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1.
A A Pract ; 18(4): e01783, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38619143

RESUMO

Implanting neuromodulation devices requires that pain medicine physicians be well-versed in proper surgical technique and postoperative wound management. To be able to identify abnormal wound healing, a basic understanding of normal wound healing is required. When postoperative wounds deviate from expected healing, it is important that pain medicine physicians entertain a broad differential diagnosis, including nonsurgical dermatologic pathology.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Cicatriz , Carcinoma Basocelular/cirurgia , Neoplasias Cutâneas/cirurgia , Medula Espinal , Dor
2.
A A Pract ; 15(8): e01509, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34388138

RESUMO

A transverse abdominis plane (TAP) block is one option in the management of chronic groin pain after inguinal hernia repair. Steroid-induced lipoatrophy following local injection is an infrequent complication of this procedure, but can be distressing to patients when it does occur. A 36-year-old male patient of ours sustained this rare procedural complication and underwent successful reversal of the lipoatrophy through serial intralesional isotonic saline injections. The serial intralesional injection of isotonic saline is technically simple and may be an effective means of treating lipoatrophy. Pain specialists may opt to treat this procedural complication rather than refer to dermatology.


Assuntos
Bloqueio Nervoso , Músculos Abdominais , Adulto , Humanos , Injeções Intralesionais , Masculino , Bloqueio Nervoso/efeitos adversos , Dor Pós-Operatória/tratamento farmacológico , Esteroides
3.
Pain Manag ; 11(5): 437-449, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33840206

RESUMO

Migraine is a leading cause of morbidity and disability worldwide. Triptans were the first migraine-specific drug class developed and have proven efficacy in treatment of this neurological disease. They are however contraindicated in patients with cardiovascular disease and possibly others, owning to their vasoconstrictive properties. This review will focus on lasmiditan, which has been called the first 'ditan' and 'neurally acting anti-migraine agent', designed to selectively agonize the serotonin 5-HT1F receptor subtype, providing anti-migraine effects without concomitant vasoconstriction. To date, lasmiditan has proven safe and effective for the acute treatment of migraine in two Phase II and four Phase III trials. Post hoc analysis revealed that the majority of treatment-emergent adverse events were CNS-related, mild-to-moderate in severity and self-limiting. The US FDA label recommends that patients not drive or operate machinery until at least 8 h after taking each dose of lasmiditan.


Lay abstract Migraine is a leading cause of pain and disability worldwide. Triptans (e.g., sumatriptan) were the first migraine-specific drug class developed and have proven to be effective treatments. Triptans are however contraindicated in patients with heart disease and possibly in some subsets of migraine, due to vasoconstriction concerns. This review will focus on lasmiditan, the first 5-HT1F receptor agonist or 'ditan'. It does not carry vasoconstrictive concerns and is safe to use in patients who cannot take triptans. To date, lasmiditan has proven safe and effective for the acute treatment of migraine in multiple medical studies. Data from these studies indicates that the most common adverse effects from lasmiditan were dizziness, tingling and sleepiness. These symptoms were generally mild-to-moderate in severity and self-limiting. The US FDA label recommends that patients not drive or operate machinery until at least 8 h after taking each dose of lasmiditan.


Assuntos
Transtornos de Enxaqueca , Agonistas do Receptor de Serotonina , Benzamidas , Humanos , Transtornos de Enxaqueca/tratamento farmacológico , Piperidinas , Piridinas , Receptores de Serotonina
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