phantom-limb pain is highly prevalent after limb amputation but remains an extremely challenging pain condition to treat1,2. the treatment must be multimodal and mechanism-based because the underlying pathological changes occur in both the peripheral and the central nervous system after amputation1,2. We report a patient who had suffered from intractable phantom-limb pain for years, successfull...

Pain is prevalent in advanced malignancies; however, some patients cannot get adequate pain relief by conservative routes of analgesic administration or experience serious side effects related to high dose of opioids. For those who have exhausted multimodal conservative analgesic, intrathecal drug delivery is an alternative intervention for truly effective pain management. The objective of this...

The journal is the official publication of College Surgeons Sri Lanka. Its mission to reach highest standard scientific surgical practice by dissemination high quality information and foster promote growth surgery in Lanka region. Journal Surgery publishes peer-reviewed leading articles, review perspectives case reports field broadly related sciences adheres ethics as portrayed Committee on Pub...

Intraspinal drug delivery systems can be effective in controlling intractable pain. However, before these invasive pain therapies are initiated and to avoid or minimize any complications associated with their use, there must be a thorough understanding of the etiology of the pain, the underlying cancer, and antineoplastic therapy. For example, the assumption that intraspinal cannulation is cont...

In terminally ill cancer patients with refractory pain, long-term spinal opioid therapy may provide a profound analgesia with minimal side effects. The reversibility of the technique and its efficacy throughout the body and for different types of pain are important advantages. For epidural administration, it is preferable to use lipid soluble opioids (sufentanil). For intrathecal administration...

BACKGROUND/AIMS Thalamic deep brain stimulation (DBS) for the treatment of medically refractory pain has largely been abandoned on account of its inconsistent and oftentimes poor efficacy. Our aim here was to use diffusion tensor imaging (DTI)-based segmentation to assess the internal thalamic nuclei of patients who have undergone thalamic DBS for intractable pain and retrospectively correlate ...

ALTHOUGH it has never been claimed that the phenothiazines have an analgesic action comparable to that of the opiates, it is frequently inferred that they have some effect on pain. They are widely used to potentiate analgesic drugs in the management of intractable pain and have enjoyed great popularity in the treatment of the terminal stages of malignant disease. Apart from their anti-emetic ef...

In symptomatic bone metastases with significant pain, refractory to standard analgesics and radiotherapy, loading dose zoledronic acid (ZA) represents a simple and nontoxic treatment to obtain significant pain relief in a very short time. Its analgesic effect is limited to patients with massive osteoclast activation with high initial serum C-telopeptide (CTX). The pain reduction is proportional...