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388 Tension-type headache 18. Lance JW, Anthony M. Cyclobenzaprine in the treatment of chronic tension headache. Med J Aust. 1972;2:1409–1411. 19. Larsson B, Melin L, Doberl A. Recurrent tension headache in adolescents treated with self-help relaxation training and a muscle relaxant drug. Headache. 1990;30:665–671. 20. Saper JR, Winner PK, Lake AE, 3rd. An open-label dose-titration study of the efficacy and tolerability of tizanidine hydrochloride tablets in the prophylaxis of chronic daily headache. Headache. 2001;41:357–368. 21. Bigal ME, Bordini CA, Speciali JG. <strong>Int</strong>ravenous chlorpromazine in the acute treatment of episodic tension-type headache: a randomized, placebo controlled, double-blind study. Arq Neuropsiquiatr. 2002;60:537–541. 22. Bendtsen L, Buchgreitz L, Ashina S, et al. Combination of low-dose mirtazapine and ibuprofen for prophylaxis of chronic tension-type headache. Eur J Neurol. 2007;14:187–193. 23. Tajti J, Almasi J. [Effects of mirtazapine in patients with chronic tension-type headache. Literature review.] Neuropsychopharmacol Hung. 2006;8:67–72. 24. Evers S, Frese A. Recent advances in the treatment of headaches. Curr Opin Anaesthesiol. 2005;18:563–568. 25. Prousky J, Seely D. The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid): systematic review of the literature. Nutr J. 2005;4:3. 26. Robbins L. Tramadol for tension-type headache. Headache. 2004;44:192–193.
Trigeminal neuralgia SOHAN PAREKH AND ANDY JAGODA n Agents n Anticonvulsants n Baclofen n Evidence The anticonvulsants constitute the major drug therapy for trigeminal neuralgia (TN). Cochrane review has shown that, of the older agents, the treatment of choice is carbamazapine (200–400 mg PO BID, titrated up to 1200 mg daily maximum dose). 1 Carbamazepine’s keto-analogoxcarbazepine (300–600 mg PO BID) is equally effective. Most of the evidence for carbamazepine’s efficacy in TN comes from the outpatient setting. However, given the drug’s decades of usefulness, it is a reasonable first-line choice for ED therapy of TN. 1,2 In addition to its utility in the general population of patients with TN, carbamazepine is recommended for treatment of TN in the elderly. 3 Phenytoin and valproic acid can be of some use in TN. Phenytoin is likely a good second-choice agent, but carbamazepine’s “number needed to treat for 50% pain relief” of 1.8 reflects its superiority over the other older anticonvulsants. 1,4,5 Just as carbamazepine incurs certain risks (e.g. blood cell counts and liver function tests must be monitored), phenytoin’s use in TN is associated with some chance of side effects such as psychosis. 6 A preliminary case series found that fosphenytoin helps in acute refractory TN, but the evidence for this approach remains limited. 7 There are data to suggest utility of new-generation anticonvulsants for TN. Currently, the main ED role for these agents in TN is for patients who fail to respond to, or cannot tolerate, single-drug therapy with carbamazepine.<strong>Int</strong>he near future, though, the newer anticonvulsants may replace carbamazepine 389
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Emergency Department Analgesia An E
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Contents List of contributors page
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Tension-type headache 384 Trigemina
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Michel Galinski, MD Attending Physi
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Benjamin A. White, MD Resident, Har
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xiv Foreword code to light up the p
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xvi Foreword The authors of the boo
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Preface A typical shift in the Emer
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Acknowledgments Many thanks to this
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General considerations
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4 Introduction and general approach
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10 Assessment of pain CATHERINE A.
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12 Assessment of pain n Pain assess
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14 Assessment of pain The Face, Leg
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16 Assessment of pain 3. Silka P, R
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18 Assessment of pain 33. Melzack R
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20 Prehospital analgesia and protoc
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22 Prehospital analgesia prehospita
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24 Prehospital analgesia care provi
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26 Prehospital analgesia EMS settin
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28 Prehospital analgesia 18. Kurtz
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30 Prehospital analgesia 48. Helm M
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32 Epidemiologic overview of ED pai
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42 Geriatric analgesia ULA HWANG AN
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44 Geriatric analgesia physiologic
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46 Geriatric analgesia Analgesic ap
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48 Geriatric analgesia The common e
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50 Geriatric analgesia 12. Hohl C,
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52 Chronic pain DAVID CLINE AND STE
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54 Chronic pain care providers, it
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56 Chronic pain the agent’s monoa
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58 Chronic pain be in the ED record
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60 Chronic pain 7. Freynhagen R, Bu
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62 NSAIDs and opioids applicable sa
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64 NSAIDs and opioids We believe th
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66 NSAIDs and opioids well-demonstr
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68 NSAIDs and opioids 5. Navascues
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70 Nonstandard medication delivery
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78 Reflections on ED analgesia of u
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80 Reflections on ED analgesia para
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82 Reflections on ED analgesia chem
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Chief complaints and diagnoses
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88 Abdominal aortic aneurysm occurs
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90 Abdominal aortic aneurysm 19. Le
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92 Aortic dissection Citing sedativ
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94 Arthritis TODD M. LISTWA AND STE
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96 Arthritis NSAIDs may be safer th
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98 Arthritis for patients with high
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100 Arthritis rofecoxib, ordiclofen
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102 Arthritis For breakthrough pain
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104 Arthritis Pediatric: NSAID (e.g
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106 Arthritis 13. Hur C, Chan AT, T
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108 Arthritis 38. Curtis SP, Ko AT,
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110 Arthritis 63. Bliddal H, Tersle
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112 Biliary tract pain A retrospect
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114 Biliary tract pain n Summary an
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116 Biliary tract pain 20. Malesci
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118 Bites and stings - marine enven
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120 Bites and stings - marine jelly
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122 Bites and stings - marine 11. C
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124 Bites and stings - terrestrial
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134 Breast pain COX-2 selective NSA
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136 Breast pain Pregnancy: acetamin
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138 Burns JEREMY ACKERMAN AND ADAM
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140 Burns for moderate-to-severe bu
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142 Burns References 1. Singer AJM,
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144 Burns 30. Patterson DR, Ptacek
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146 Bursitis and periarticular infl
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152 Cancer and tumor pain bony (or
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154 Cancer and tumor pain (20 mg ev
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156 Cancer and tumor pain existing
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158 Cancer and tumor pain n Summary
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160 Cancer and tumor pain 21. Carac
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162 Cardiac chest pain KALANI OLMST
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164 Cardiac chest pain has traditio
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166 Cardiac chest pain Practice Gui
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168 Chest wall trauma MICHEL GALINS
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170 Chest wall trauma NSAIDs. As is
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172 Chest wall trauma n Summary and
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174 Chest wall trauma 21. Seltzer J
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176 Chronic low-back pain limited t
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178 Chronic low-back pain n Summary
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180 Cluster headache SOHAN PAREKH A
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182 Cluster headache n Summary and
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184 Corneal abrasion LISA CALDER n
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186 Corneal abrasion 6. Patrone G,
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188 Cystitis, urethritis, and prost
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194 Dysmenorrhea to that achieved w
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196 Dysmenorrhea 12. Fine PG. The r
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198 Endometriosis by 50-74% compare
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200 Esophageal spasm KALANI OLMSTED
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202 Esophageal spasm via central mo
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204 Fibromyalgia MICHAEL WALTA AND
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206 Fibromyalgia A multicenter plac
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208 Fibromyalgia n Summary and reco
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210 Fibromyalgia 15. Sayar K, Aksu
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212 Fibromyalgia 41. Russell IJ, Mi
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214 Gastritis and peptic ulcer dise
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226 Gastroesophageal reflux disease
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232 Hemorrhoids and perianal pain B
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234 Hemorrhoids and perianal pain a
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236 Hemorrhoids and perianal pain t
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238 Hemorrhoids and perianal pain C
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240 Hemorrhoids and perianal pain 9
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242 Hemorrhoids and perianal pain 3
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244 Migraine and undifferentiated h
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254 Mucositis and stomatitis KELLY
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256 Mucositis and stomatitis eviden
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258 Mucositis and stomatitis above)
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260 Mucositis and stomatitis 5. Dem
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262 Mucositis and stomatitis 30. Mu
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264 Neck and back pain - mechanical
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266 Neck and back pain - mechanical
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268 Neck and back pain - radicular
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274 Neck and back pain - spinal spo
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276 Neck and back pain - spinal spo
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278 Neuropathy - complex regional p
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280 Neuropathy - diabetic DAVID CLI
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282 Neuropathy - diabetic n Summary
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284 Neuropathy - diabetic 16. Lesse
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286 Neuropathy - HIV related 3600 m
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288 Neuropathy - HIV related 12. Le
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290 Neuropathy - overview OVER-THE-
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292 Neuropathy - overview The TCAs,
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294 Neuropathy - overview Gabapenti
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296 Neuropathy - overview However,
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298 Neuropathy - overview Reference
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300 Neuropathy - overview 27. Wiffe
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302 Neuropathy - phantom limb pain
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304 Neuropathy - phantom limb pain
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306 Ocular inflammation STEPHEN H.
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308 Ocular inflammation Other RCT d
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310 Ocular inflammation Pregnancy:
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312 Ocular inflammation 20. Frucht-
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314 Odontalgia MICHAEL T. SCHULTZ A
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316 Odontalgia 100 mg caffeine and
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318 Odontalgia TOPICAL THERAPY Topi
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320 Odontalgia 4. Cooper SA, Engel
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322 Odontalgia 32. Sveen OB, Yaekel
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324 Orthopedic extremity trauma inf
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326 Orthopedic extremity trauma The
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328 Orthopedic extremity trauma fem
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330 Orthopedic extremity trauma 35.
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332 Osteoporotic vertebral compress
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334 Osteoporotic vertebral compress
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336 Otitis media and externa benefi
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Page 364 and 365: 340 Pancreatitis (which lacks effec
Page 366 and 367: 342 Pancreatitis 5. Hubbard GP, Wol
Page 368 and 369: 344 Pharyngitis KELLY YOUNG n Agent
Page 370 and 371: 346 Pharyngitis complete pain relie
Page 372 and 373: 348 Pharyngitis 7. Blagden M, Chris
Page 374 and 375: 350 Pharyngitis 31. Shi Y, Gu R, Li
Page 376 and 377: 352 Postdural puncture headache Cas
Page 378 and 379: 354 Post-herpetic neuralgia JEREMY
Page 380 and 381: 356 Post-herpetic neuralgia virtual
Page 382 and 383: 358 Post-herpetic neuralgia 11. Raj
Page 384 and 385: 360 Renal colic scores. 3 The Cochr
Page 386 and 387: 362 Renal colic References 1. O’C
Page 388 and 389: 364 Sialolithiasis n Summary and re
Page 390 and 391: 366 Sickle cell crisis concluded th
Page 392 and 393: 368 Sickle cell crisis One potentia
Page 394 and 395: 370 Sickle cell crisis titrated in
Page 396 and 397: 372 Sickle cell crisis but acute ca
Page 398 and 399: 374 Sickle cell crisis treatment ti
Page 400 and 401: 376 Sickle cell crisis 3. Dunlop RJ
Page 402 and 403: 378 Sickle cell crisis Disease-rela
Page 404 and 405: 380 Temporomandibular disorders NAT
Page 406 and 407: 382 Temporomandibular disorders n S
Page 408 and 409: 384 Tension-type headache SOHAN PAR
Page 410 and 411: 386 Tension-type headache for TH, b
Page 414 and 415: 390 Trigeminal neuralgia as the ini
Page 416 and 417: 392 Undifferentiated abdominal pain
Page 422 and 423: Tables
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Page 428 and 429: Other analgesic drugs Lactation Dos
Page 430 and 431: Other analgesic drugs (cont.) Lacta
Page 432: Other analgesic drugs (cont.) Lacta
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