pain-relief-11.matches: pain relief
[Radiotherapy of vertebral hemangiomas]

[Article in Polish]

Miszczyk L, Spindel J, Trela K, Ficek K.

Zaklad Radioterapii, Centrum Onkologii-Instytut im. M. Sklodowskiej-Curie, Oddzial w Gliwicach.

The paper presents the analysis of results of treatment with radiotherapy of 14 cases of vertebral hemangiomas. All patients were irradiated in accordance with conventional schedule fractionated doses, using 2 Gy per fraction. The total radiation dose amounted to 20 Gy (1 case), 24 Gy (4 cases) and 30 Gy (9 cases). The degree of pain relief and lesion reossification was assessed 1 months and 6 months after completion of radiotherapy. Complete pain relief 1 month post radiotherapy was noted in 5 cases (on average patients claimed that radiotherapy resulted in a 70% decrease of pain syndromes). Six months post radiotherapy complete pain relief was noted in 8 cases (on average patients reported a 90% decrease in pain). Signs of reossification were observed in cases 6 months after treatment. No correlation was noted neither between the degree of pain relief and reossification, nor between the total delivered dose and the degree of pain relief. The obtained results allow to conclude that conventionally fractionated radiotherapy (using 20-24 Gy as total dose) is a good method of analgetic treatment of vertebral hemangiomas probably based on the anti-inflammatory effect of radiation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11144077&dopt=Abstract pain, pain medicine, pain relief



pain-relief-27.matches: pain relief
Pain control in children following tonsillectomies: a retrospective study.

Rauen KK, Holman JB.

Children in this documentation study were found to receive adequate analgesia that led to adequate pain control most of the time. Fewer analgesic doses were given during the night shift compared to the day and afternoon shifts. Nonanalgesic methods of pain control were consistently used for the children studied. Nurses measure pain relief in children based on verbal and behavioral indicators. The findings of this study will be presented to staff at a future unit practice council meeting. Recommendations will include: (1) administer analgesics at regular intervals throughout the hospital stay, (2) continue to consistently provide nonanalgesic methods of pain control, and (3) conduct a follow-up study using the same tool and guidelines. The results of both studies will be compared. Others who provide nursing care to children following tonsillectomies are encouraged to study the effectiveness of pain relief measures for children in their respective institutions. Pain relief is a measure of quality care.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2768426&dopt=Abstract pain, pain medicine, pain relief



pain-relief-27.matches: pain relief
Experience with oral morphine for cancer pain relief.

Vijayaram S, Bhargava K, Ramamani, Chandrasekhar, Sudharshan, Heranjal R, Lobo B.

The authors report a prospective survey of 88 patients with cancer pain who were treated with oral morphine solution during a period of 140 days at the Pain Relief Unit, Kidwai Memorial Institute of Oncology, Bangalore. A high percentage of pain relief was achieved at the end of the first week of titrated therapy; relief was maintained at satisfactory levels throughout the study period in a majority of patients (86%). Interruption of oral morphine administration was necessitated by intractable vomiting in two patients. The majority of patients (65%) did not manifest any side effects, and appropriate medication successfully managed those who did. Oral morphine therapy for cancer pain offers effective pain relief with minimal side effects in the majority of patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2778361&dopt=Abstract pain, pain medicine, pain relief



pain-relief-11.matches: pain relief
Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia.

Maesawa S, Salame C, Flickinger JC, Pirris S, Kondziolka D, Lunsford LD.

Department of Neurological Surgery, University of Pittsburgh, Pennsylvania, USA.

OBJECT: Stereotactic radiosurgery is an increasingly used and the least invasive surgical option for patients with trigeminal neuralgia. In this study, the authors investigate the clinical outcomes in patients treated with this procedure. METHODS: Independently acquired data from 220 patients with idiopathic trigeminal neuralgia who underwent gamma knife radiosurgery were reviewed. The median age was 70 years (range 26-92 years). Most patients had typical features of trigeminal neuralgia, although 16 (7.3%) described additional atypical features. One hundred thirty-five patients (61.4%) had previously undergone surgery and 80 (36.4%) had some degree of sensory disturbance related to the earlier surgery. Patients were followed for a maximum of 6.5 years (median 2 years). Complete or partial relief was achieved in 85.6% of patients at 1 year. Complete pain relief was achieved in 64.9% of patients at 6 months, 70.3% at 1 year, and 75.4% at 33 months. Patients with an atypical pain component had a lower rate of pain relief (p = 0.025). Because of recurrences, only 55.8% of patients had complete or partial pain relief at 5 years. The absence of preoperative sensory disturbance (p = 0.02) or previous surgery (p = 0.01) correlated with an increased proportion of patients who experienced complete or partial pain relief over time. Thirty patients (13.6%) reported pain recurrence 2 to 58 months after initial relief (median 15.4 months). Only 17 patients (10.2% at 2 years) developed new or increased subjective facial paresthesia or numbness, including one who developed deafferentation pain. CONCLUSIONS: Radiosurgery for idiopathic trigeminal neuralgia was safe and effective, and it provided benefit to a patient population with a high frequency of prior surgical intervention.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11147887&dopt=Abstract pain, pain medicine, pain relief



pain-relief-27.matches: pain relief
Is outcome for low risk obstetric patients influenced by parity and intervention?

Tilyard MW, Williams S, Seddon RJ, Oakley ME, Murdoch JC.

Department of General Practice, University of Otago Medical School, Dunedin.

Maternal and perinatal morbidity were examined to assess the influence of parity and intervention procedures among 1032 women considered low risk at commencement of labour. A diagnosis of fetal distress, failure to progress during labour, maternal problems after delivery and consultation with or transfer of the neonate to a paediatrician occurred more frequently amongst nulliparous women (p less than 0.001). Failure to progress in labour was found to be influenced by parity (primigravida), maternal age (less than 20 years) and also by the use of epidural anaesthetic for pain relief (p less than 0.001). Prevalence of abnormal delivery was found to be influenced by parity (primigravida), failure to progress in labour and diagnosis of fetal distress. The use of epidural anaesthesia for pain relief was also found to increase the rate of abnormal delivery (p less than 0.001). Statistically significant differences occurred between the groups of patients, with patients of private specialists having the highest rates for induction (34%), use of epidural for pain relief (40%) and abnormal delivery (46%).

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2797585&dopt=Abstract pain, pain medicine, pain relief



pain-relief-28.matches: pain relief
Low dose single fraction radiotherapy in the treatment of metastatic bone pain: a pilot study.

Price P, Hoskin PJ, Easton D, Austin D, Palmer S, Yarnold JR.

Academic Radiotherapy Unit, Royal Marsden Hospital, Sutton, Surrey, UK.

Single fraction radiotherapy can be used effectively to palliate painful bone metastases. The optimal single dose of radiotherapy required for pain relief is unknown. Twenty-six patients have been treated with a single fraction of 4 Gy to the site of the bone pain. Partial pain relief was seen in 9/21 (5%). Response occurred within 3 weeks of radiotherapy. These results question the mechanism of pain relief following radiotherapy and suggest a method of pain control using single repeatable low dose treatments.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2460900&dopt=Abstract pain, pain medicine, pain relief



pain-relief-28.matches: pain relief
The responsiveness of bone metastases to radiotherapy: the effect of site, histology and radiation dose on pain relief.

Arcangeli G, Micheli A, Arcangeli G, Giannarelli D, La Pasta O, Tollis A, Vitullo A, Ghera S, Benassi M.

Istituto Medico e di Ricerca Scientifica, Rome, Italy.

281 patients with a total of 463 symptomatic osseous metastases treated for palliation between 1975 and 1985 have been retrospectively analysed. The most frequent primary sites were breast (50.1%) prostate (16.6%) and lung (11%), accounting for more than three fourths of all metastatic areas. Other primaries were represented by bladder, kidney, colorectal, uterus (corpus and cervix) melanoma and thyroid tumors, and by cancer from unknown origin. Palliation was evaluated only on a subjective pain score. Complete response meant complete pain relief, and partial response meant more than 50% and less than complete pain relief in all treated sites. Complete response rates were similar independently from the primary site, except for the adenocarcinomas of the kidney and for non-small cell carcinomas of the lung in which the response tended to be lower. A correlation was also found between the incidence of pain relief and the site of bone metastases, in that a lower response was shown in limb localizations. Also, the number of metastatic sites did not influence the complete response rate. As expected, the response rate in all cases seemed to be dependent on total absorbed dose while, surprisingly, it could not be shown to be affected by the fraction size. A similar trend was shown for the pain recurrence.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2469105&dopt=Abstract pain, pain medicine, pain relief