Difficult pain

A difficult balance--pain management, drug safety, and the FDA.

n engl j med 361;22 nejm.org november 26, 2009 2105 conditions, pain is most common­ ly treated with analgesics. Over the past decade, there have been growing concerns about the harm — abuse and addiction, as well as serious injury and death — caused by the use of prescription and over­the­counter analgesics. These concerns have emerged in parallel with the evolving under­ standing of the impor...

A difficult combination: chronic physical illness, depression, and pain.

Boerhaave's syndrome - a difficult differential diagnosis of chest pain.

Boerhaave's syndrome is a very rare disease characterised by a spontaneous rupture of the oesophagus. It is often misdiagnosed and there is no consensus as to the best treatment. We describe a case of a 61 year-old man without significant previous medical history presenting in the emergency room with acute chest and back pain. Despite objective and laboratory tests negative for chest pain scree...

Cannabinoids in the management of difficult to treat pain

This article reviews recent research on cannabinoid analgesia via the endocannabinoid system and non-receptor mechanisms, as well as randomized clinical trials employing cannabinoids in pain treatment. Tetrahydrocannabinol (THC, Marinol((R))) and nabilone (Cesamet((R))) are currently approved in the United States and other countries, but not for pain indications. Other synthetic cannabinoids, s...

Management of the difficult Airway

The appropriate airway management is the important point during the anesthesia. For it dose, ‎taking history, physical examination (head and neck, mandible, mouth opening, neck ‎movements …) must be done completely and they are helpful in estimating difficult ‎intubation.‎ It is necessary to note that one case from every ‎‏5000‏‎ cases of anesthesia, not o...