Related Experiment Videos
Diagnostic epidural opioid technique
J S Ellis1, S Ramamurthy, L S Schoenfeld
1Department of Anesthesiology, Wilford Hall Air Force Medical Center, Lackland Air Force Base, San Antonio, Texas.
The Clinical Journal of Pain
|September 1, 1989
Summary
Chronic pain patients responding to lidocaine but not fentanyl may have learned pain responses. This suggests diagnostic opioid techniques could improve chronic pain diagnosis.
Area of Science:
- Anesthesiology
- Pain Medicine
- Psychology
Background:
- Diagnostic epidural blocks are used to manage chronic pain.
- Patient responses to epidural solutions can vary significantly.
Purpose of the Study:
- To investigate patient responses to epidural saline, fentanyl, and lidocaine.
- To identify characteristics of patients who respond to lidocaine but not fentanyl.
Main Methods:
- 27 chronic pain patients received sequential epidural blocks with saline, fentanyl, and lidocaine.
- Patients were categorized into four groups based on their pain relief response.
- Groups were compared using demographic and clinical variables.
Main Results:
- The lidocaine response group (LRG) had a significantly longer average duration of pain.
- LRG patients did not achieve pain relief with epidural fentanyl.
- No significant differences were found in other demographic or clinical factors.
Conclusions:
- LRG patients may represent a subset of operant or learned pain patients.
- Failure to respond to fentanyl might indicate a learned association between sensory input and pain.
- Diagnostic opioid techniques may be refined for more sensitive chronic pain diagnosis.