Archive for the ‘Pain Relief-Muscle Relaxers’ Category

ADJUVANT ANALGESICS: ORAL LOCAL ANAESTHETICS, ANTIBIOTICS AND KETAMEVE

July 6, 2011 - 5:42 am Comments Off
Indication. Neuropathic pain refractory to other therapy.
Action-Probably by neuronal membrane stabilisation.
Drugs-Mexiletine is the preferred drug; flecainide was associated with an increased risk of sudden death in post-myocardial infarction patients. Mexiletine is commenced at a dose of 150 mg/d and increased by the same amount each few days up to a maximum of 750 mg/d. The medication should be taken with food. The side effects include nausea, sedation and tremor. Mexiletine must be given with particular care to patients with ischaemic heart disease or cardiac arrhythmias.
Ketamine-Ketamine, a dissociative anaesthetic used for short surgical procedures, can relieve unresponsive neuropathic pain. It acts as a NMDA receptor antagonist. It is given in subanaesthetic doses by subcutaneous infusion: 0.1-0.5 mg/kg/h and titrated against effect.
Antibiotics-The pain of cellulitis, mucositis and fungating tumours is often compounded by secondary infection. The use of appropriate antibiotic or antifungal agents can improve pain control.
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TIPS TO PREVENT BACK PAIN AND SCIATICA FOR HOME WORKERS

Bending over beds, heaving a vacuum cleaner around, dusting in corners and standing cooking in the kitchen are all ingredients that add up to a recipe for increased risk of back strain and other muscle pain.

It’s easy to mistreat your body as you give the carpet a clean -twisting from the waist to get the vacuum cleaner into position can harm the back and strain the arms. Keep the handle close to your body and use the machine’s wheels to move it around.

Beds are usually designed for the benefit of the sleeper, not the one who has to change the sheets. To make changing bed linen safer, don’t lean over to the other side to tuck sheets in, but go round to do it. Similarly, pictures are designed to be looked at, not cleaned; floors to be trodden on, not bent down to for cleaning. But a long-handled duster and brooms used with an upright back, with the handle held close to the body, will help you avoid strains.

The height of work surfaces such as ironing-boards and kitchen units is also important to avoid uncomfortable bending. The most efficient height is usually 2-4 inches below elbow height. In fact, ironing is often best done sitting down, with the chair close to the board.

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THE CRAMPS (SPASMODIC DYSMENORRHOEA): COPING WITH FAINTS

Some people feel dizzy and sick, but manage to stay conscious. Some feel dizzy for a little while and then faint; others just pass out cold without any warning; some recover very quickly and really don’t seem much the worse; others feel and look absolutely awful when they come round. Often the first sign of a fainting fit is a change of colour. White skins go very pale, often with a greenish tinge; brown skins turn grey-mauve. If you’re one of those who faint without warning you might find your family or friends will see the danger signals even before you feel them and can warn you to take action.

But what action? If you feel faint and you’re in the middle of a crowd —in a busy office, or a shop, for example, or at a school assembly —you can keep yourself conscious for a few valuable seconds by clenching and unclenching your calf muscles as fast as you can. This could just give you enough time to get out of the crowd and into a chair where you can sit with your head between your knees and recover. If you have fainted, it’s a mistake to rush to get up when you come round or you run the risk of passing out again. Stay where you are and relax completely until you feel quite yourself again. Then get up slowly, a step at a time, as you do anyway after you’ve been relaxing.

Some fainting fits are caused by tension, so as you get used to relaxing and the relaxation takes effect, you may find that you don’t faint so often, if at all. Some fainting spells disrupt your breathing pattern. When you come round your breathing is upset, which can be alarming. A few deliberate deep breaths will often help you to breathe normally again and they will certainly make you feel calmer until you recover.

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