ABSTRACT
Injury to central or peripheral nervous system causes neuropathic pain. Initially it affects the sensory nerves, then the motor nerves. In crush or traumatic injuries the sensory or motor nerves are affected simultaneously and the symptoms develop simultaneously. Spontaneous pain, abnormal evoked pains and paroxysmal evoked pain are the pesenting symptoms. Types of neuropathies are: Peripheral nerve lesion, spinal or ganglionic lesion and spinal cord lesion. Diabetic neuropathy, postherpetic neuralgia and painful polyneuropathy are the types which should be looked meticulously. The treatment modality can be subdivided into pharmacological pain management and interventional pain management. The following groups of drugs can be used either singularly or in combination in pharmacological pain management: Analgesics, anticonvulsants, antidepressants and miscellaneous group. Interventional pain management can be done by: Neural blockade, electric stimulation and implantable devices.
Subject(s)
Analgesics, Opioid/therapeutic use , Diabetic Neuropathies/therapy , Neuralgia/therapy , Polyneuropathies/therapy , Diabetic Neuropathies/diagnosis , Electric Stimulation , Humans , Neuralgia/classification , Neuralgia/diagnosis , Polyneuropathies/diagnosisABSTRACT
The anaesthetic management of two cases of insulinoma treated by distal pancreatectomy is presented. Stress is laid on pre-operative and intra-operative glucose administration in sufficiently high quantity. Pre-operative corticosteroid therapy is better avoided. Dextrose infusion should be stopped soon after removal of the tumour to prevent excessive hyperglycemic response in the postoperative period. Methyoxyflurane was used because it tends to raise the blood sugar level. Pancuronium bromide was preferred because of the stable cardiovascular conditions it produces.
