Pain relief could be easy with a simple injection

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Pain relief could be easy with a simple injection 19 Nov 2004

http://www.medicalnewstoday.com/medicalnews.php?newsid=16555

A recent study, published in the journal Pain Practice, identified

situations in which injections of local anesthetic would be the best

treatment for pain and reduce unnecessary risk and procedural costs.

While the use of sympathetic blocks (injections) is controversial, in

this study, 20 patients suffering from complex regional pain syndrome

(CRPS) were given injections to examine the method's contribution " as

prospective predictors of outcome. "

The patients, who exhibited allodynia, or pain with light touch, were

given an initial " diagnostic " injection after which results were

analyzed to determine if further treatments would be advantageous. This

treatment consists of injections into the sympathetic nerves that run

along the front side of the spinal column.

Those who showed at least a 50% improvement were treated with subsequent

blocks. Patients who did show initial improvement were considered to

have " sympathetically maintained pain " (SMP) and were also more likely

to experience greater long-term improvement as well. Cases in which

patients did not have significant improvement were considered to have

" sympathetically independent pain " (SIP) and no further treatment was

given.

Previous studies by Cepeda et al (1) showed that less than one-third of

CRPS patients are likely to respond to this type of procedure.

" Reserving these invasive procedures for patients who will receive the

greatest benefit could have significant value by reducing unnecessary

risk for adverse events, as well as significant economic benefit by

limiting the costs associated with unnecessary procedures, " states lead

researcher, Dr. Craig T. Hartrick.

Although this study was not randomized and was not placebo-controlled,

it " speaks to the rational use of sympathetic block " and suggests that

this procedure is especially useful when allodynia is present.

This study is published in Pain Practice.

About the Author

Craig T. Hartrick, M.D., D.A.B.P.M., F.I.P.P., directs the clinical and

basic science laboratory research for the Department of Anesthesiology

at the Beaumont Hospital Research Institute. Hartrick has

published over 80 articles, abstracts, chapters, reviews and editorials

and serves on the editorial boards for Pain Practice and MD Consult Pain

Medicine. His current research involved cytokine mediated nitric oxide

release in CRPS and outcomes following interventional pain management

techniques.

About Pain Practice

Pain Practice, the official journal of World Institute of Pain,

publishes international multidisciplinary articles on pain that provide

its readership with up-to-date knowledge of the research, evaluation

methods, and techniques of pain management. The present literature on

pain medicine is diverse and published in a variety of basic and

clinical specialty journals. For a practitioner to subscribe to all the

venues needed to cover the field of pain medicine would be impractical,

if not impossible. Likewise, the literature search can be cumbersome,

costly, and entirely unavailable in some areas. As a thorough,

multidisciplinary journal, Pain Practice is a convenient, cost-effective

way to resolve these dilemmas. Published on behalf of the World

Institute of Pain. For more information on membership, please visit

http://www.wipain.org.