostic workup the lung tumor was found. The biopsy showed pulmonary adenocarcinoma.ConclusionsThe symptoms of lung cancer with cerebral metastases can mimic side effects of gabapentin.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1243-1243
Author(s):  
F. Gutierrez ◽  
C. Losada ◽  
M. López ◽  
C. Rozados ◽  
J.M. Olivares ◽  
...  

Pisa syndrome is known to be a condition in which there is sustained involuntary flexion of the body and head to one side and slight rotation of the trunk so the person appears to lean like the Leaning Tower of Pisa.The development of Pisa syndrome is most commonly associated with prolonged treatment with antipsychotics. Although less frequently, Pisa syndrome has been reported, in patients who are receiving other medications (such as cholinesterase inhibitors and antiemetics), in those not receiving medication (idiopathic Pisa syndrome) and also patients with neurodegenerative disorders like Alzheimer's disease and multiple system atrophy.We report a case of a 67 year- old male diagnosed with Schizophrenia for 20 years. He has been following a treatment with Clozapine 400 mg/day for 4 years. Amisulpiride was added to the established regimen of antipsychotic and increased during the last month reaching the doses of 600 mg/day. Three weeks later he was observed walking with a tilt toward the right. A first physical examination revealed sustained tonic flexion of the trunk to the right side. No deficits or mental status changes during neurological exploration were shown. We prescribed biperidene hydrochloride therapy. After 24 hour side effects disappeared.As far as we know, no many cases of amisulpride-induced Pisa syndrome in the literature have been reported. This abstract presents a case of amisulpride induced Pisa syndrome.


1974 ◽  
Vol 2 (2) ◽  
pp. 149-152 ◽  
Author(s):  
B Kay

A double-blind between-patient study involving 225 adult patients was carried out to compare the efficacy of oral aspirin ( 650 mg), dextropropoxyphene (65 mg) and pentazocine ( 50 mg) in post-operative pain. All the patients were initially in moderate or severe pain and all three drugs produced some degree of pain relief. The onset of action of pentazocine was significantly more rapid than that of aspirin or dextropropoxyphene. The analgesia provided by dextropropoxyphene was significantly inferior to that achieved with aspirin or pentazocine and the duration of action, assessed by patient demand for further analgesic drugs, was also significantly shorter than that of the other two drugs. The incidence and severity of side-effects was greatest in the dextropropoxyphene group and it is concluded from these results that pentazocine should be the oral analgesic of choice in the treatment of post-operative pain.


Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 513-519 ◽  
Author(s):  
Piergiorgio Fedeli ◽  
Sergio Giorgetti ◽  
Nunzia Cannovo

AbstractIntroductionIn Italy, both parents have parental responsibility, so they have the power to give or withhold consent to medical procedures on their children.MethodsThe present work reports the case of a 5-year-old boy diagnosed with neuroblastoma in the right adrenal loggia, who underwent several chemotherapy treatments that prolonged his life until the age of 10. Informed consent for treatments was requested exclusively of the parents, without taking into consideration the minor’s will, not even when he asked for increased pain relief medication instead of other palliative treatments.ResultsThe authors thought it interesting to examine the case in the light of new Italian legislation on informed consent and to verify whether it promotes greater participation of minors in healthcare choices, given that the issue of acquisition of informed consent is becoming increasingly broad and complex.ConclusionThe case examined here indicates that current Italian legislation, even including the modifications introduced, does not allow for concrete and active participation of minors, especially those under the age of 12, in the discussion of choices about their health, not even in choices regarding the end of life, and not even when the minor manifests a mature capacity for discernment.


2015 ◽  
Vol 41 (01) ◽  
pp. 39-43
Author(s):  
Shang-Lin Wang ◽  
Jih-Jong Lee ◽  
Albert Taiching Liao

An eight-year-old neutered male Cocker Spaniel with multiple subcutaneous masses on the right flank was presented to National Taiwan University Veterinary Hospital. The masses were excised and submitted for histopathologic evaluation and bacterial culture. A diagnosis of severe panniculitis was made and no microorganism was identified with bacterial culture. The patient did not respond well and showed significant side effects from prednisolone therapy. Later, low-dose cyclosporine was used instead and the lesions resolved. Complete remission was observed when ketoconazole was added in order to increase the blood concentration of cyclosporine in the patient. There were no adverse side effects noted during this combination therapy. The patient has remained free of the disease at the time this report was written. In conclusion, low-dose cyclosporine combined with ketoconazole therapy is safe and effective for treating sterile nodular panniculitis, when glucocorticoid does not provide an adequate clinical result.


2010 ◽  
Vol 20 (3) ◽  
pp. 183-192 ◽  
Author(s):  
Gary McCleane

SummaryAt times providing pain relief in elderly patients can prove troublesome. Their tolerance and perception of pain can differ from that of younger patients, while the incidence of pain is above that found in those of less advanced years.Conventional approaches to providing pain relief can be successful, but the tolerance to the side-effects of those drugs used to provide pain relief can be less. Furthermore, polypharmacy can have implications for the range of analgesic drugs that can be considered. Fortunately there are an increasing range of medicinal products with reduced potential for side-effects that can be considered when treating older patients with pain.


VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.


2019 ◽  
Author(s):  
BA Högerle ◽  
EL Bulut ◽  
L Klotz ◽  
F Eichhorn ◽  
M Eichhorn ◽  
...  

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