Intra-articular bupivacaine plus opioid for chronic joint pain

Traditionally opioids are considered to exert their analgesic effects within the central nervous system. There are receptors in joints also, which are sensitive to minimal doses of opioids. We have injected combined of local anaesthetic and minimal doses of Pethedine/Nubain [Nalbuphine] to see result in chronic osteoartritic knee pain and other small joints pain. The results were compared with Transcutaneous Electrical Nerve Stimulation [TENS], Non Steroidal Anti-inflammatory Drugs [NSADIAs] and Intra-Articular Steroids. We have observed that twice-a-week injection of 10 mg Pethedine or 5mg Nubain plus 10 ml of 0.25% Bupivacaine in a 70kg patient had much longer analgesic effect

Post herpetic neuralgia: use of streptomycin preliminary report

Many treatment modalities have been tried for post-herpetic neuralgia without proving to be specific or reliable. Aminoglycosides, due to their different effects on cellular functions, have been successfully tried in trigeminal neuralgia and various neuropathic pains. At the Pain Centre, Combined Military Hospital, Karachi, intercostal block with 1g streptomycin in 2ml of 2% lignocaine was used on alternate days in 16 patients of post-herpetic neuralgia with favourable results. Of the 16 patients, 9 found the treatment helped to reduce the severity of pain, while in 7 complete pain relief was achieved. These initial results are encouraging and worthy of further investigation