Anesthesia

30 Opioid Therapy in Chronic Nonmalignant Pain

30 Opioid Therapy in Chronic Nonmalignant Pain The Massachusetts General Hospital Handbook of Pain Management 30 Opioid Therapy in Chronic Nonmalignant Pain Scott M. Fishman and Jianren Mao Thou only givest these gifts to man, and thou hast the keys of Paradise, O just, subtle and mighty opium! —Thomas De Quincey (1785–1859) I. Rationale II. […]

29 Facial Pain

29 Facial Pain The Massachusetts General Hospital Handbook of Pain Management 29 Facial Pain Martin A. Acquadro and Avine M. Lydon Pain is the most urgent of symptoms. —Henry K. Beecher, first chairman of anesthesia at MGH (1904–1976) I. Neuroanatomy and neurophysiology II. Psychological aspects III. Temporomandibular joint dysfunction, temporomandibular muscle dysfunction, and myofascial dysfunction […]

28 Headache

28 Headache The Massachusetts General Hospital Handbook of Pain Management 28 Headache F. Michael Cutrer and Pramit Bhasin I have a pain upon my forehead here. —Othello Act 3, Scene 3, by William Shakespeare (1564–1616) I. Anatomy of head pain II. Pathogenic theories of headache 1. Vasogenic theory 2. Neurogenic theory 3. Peripheral sensitization 4. […]

27 Back and Neck Pain

27 Back and Neck Pain The Massachusetts General Hospital Handbook of Pain Management 27 Back and Neck Pain Shihab U. Ahmed Pain wanders through my bones like a lost fire. —Theodore Roethke (1908–1963) I. Definitions II. Anatomic and pathologic basis of back and neck pain 1. Vertebral bodies 2. Intervertebral discs 3. Ligaments 4. Muscles […]

26 Complex Regional Pain Syndromes

26 Complex Regional Pain Syndromes The Massachusetts General Hospital Handbook of Pain Management 26 Complex Regional Pain Syndromes Katharine H. Fleischmann and Edward Lubin Pain, whose unchecked and familiar speed Is howling, and keen shrieks day after day. —Percy Bysshe Shelley (1792–1822) I. History II. Basic mechanisms III. Clinical presentation 1. Acute stage 2. Dystrophic […]

25 Neuropathic Pain Syndromes

25 Neuropathic Pain Syndromes The Massachusetts General Hospital Handbook of Pain Management 25 Neuropathic Pain Syndromes John D. Markman and Anne Louise Oaklander It is evidently impossible to transmit the impression of pain by teaching, since it is only known to those who have experienced it. Moreover, we are ignorant of each type of pain […]

24 Pain Management in Sickle Cell Disease

24 Pain Management in Sickle Cell Disease The Massachusetts General Hospital Handbook of Pain Management 24 Pain Management in Sickle Cell Disease Jatinder S. Gill Pain is not just a symptom demanding our compassion; it can be an aggressive disease that damages the nervous system. —Gary Bennett I. Pathophysiology II. Clinical features and contemporary management […]

23 Pain in Burn Patients

23 Pain in Burn Patients The Massachusetts General Hospital Handbook of Pain Management 23 Pain in Burn Patients Salahadin Abdi and Bucknam J. McPeek There is physical pain, there is mental pain and scarring. You can see the outside, but what a lot of people don’t see is that we are truly burned on the […]

22 Postoperative Pain in Children

22 Postoperative Pain in Children The Massachusetts General Hospital Handbook of Pain Management 22 Postoperative Pain in Children William T. Denman and Jane Ballantyne Charm ache with air and agony with words. —William Shakespeare (1564–1616) I. Planning for postoperative analgesia II. Assessing acute pain in infants and children III. Treatment choices 1. Acetaminophen and the […]

21 Postoperative Pain in Adults

21 Postoperative Pain in Adults The Massachusetts General Hospital Handbook of Pain Management 21 Postoperative Pain in Adults Elizabeth Ryder and Jane Ballantyne Rich the treasure, Sweet the pleasure Sweet is pleasure after pain For all the happiness man can gain Is not in pleasure, but in rest from pain. —John Dryden (1631–1700) I. Rationale […]