Nondermatomal Somatosensory Deficits (NDSDs) and Pain: State-of-the-Art Review

Mailis, Angela; Nicholson, Keith

doi:10.1007/s12207-017-9300-z

Cited by 1 publication

(4 citation statements)

References 64 publications

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“…Our SP study demonstrates results identical to those of the older IV SA interview (supporting previously reported effects of SA in patients with chronic pain) [2][3][4][5][6][7][8][9][10][11][12][13]:…”

Section: Discussionsupporting

confidence: 87%

“…Our interpretation of IV SP responses based on the results of this study is identical to that of SA documented previously in several of our papers [2][3][4][5][6][7][8][9][10][11][12][13], and we will collectively refer to our interpretation of the effects of "IV barbiturates" (implying both SA and SP) as follows:…”

Section: Discussionsupporting

confidence: 83%

“…In regard to SA interview for use in diagnosing chronic pain, several studies and reviews of its application as an investigational/diagnostic tool in patients with chronic pain have been published by our group at the Toronto Western Hospital/University Health Network. Many of our studies have been performed using singleblinded infusions of SA and normal saline (NS) [2][3][4][5][6][7][8][9][10][11], and have shown that IV SA seems to exert numerous effects in patients with different types of pain.…”

Section: Historical Perspective/literature Reviewmentioning

confidence: 99%

“…The application of IV SA (or SA interview), specifically as a diagnostic aid for chronic noncancer pain, has been studied extensively and reported by our group at the Toronto Western Hospital/University Health Network (a large hospital conglomerate in downtown Toronto, Ontario, Canada), with numerous studies conducted between 1988 and 2017 [2][3][4][5][6][7][8][9][10][11]. SA was discontinued in Canada in 2003, and the pain team had to resort to sodium pentobarbital (SP), an isomer of amobarbital known as Nembutal [12].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Intravenous Sodium Pentobarbital on Pain and Sensory Abnormalities in Patients with Chronic Non-Cancer Pain: Narrative Literature Review, Research Study, and Illustrative Case Reports

Lakha,

Mailis

2024

Pain Ther

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Introduction Sodium pentobarbital (SP), a short- to intermediate-acting barbiturate, has limited information in the existing literature. The objectives of this study are to describe (a) the effect of intravenous (IV) SP infusion on pain and sensory abnormalities, and (b) its utility in the diagnosis and management of patients with chronic pain. Methods A narrative review of barbiturate applications for chronic pain was followed by a pragmatic study of 176 consecutive patients admitted to an inpatient pain unit (2004–2009). We collected demographic information upon admission, diagnoses retrieved from chart review, and pain ratings and sensory abnormalities at baseline and after blinded infusion of normal saline (NS) followed by SP. Results The study group consisted of 83 men and 93 women (mean age 41 ± 11 years); the mean NS dose was 7.8 ± 2.3 (range 2–10 ml), the SP dose was 223.8 ± 88 mg (range 40–420), and the numeric rating scale (NRS) baseline pain score was 6.0 ± 2. The mean reduction in NRS reached both statistical and clinical significance in 150 responders to either NS/SP or SP only. Collectively, we found (a) an extremely high rate of response to IV SP irrespective of the underlying pathology, (b) greater response for pain than for sensory abnormalities (sensory gains or deficits), (c) greater response for sensory gain than for sensory deficit, and (d) greater response for allodynia than for pinprick hyperalgesia. Illustrative case reports are also presented. Discussion IV SP infusion is a diagnostic tool that assists in elucidating pain generators and the nature of sensory abnormalities (central vs. peripheral), with effects similar to those of IV sodium amytal. The test cannot be viewed as a tell-all diagnostic modality and must be used in conjunction with clinical judgment, investigations, and psychological reports.

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