TY - JOUR
T1 - NEUROPATHIC CHRONIC PAIN FOLLOWING TRAUMATHIC BRACHIAL PLEXUS TOTAL SECTION MANAGED BY TRANSDERMAL BUPRENORPHINE PATCH(TDS): ORIGINAL CASE REPORT
AU - Evangelista, Maurizio
AU - Cappa, Benedetta
PY - 2012
Y1 - 2012
N2 - Male, 24 years old, total section of the brachial plexus, Tinel/B. Horner signs: +. Suture of the accessory on suprascapular nerve, front and rear, and a wrapping of four 8 cm junctions, between C6 and the branches of the SPT, has been acted. Burning, continuous pain, VAS8, and clusters of intermittent shocks, VAS9, begun after surgery. Pain was, initially, treated with: carbamazepin 200 mg. SR/bid, amitriptilin 25 mg, tramadol 100 mg SRbid increasing of 100 mg, every two days, up to 400 mg/die; RD: tramadol drops 50 mg. Two weeks after, because of pain relief absence, tramadol was replaced by TDS37. 5 mcgr/h with titration scheme: 1/4 for 7, 1/2 for 21, 1 for 28 days; RD: buprenorphin s.l. 0.2mg. Weekly, for a period of 8 weeks, have been checked: Vas, side effects (number of episodes) and number of RD.
Results: see enclosed figure.
Conclusions: a difficult case of neuropathic chronic pain, refractory to the theraphy, has founded significative improvement by TDS that, joint with anticonvulsant and triciclic antidepressant drugs, has allowed significative basal pain control and reduction of the number of the breakthrough pain episodes
AB - Male, 24 years old, total section of the brachial plexus, Tinel/B. Horner signs: +. Suture of the accessory on suprascapular nerve, front and rear, and a wrapping of four 8 cm junctions, between C6 and the branches of the SPT, has been acted. Burning, continuous pain, VAS8, and clusters of intermittent shocks, VAS9, begun after surgery. Pain was, initially, treated with: carbamazepin 200 mg. SR/bid, amitriptilin 25 mg, tramadol 100 mg SRbid increasing of 100 mg, every two days, up to 400 mg/die; RD: tramadol drops 50 mg. Two weeks after, because of pain relief absence, tramadol was replaced by TDS37. 5 mcgr/h with titration scheme: 1/4 for 7, 1/2 for 21, 1 for 28 days; RD: buprenorphin s.l. 0.2mg. Weekly, for a period of 8 weeks, have been checked: Vas, side effects (number of episodes) and number of RD.
Results: see enclosed figure.
Conclusions: a difficult case of neuropathic chronic pain, refractory to the theraphy, has founded significative improvement by TDS that, joint with anticonvulsant and triciclic antidepressant drugs, has allowed significative basal pain control and reduction of the number of the breakthrough pain episodes
KW - NEUROPATHIC CHRONIC PAIN
KW - TRANSDERMAL BUPRENORPHINE PATCH
KW - TRAUMATHIC BRACHIAL PLEXUS TOTAL SECTION
KW - NEUROPATHIC CHRONIC PAIN
KW - TRANSDERMAL BUPRENORPHINE PATCH
KW - TRAUMATHIC BRACHIAL PLEXUS TOTAL SECTION
UR - http://hdl.handle.net/10807/64381
UR - http://onlinelibrary.wiley.com/enhanced/doi/10.1016/j.ejpain.2007.03.337
U2 - 10.1016/j.ejpain.2007.03.337
DO - 10.1016/j.ejpain.2007.03.337
M3 - Article
SN - 1090-3801
VL - 2012
SP - N/A-N/A
JO - European Journal of Pain
JF - European Journal of Pain
ER -