Journal of Japan Society of Pain Clinicians
Online ISSN : 1884-1791
Print ISSN : 1340-4903
ISSN-L : 1340-4903
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Volume 20, Issue 2
Displaying 1-13 of 13 articles from this issue
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  • Analgesic effects of calcitonin on women patients with osteoporosis suffering proximal femur fracture
    Shinji KOBAYASHI, Nagisa KOBAYASHI
    2013 Volume 20 Issue 2 Pages 79-82
    Published: 2013
    Released on J-STAGE: July 06, 2013
    Advance online publication: May 24, 2013
    DOIhttps://doi.org/10.11321/jjspc.12-0013
    JOURNAL FREE ACCESS
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    This study has been performed to determine whether calcitonin is effective for pain relief and early ambulation in women patients with osteoporosis who underwent surgery for fractures of the proximal femur.
    Thirty-one patients were included in this study. Twenty-one received a 20 IU intramuscular injection of calcitonin once a week (calcitonin group), and 11 received no calcitonin (noncalcitonin group). We assessed the pain at rest and at rehabilitation every week using the face visual analogue scale (f-VAS) and the periods of ambulation with the therapists' aides in each group. As a result, in the calcitonin group f-VAS was lower at the first and second week's points(p<0.05), and the periods of ambulation with the therapists' aides revealed a mean (and standard) deviation of 17.8±8.4 days, compared with 26.4±15.9 days (p<0.05) in the noncalcitonin group. A calcitonin injection once a week is thus considered sufficient to provide pain control and to improve a patient's ambulation.
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  • Effectiveness and side effects of pregabalin for neuropathic pain in patients with and without a history of antiepileptic therapy
    Miharu SHIRAISHI, Satoshi NISHIIKE, Masao OGAWA, Hideaki TSUCHIDA
    2013 Volume 20 Issue 2 Pages 83-86
    Published: 2013
    Released on J-STAGE: July 06, 2013
    Advance online publication: May 24, 2013
    DOIhttps://doi.org/10.11321/jjspc.12-0026
    JOURNAL FREE ACCESS
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    OBJECTIVES: To compare the effectiveness and side effects of pregabalin in patients naïve to antiepileptic drugs (naïve group) and those who had changed to pregabalin (change group).
    METHODS: The clinical records of 69 patients were retrospectively examined.
    RESULTS: There were 36 patients in the change group and 33 in the naïve group. Pain significantly improved in the naïve group compared with the change group (p=0.027). Among 62 patients who underwent blood examinations (n=31 in each group), liver enzymes were elevated in 22 (p=0.596) and serum creatinine in 3 (p=0.554). Twenty patients experienced subjective symptoms, such as fatigue, drowsiness, and exhaustion (p=0.068), and 3 (all in the change group) stopped taking pregabalin.
    CONCLUSIONS: Pregabalin was more effective in naïve patients than in patients in the change group. However, no differences in the occurrence of side effects were found between the two groups; thus regular liver and renal function examinations are strongly advocated.
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  • VAS score for pain and sleep at the initial visit
    Atsuko HIRANO, Masako ISEKI, Yoshihito MORITA, Masataka IFUKU, Shuuji ...
    2013 Volume 20 Issue 2 Pages 87-92
    Published: 2013
    Released on J-STAGE: July 06, 2013
    Advance online publication: May 24, 2013
    DOIhttps://doi.org/10.11321/jjspc.12-0005
    JOURNAL FREE ACCESS
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    【Objective】We have used questionnaires and pain VAS scores at our pain clinic to evaluate the quality and degree of sleep disturbance related to pain. We tried to find a relationship between the characteristics of pain-related sleep disturbance and the original disorders. 【Methods】We analyzed the relationship among the demographics of patients, the original disease, and the extent and duration of pain and sleep disturbance.【Results】The mean of pain VAS score was 70.1 mm, whereas of sleep disorder it was 47.6 mm. A relationship between the pain VAS scores and the sleep disorder VAS scores was found in patients with cervical spinal disease and herpetic neuralgia.【Conclusions】The relationship between the severity of pain and the degree of sleep disturbance was different in various original diseases. The sleep disturbance should be carefully sought. It is prudent to stop the vicious cycle created by pain and sleep disturbance to improve the quality of life.
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  • Criterion for determining the prognosis of reduction in the mechanical touch threshold caused by trigeminal peripheral nerve injury
    Shigenobu KURATA, Yutaka TANAKA, Makoto TERUMITSU, Tatsuru TSURUMAKI, ...
    2013 Volume 20 Issue 2 Pages 93-97
    Published: 2013
    Released on J-STAGE: July 06, 2013
    Advance online publication: May 24, 2013
    DOIhttps://doi.org/10.11321/jjspc.12-0002
    JOURNAL FREE ACCESS
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    We have reported that natural recovery was difficult in patients whose mechanical touch threshold (MTT) increased to greater than 0.84 g after orthognathic surgery. This study was performed retrospectively to investigate the MTT (measured in the mental area) for determining a difficult natural recovery after oral and maxillofacial surgery. A total of 69 patients were included in this study. The first evaluation was performed from 1 to 2 weeks after the nerve injury. The second evaluation was performed from 3 to 8 weeks after the nerve injury. The diagnostic accuracies, including sensitivity, specificity, positive predictive value, and negative predictive value, were estimated. Diagnostic efficiency for determining a difficult natural recovery was also calculated and reached its highest value at 3.0 g in the first evaluation. Therefore an MTT value greater than 3.0 g in the first evaluation is a good criterion for diagnosing difficulty in a natural recovery.
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  • A case report of thermocoagulation therapy for a PHN patient during anticoagulotherapy
    Eri IKEDA, Yoshie OHTANI, Megumi OHATA, Akio MASUDA, Koshi MAKITA
    2013 Volume 20 Issue 2 Pages 98-101
    Published: 2013
    Released on J-STAGE: July 06, 2013
    Advance online publication: May 24, 2013
    DOIhttps://doi.org/10.11321/jjspc.12-0032
    JOURNAL FREE ACCESS
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    We report a patient during anticoagulotherapy for pulmonary thromboenbolism whose PHN (postherpetic neuralgia) pain was treated by thermocoagulation therapy.
    Before the patient had suffered from pulmonary embolism, her PNH pain was effectively treated by epidural analgesia and root block.
    To avoid the risk of complication of bleeding in the epidural space, we planned the permanent nerve root block by thermocoagulation therapy instead of by epidulal analgesia.
    We stopped warfarin for 3 days and heparin for 6 hours before the procedure, We then performed the root thermocoagulation at the level of the thoracic nerves of 11 and 12.
    Heparin was restarted 3 hours after the nerve block. The patient had no complications, and the pain was controlled successfully. A nerve block can be instrumental in pain relief during anticoagulotherapy.
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  • Endocrine dysfunction in a patient with chronic nonmalignant pain receiving long-term opioid therapy
    Hironobu UEMATSU, Tetsuyuki YASUDA, Yukiko TABUCHI, Takashi MASHIMO, I ...
    2013 Volume 20 Issue 2 Pages 102-106
    Published: 2013
    Released on J-STAGE: July 06, 2013
    Advance online publication: May 24, 2013
    DOIhttps://doi.org/10.11321/jjspc.12-0040
    JOURNAL FREE ACCESS
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    We report a case of endocrine dysfunction caused by the long-term use of opioids for chronic nonmalignant pain treatment. A 51-year-old man was diagnosed with Complex Regional Pain Syndrome (CRPS) of his lower extremity. He underwent neural blockade, rehabilitation, spinal cord stimulation, and medications, all of which provided adequate pain relief. Opioid therapy was initiated with morphine and was continued for 4 years until the patient was converted to continuous transdermal fentanyl. Shortly after the change, the patient began to experience a rapid decrease in body weight, a loss of appetite, and serious fatigue, and all continued for six months. Serum-hormone tests and hormone-loading tests were performed. The patient was diagnosed as having adrenal insufficiency and hypogonadism induced by opioid therapy. Because opioid therapy could not be stopped as a result of the ongoing pain,,hydrocortisone replacement therapy was started. Fatigue and loss of appetite disappeared immediately, and the body weight slowly recovered over a period of nine months
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  • A case of varicella zoster encephalomeningitis accompanied by herpes zoster on thoracic nerve lesion
    Kunihito KAYAMA, Toshihiko NAKATANI, Tatsuya HASHIMOTO, Yoji SAITO
    2013 Volume 20 Issue 2 Pages 107-110
    Published: 2013
    Released on J-STAGE: July 06, 2013
    Advance online publication: May 24, 2013
    DOIhttps://doi.org/10.11321/jjspc.12-0041
    JOURNAL FREE ACCESS
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    A man in his '70s was suffering from herpes zoster on the left 7, 8, and 9 thoracic spinal nerve lesions. At first, he was treated in the Department of Dermatology with antivirus medication. Treatment in dermatology was finished, and dermatologists consulted our Department of Pain Management. On the day of consulting, he had poor dietary intake, lethargy, fever, difficulty in speaking, and his consciousness level gradually worsened. Nuchal rigidity and Kernig's sign were recognized. Abnormalities were not accepted in a head image inspection, and an inspection of the cerebrospinal liquid revealed a diagnosis of herpes zoster encephalomeningitis. After drip infusion of antivirus and steroid medication, he recovered without any sequela.
    We should consider encephalomeningitis accompanied with herpes zoster other than cranial nerves when a patient develops a disorder in the central nervous system accompanied by fever.
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