free powerpoint templates page 1 free powerpoint templates interventional pain management in cancer

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Interventional Pain Management in Cancer


Interventional Pain Management

• Botulinum Toxin

• Acupuncture

• Local Blockade

• Sympathetic Blocks

• Spinal Procedures


Botulinum Toxin

• Treatment for spasticity, musculoskeletal pain, muscle spasms and neuropathic pain.

• Block the release of pain mediators• Radiation induced myokimia and

spasticity• Reduced postoperative pain after

mastectomy• Reduce pain in muscle spasm after

radiotherapy in patients with head and neck cancer.


Botulinum Toxin

• Radiation fibrosis syndrome

• Radiation induced dystonia, trigeminal neuralgia, cervical plexus neuralgia

• No standard guidelines– Low dose 100-300 units per

treatment

• Relief: 6-12 weeks


Acupuncture

• Stimulating specific discrete anatomic points

• Adjunct for pain control, nausea, vomiting post-chemotherapy, back pain

• Short term pain relief


Local Blockade

• Local anesthetics

• Done before proceeding to neurolysis

• Neurolysis:– Intercostal nerves– Cutaneous sensory nerves

(trigeminal and saphenous)


Local Blockade

• Neurolysis:– Freezing

• Application of subzero temperatures• Ice crystals create vascular damage

to the vasa nervorum• Used in trigeminal neuralgia and

intercostal nerves


Local Blockade

• Neurolysis:– Heating

• Radiofrequency ablation (RF)– Sacroiliac pain, trigeminal neuralgia

– Chemical Techniques• Phenol or ethanol preparations


Sympathetic Blocks

• Superior hypogastric plexus– Mainly for chronic pelvic cancer

pain

• Celiac Plexus– Cancer of the abdominal viscera– May cause hypotension and

diarrhea.


Spinal Procedures

• Epidural Steroid Injections– Acute radicular pain due to

herniated nucleus pulposus.– Earlier pain relief and return to

function.


Spinal Procedures

• Vertebral Procedures– Tumor involvement of vertebra– Kyphoplasty

• Balloon expansion of the vertebrae

– Vertebroplasty• Introduces cement to damage

vertebra


Spinal Procedures

• Facet Arthropathy– Osteoarthiritis and tumor– Intraarticular injection of steroids– Radiofrequency ablation


Complementary Therapies for Pain

Management in Cancer


Complementary Therapies

• Acupuncture

• Massage Therapy

• Hypnosis

• Music Therapy

• Dietary Supplements


Acupuncture

• Induce analgesics effect

• Studies:– Showed improvement– Short term pain relief


Massage Therapy

• Stretch and compress a patient’s muscle & connective tissue.

• Increased circulation• Stimulation of lymphatic

damage• Improve muscle tissue

metabolism and elasticity


Massage Therapy

• Reduce anxiety, emotional stress, fatigue.

• Effect on physical symptoms

• Reduce patient’s need for NSAIDs


Hypnosis

• Altered state of consciousness

• A state between wakefulness and sleep

• Control of his behavior

• Hypnotic analgesia


Music Therapy

• Ease pain, anxiety and depression

• Decreased opioid requirement further study


Herbal Remedies

• Should be cautious• Musculoskeletal pain and

arthritic conditions glucosamine

• Glutamine reducing peripheral neuropathy; dec toxicity of chemotherapy and radiation


Thank you...

free powerpoint templates page 1 free powerpoint templates interventional pain management in cancer

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