Interventional Pain Management: A Practical Approach DK Baheti, Sanjay Bakshi, Sanjeeva Gupta, RP Gehdoo
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1Interventional Pain Management—A Practical Approach
Under the aegis
of
Bombay Hospital Institute of Medical Sciences
and
Pain Management and Research Foundation (India)
2Interventional Pain Management—A Practical Approach
Editors DK Baheti MD Chief of Anaesthesiology and Pain Management Clinic Bombay Hospital Institute of Medical Sciences, Mumbai, India Sanjay Bakshi MD Interventional Pain Management Lenox Hill Hospital, New York, USA Beth Israel Hospital, New York, USA Spine and Pain Medicine 899 Park Avenue, NY 10021, USA Sanjeeva Gupta MD, Dip. NB, FRCA, FIPP Consultant in Pain Management and Anaesthesia Bradford Teaching Hospitals NHS Foundation Trust Department of Anaesthesia, Pain Management and Critical Care, Field House, Bradford Royal infirmary, Duckworth Lane, Bradford, BD9 6RJ, United Kingdom RP Gehdoo MD, DA Professor of Anaesthesia, Tata Memorial Hospital, Parel, Mumbai (India) 400 012
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Interventional Pain Management—A Practical Approach
© 2008, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2008
9788184483192
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset & Packagins Ltd., New Delhi
4Dedicated
to
All Pain Patients
5Contributors 8Foreword
Dr. B.K. Goyal
FAMS (IND), FRCP (EDIN), FSCAI, FACC (USA), B.Sc., MB, DTM & H (LIV), FICP, FICC, FICA (NY), FIMSA, MICTD (BER), FCCP (USA), FRSTM (LOND)
INTERVENTIONAL CARDIOLOGIST
Lotus House, Marine Lines, Mumbai 400 020
Tel.: 2203 7777 / 2201 0000
Bom Hos: 2203 2222 · 2206 7676 · Mobile: 98201 54445
Residence: 2367 9999 · Fax: 91-22-2201 0000
e-mail: drbkgoyal@hotmail.com
Pain is an integral part of the sufferings of human life. One can only realize agony when one suffers from it. Pain especially a chronic one, is not a mere symptom, it itself is a disease. Chronic pain not only disturbs various systems of the body, but also is responsible for emotional disturbances and can lead to loss of working hours.
Pain management is fast growing as superspeciality of anaesthesiology in India. In USA and other western countries pain management is already established as a superspeciality subject.
At Bombay Hospital, Dr DK Baheti, Chief of Anaesthesiology, realized the need for development of pain clinic. He visited Cleveland Clinic and Memorial Sloan-Kettering Cancer Centre for the first hand training.
For the last 17 years he has been successfully managing the Pain Management clinic at Bombay Hospital. During this period he organized international conferences like Global Update on Pain, conducted live demonstrations and hands on cadaver workshops for training young anaesthesiologists at Bombay Hospital.
Interventional pain procedures are important modalities for relief of pain. Dr DK Baheti, along with Dr Sanjay Bakshi (USA), Dr Sanjeeva Gupta (UK), 9and Dr RP Gehdoo (Mumbai) have joined hands to bring out a comprehensive book on Interventional Pain Management.
I am confident that this book will be very useful as a reference book for the medical students and will also provide practical tips to practicing physicians and young anaesthesiologists whose mission is to relieve humanity from the agony of sufferings.
(Dr B K Goyal)
10Preface
Interventional pain management is one of the most important components of managing chronic intractable pain. It is mandatory that interventional procedures need to be performed correctly right from the time of diagnosis to the relief of pain, so as to provide the best possible results.
Many universities in India as well as abroad do not have appropriate pain training program in their curriculum not only at the undergraduate but, also at postgraduate levels. There are very few pain certification programs or pain specialists or pain training facilities across the world.
Even in the countries where such programs exist, there are significant inadequacies and lacunae in teaching of the techniques. Although there are courses run by various organizations, they only incorporate a few common techniques and hence can never be comprehensive.
Many pain physicians are enthusiastic to learn the art of interventional techniques for managing pain, but do not have an access to appropriate reference books. The availability and cost of the books adds to further constraints.
We, the practicing pain physicians, have recognized the problem and realized the need for a book on Interventional Pain Management techniques, which can be both comprehensive and affordable.
It is our sincere attempt to come out with a book on interventional pain procedures due to existing vacuum in this field.
We express our heartfelt gratitude to all the contributors, without whose support this Herculean task would have been impossible.
We have taken utmost care to bring out this book with an international quality at an affordable price.
We sincerely hope that our efforts to come out with this book will benefit the pain physicians as well as the chronic pain patients.
DK Baheti, Sanjay Bakshi
Sanjeeva Gupta, RP Gehdoo