ketamine is a promising alternative agent for pain control that offers benefit to traditional strategies, particularly in the setting of rib fracture. current pharmacologic therapies have clear adverse effects, and other options may be invasive, cost prohibitive, or marginally effective. we describe three consecutive patients with traumatic injuries including rib fracture for which a ketamine i...

Complex regional pain syndrome (CRPS) remains a challenging condition to diagnose and treat. There are few large-scale, randomized trials of pharmacologic agents, and most published studies are small, uncontrolled, or presented only in abstract form at meetings. The most commonly used agents, such as anticonvulsants, antidepressants, and opiates, have been found to be useful for other neuropath...

The intent of this article is to provide oncology nurses with practical information on the pharmacologic management of pain. The use of chemotherapy, radiation therapy, and surgery in pain management will not be addressed in this article. It is the second in a three-part series on cancer pain management. The first in the series (September 2006) addressed cancer pain assessment. In a future issu...

The generally accepted current definition of breakthrough cancer pain (BTCP) is as follows: “a transient exacerbation of pain that occurs either spontaneously, or in relation to a specific and predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain.”1 Spontaneous pain is also referred to as idiopathic pain. Triggers are also referred to as incid...

INTRODUCTION Diabetic peripheral neuropathic pain (DPNP) is a debilitating and distressing complication that occurs in patients with diabetes mellitus. This article provides an overview of diabetic peripheral neuropathy focusing on DPNP. AREAS COVERED This article reviews the diagnosis, pathogenesis, prevention and treatment of diabetic neuropathy and neuropathic pain. A comprehensive and sys...

MYOFASCIAL pain is a significant source of discomfort in individuals with regional pain symptomatology. The prevalence of myofascial pain ranges from around 20% in patients with chronic low back pain (LBP) to 30% in patients with regional pain complaints seen in primary care clinics to upward of 85% in patients presenting to specialized pain management centers. To understand the origin of myofa...

The management of cancer pain requires familiarity with a range of therapeutic strategies, including antineoplastic therapies, analgesic pharmacotherapy, and anesthetic, neurosurgical, psychological, and rehabilitation techniques. Successful pain management is characterized by implementation of the techniques with the most favorable therapeutic index for the prevailing circumstances, along with...

Few randomized controlled trials of oral pharmacotherapy have been performed in patients with complex regional pain syndrome (CRPS). The prevalence of CRPS is uncertain. Severe and advanced cases of CRPS are easily recognized but difficult to treat and constitute a minority compared with those who meet minimum criteria for the diagnosis. Unsettled disability or liability claims limit pharmaceut...