Jeffrey Loh

BACKGROUND: Cancer pain is difficult to treat, often requiring a multimodal approach. While medication management remains the mainstay for the treatment of cancer pain, medications are often associated with undesired side effects. Transcutaneous electrical nerve stimulation (TENS) provides a potential adjunctive method for treating cancer pain with minimal side effects.

OBJECTIVE: Few studies have been performed evaluating the efficacy of TENS on cancer pain. We sought to examine the ...

BACKGROUND: High-intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique. High-intensity focused ultrasound has been used in small-animal models to lesion neural tissue selectively. This study aimed to evaluate the efficacy of HIFU in a large-animal model for ablation of nerves similar in size to human nerves.

METHODS: Twelve acute magnetic resonance-guided HIFU ablation lesions were created in intercostal nerves in a swine model. In a second pig, as a control, 4 ...

Introduction

Spastic patients often seek neurolysis, the permanent destruction of the sciatic nerve, for better pain management. MRI-guided high-intensity focused ultrasound (MRgHIFU) may serve as a noninvasive alternative to the prevailing, more intrusive techniques. This in vivo acute study is aimed at performing sciatic nerve neurolysis using a clinical MRgHIFU system.MethodsThe HIFU ablation of sciatic nerves was performed in swine (n = 5) using a HIFU system integrated with a 3 T ...

SUMMARY 

BACKGROUND: Pain is often the initial presenting symptom with sarcomas. Upon resection of a sarcoma, most patients experience a resolution of their pain. However, in those patients with continued pain, treatment often requires multiple medications with moderate benefit.

AIMS: The authors present eight patients who suffer from continued sarcoma-related pain following resection of their initial cancer.

METHODS: For each patient, we describe the use of transcutaneous electrical ...

Throughout history, physicians believed that the perception of pain could be explained by a single, simplified physiologic pathway (Loeser et al. 2001a). Their theories described pain as its own sensory apparatus, independent of touch and other senses, or as a result of excessive stimulation from the touch sensation. While the exact mechanisms were unknown, most physicians agreed that pain required a triggering stimulus and that removal of the stimulus should relieve pain. More recently, ...

SUMMARY Choosing the initial medications for intrathecal delivery is often confusing and not standardized. We describe a novel way for using a combined spinal-epidural technique to compare two first-line medications for intrathecal delivery; ziconotide and morphine (or hydromorphone). Five patients with intractable chronic or cancer pain were elected to have an intrathecal drug delivery system implanted for pain management. Each patient was given a 3-day inpatient trial with the combined ...