Chronic Pain

Question 1

For every pain patient:

Answer 1

History/Physical. Confirm pain source. Ask what they have been using, what works, what doesn’t. Try multimodal (APAP, NSAIDs, gabapentin, TCAs), opioid rotation. Trial blocks, then ablations.

Question 2

CRPS Budapest criteria

Answer 2

1) hyperalgesia or allodynia
2) vasomotor changes (skin color/temp)
3) pseudomotor changes (edema/sweating)
4) motor/trophic (weakness/loss of hair/nails)

Question 3

CRPS 1 v 2

Answer 3

1) no injury/crush injury
2) direct nerve cut/damage

Question 4

Uses of Stellate ganglion block

Answer 4

help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

Question 5

Sympathetic block for pancreatic cancer

Answer 5

Celiac plexus block (fluoroscopy 5-7 cm lateral to spine)

Question 6

Sympathetic block for pelvic pain

Answer 6

Superior hypogastric plexus (L5-S1)

Question 7

Sympathetic block for deep pelvic pain (prostate, cervix)

Answer 7

Inferior hypogastric plexus block

Question 8

Delete