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Ischemic Pain

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Fundamentals of Pain Medicine

Abstract

Ischemic pain is caused by tissue hypoxia and acidosis. Many conditions are implicated in the development of severe chronic ischemic pain. Among the most common ischemic pain conditions are peripheral arterial insufficiency and chronic bowel ischemia from vascular insufficiency, which result in mesenteric ischemia or celiac artery compression. Opioids have limited efficacy for the pain of critical limb ischemia because of their side effects. Besides vascularization, lumbar sympathetic blocks and neurolysis, regional anesthesia, and spinal cord stimulation can offer pain relief to patients with advanced peripheral arterial disease and chronic pain. Postprandial pain associated with mesenteric ischemia or decreased flow from fibrous bands compressing the celiac artery may respond to celiac ganglionectomy with local anesthetic or surgical manipulation; spinal cord stimulation may lessen pain in patients with ischemia in the mesenteric arterial bed.

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Author information

Authors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago Medicine, 5841 S. Maryland Ave, MC 4028, Chicago, IL, 60637, USA

    Magdalena Anitescu MD, PhD

Authors
  1. Magdalena Anitescu MD, PhD
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Correspondence to Magdalena Anitescu MD, PhD .

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Editors and Affiliations

  1. Professor of Anesthesiology President-elect, American Academy of Pain Medicine, Director, Cleveland Clinic Multidisciplinary Pain Medicine Fellowship Program, Departments of Pain Management and Neurosciences, Cleveland Clinic Anesthesiology Institute and Lerner Research Institute, Cleveland, Ohio, USA

    Jianguo Cheng

  2. Chairman, Department Pain Management, Cleveland Clinic, Cleveland, Ohio, USA

    Richard W. Rosenquist

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Anitescu, M. (2018). Ischemic Pain. In: Cheng, J., Rosenquist, R. (eds) Fundamentals of Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-64922-1_16

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  • DOI: https://doi.org/10.1007/978-3-319-64922-1_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64920-7

  • Online ISBN: 978-3-319-64922-1

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