Decision Making in Pain Management, 2nd Edition by Somayaji Ramamurthy MD, Euleche Alanmanou MD, James N.

By Somayaji Ramamurthy MD, Euleche Alanmanou MD, James N. Rogers MD

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If a patient has neurologic or muscular symptoms such as shooting or burning pain, numbness, or weakness, electromyography (EMG) and nerve conduction studies (NCSs) can be useful in the evaluation and treatment. Many lesions of the peripheral nervous system (dorsal root ganglion and distal) can be assessed with EDX. NCSs typically involve external stimulation of the peripheral nervous system via a surface stimulator and recording electrodes. NCS gathers information regarding the function of motor and sensory nerves.

Ann Pharmacother 1996;30:224–227. Stacey BR, Rudy TE, Nelhaus D: Management of patient-controlled analgesia: a comparison of primary surgeons and a dedicated pain service. Anesth Analg 1997;85:130–134. Tramer MR, Walder B: Efficacy and adverse effects of prophylactic antiemetics during patient-controlled analgesia therapy: a quantitative systematic review. Anesth Analg 1999;88:1354–1361. Trentadue NO, Kachoyeanos MK, Lea GJ: A comparison of two regimens of patient-controlled analgesia for children with sickle cell disease.

Pentothal testing is a useful diagnostic aid for these patients. A. Traditionally, psychological testing such as the Minnesota Multiphasic Personality Inventory (MMPI) or Eysenck personality inventory has been used to identify those patients who may be predisposed to a nonorganic etiology for their pain. Similarly, diagnostic neural blockade has been used to assess the relative influence of organic and psychosocial factors in chronic pain patients. B. Pentothal testing is a modification of the sodium amytal interview, initially developed in 1961 and subsequently described in detail by Soichet (1978), in which a detailed psychological and physical examination is performed during increasing levels of sedation.

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