421 effects of slow repetitive transcranial magnetic stimulation (tms) on complex regional pain...

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ing students, 10 physician assistant students and two pharmacy students. Results. Pre-course assessment demonstrated that in each of the programs, with the exception of pharmacy, pain education received little attention, including less than 2 h within medical education. Post-course assessment indicated satisfaction with the course, as well as the aims of an interdisciplinary approach to pain education. Conclusion. Goals of this project include the compila- tion of a curriculum, including teaching materials, pow- erpoints, and other tools to assist in the implementation of similar programs at other institutions. doi:10.1016/j.ejpain.2007.03.435 421 EFFECTS OF SLOW REPETITIVE TRANSCRA- NIAL MAGNETIC STIMULATION (TMS) ON COMPLEX REGIONAL PAIN SYNDROME (CRPS) N.C. Moore *, P. MacMillan, M Cooper Department Psychiatry, Quillen College Medicine, East Tennessee State University, Johnson City, TN, USA Background. The key symptom of CRPS is continu- ous, intense pain out of proportion to the injury. Red skin, increased temperature, sweating and swelling are common. These symptoms suggest an inflammatory process. One theory is that an auto-immune process trig- gers the immune response. A single 20-min session of prefrontal repetitive TMS can alleviate pain, as shown by a 40% reduction in total morphine use after gastric bypass surgery. A similar single session applied to the motor cortex can decrease the pain of CRPS, as reported by seven of 10 patients. Aims. The aims of this study are to: (1) replicate the finding that one session of TMS provides temporary relief from CRPS pain; (2) determine if 10 sessions pro- vide more lasting relief and (3) determine if molecular markers support the theory that CRPS is an inflamma- tory process. Methods. Ten participants will receive 10 real and 10 sham TMS treatments; five will start with real, and five with sham. Patients will rate the intensity of pain on a visual analogue scale. C-reactive protein and lipopro- tein-associated phosholipase A2 (known molecular inflammatory markers) will be measured at baseline, after sham TMS and after real TMS. Results and conclusions. This study is not yet com- plete; results and conclusions will be added to the abstract by March 31, 2007. doi:10.1016/j.ejpain.2007.03.436 422 PULSED RADIOFREQUENCY TREATMENT (PRF) WITH PASHA CATH IN NEUROPATIC PAIN A. Orlando *, G. Sindaco, L. Ravaioli, L. Follini, G. Pari Medicina Del Dolore, Forli, Italy Introduction. The Pasha Cath is a multifunctional catheter used for diagnostic and therapeutic aims. The catheter is placed exactly on the wished nervous root, using the fluoroscopic images, the impedance val- ues and sensory stimulation a 50 Hz current. This cur- rent evokes paraesthesias on the metameric area related. At this point it can proceed to the selective infusion of drugs and/or PRF. Objective. To evaluate the analgesic effectiveness of PRF treatment in periferic neuropathic pain. Design. Prospective, open-label, nonrandomized trial. Setting. Department of Pain Medicine, Private Hos- pital, Italy. Inclusion criteria. All patients affected by lumbar radiculopathy for more than six months, with pathoge- netic diagnosis of periferic neuropathic pain. Interventions. In all patients it has been used a PRF treatment for 240 s using Pasha Cath, on the target root, through sensory neurostimulation. Effectiveness assessments. NRS at rest and incident, Oswestry test, QUID test (Italian Pain Questionary) at baseline, first and third month. Results: Follow-up in progress. doi:10.1016/j.ejpain.2007.03.437 423 MULTICENTRIC TRIAL FOR THE ASSESSMENT OF ANALGESIC EFFECTIVENESS OF PULSED RADIOFREQUENCY TREATMENT (PRF) WITH PASHA CATH IN LUMBOSACRAL MONO- RADICULOPATHY G. Pari *, L. Follini, G. Orlandini, A. Orlando, G. Sindaco Medicina Del Dolore, Forli, Italy Introduction. The Pasha Cath is a multifunctional catheter used for diagnostic and therapeutic aims. The catheter is placed exactly on the wished nervous root, using the fluoroscopic images, the impedance values and a sensory stimulation of a 50 Hz current. This cur- rent evokes paraesthesias on the metameric area related. At this point we can proceed to the selective infusion of drugs and/or PRF. Poster Presentations / Clinical – Other Treatments / European Journal of Pain 11(S1) (2007) S59–S207 S187

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ing students, 10 physician assistant students and twopharmacy students.

Results. Pre-course assessment demonstrated that ineach of the programs, with the exception of pharmacy,pain education received little attention, including less than2 h within medical education. Post-course assessmentindicated satisfaction with the course, as well as the aimsof an interdisciplinary approach to pain education.

Conclusion. Goals of this project include the compila-tion of a curriculum, including teaching materials, pow-erpoints, and other tools to assist in the implementationof similar programs at other institutions.

doi:10.1016/j.ejpain.2007.03.435

421EFFECTS OF SLOW REPETITIVE TRANSCRA-

NIAL MAGNETIC STIMULATION (TMS) ON

COMPLEX REGIONAL PAIN SYNDROME (CRPS)

N.C. Moore *, P. MacMillan, M Cooper

Department Psychiatry, Quillen College Medicine, East

Tennessee State University, Johnson City, TN, USA

Background. The key symptom of CRPS is continu-ous, intense pain out of proportion to the injury. Redskin, increased temperature, sweating and swelling arecommon. These symptoms suggest an inflammatoryprocess. One theory is that an auto-immune process trig-gers the immune response. A single 20-min session ofprefrontal repetitive TMS can alleviate pain, as shownby a 40% reduction in total morphine use after gastricbypass surgery. A similar single session applied to themotor cortex can decrease the pain of CRPS, asreported by seven of 10 patients.

Aims. The aims of this study are to: (1) replicate thefinding that one session of TMS provides temporaryrelief from CRPS pain; (2) determine if 10 sessions pro-vide more lasting relief and (3) determine if molecularmarkers support the theory that CRPS is an inflamma-tory process.

Methods. Ten participants will receive 10 real and 10sham TMS treatments; five will start with real, and fivewith sham. Patients will rate the intensity of pain on avisual analogue scale. C-reactive protein and lipopro-tein-associated phosholipase A2 (known molecularinflammatory markers) will be measured at baseline,after sham TMS and after real TMS.

Results and conclusions. This study is not yet com-plete; results and conclusions will be added to theabstract by March 31, 2007.

doi:10.1016/j.ejpain.2007.03.436

422PULSED RADIOFREQUENCY TREATMENT (PRF)

WITH PASHA CATH IN NEUROPATIC PAIN

A. Orlando *, G. Sindaco, L. Ravaioli, L. Follini,

G. Pari

Medicina Del Dolore, Forli, Italy

Introduction. The Pasha Cath is a multifunctionalcatheter used for diagnostic and therapeutic aims.The catheter is placed exactly on the wished nervousroot, using the fluoroscopic images, the impedance val-ues and sensory stimulation a 50 Hz current. This cur-rent evokes paraesthesias on the metameric arearelated.

At this point it can proceed to the selective infusion ofdrugs and/or PRF.

Objective. To evaluate the analgesic effectiveness ofPRF treatment in periferic neuropathic pain.

Design. Prospective, open-label, nonrandomized trial.Setting. Department of Pain Medicine, Private Hos-

pital, Italy.Inclusion criteria. All patients affected by lumbar

radiculopathy for more than six months, with pathoge-netic diagnosis of periferic neuropathic pain.

Interventions. In all patients it has been used a PRFtreatment for 240 s using Pasha Cath, on the target root,through sensory neurostimulation.

Effectiveness assessments. NRS at rest and incident,Oswestry test, QUID test (Italian Pain Questionary) atbaseline, first and third month.

Results: Follow-up in progress.

doi:10.1016/j.ejpain.2007.03.437

423MULTICENTRIC TRIAL FOR THE ASSESSMENT

OF ANALGESIC EFFECTIVENESS OF PULSED

RADIOFREQUENCY TREATMENT (PRF) WITH

PASHA CATH IN LUMBOSACRAL MONO-

RADICULOPATHYG. Pari *, L. Follini, G. Orlandini, A. Orlando, G.

Sindaco

Medicina Del Dolore, Forli, Italy

Introduction. The Pasha Cath is a multifunctionalcatheter used for diagnostic and therapeutic aims. Thecatheter is placed exactly on the wished nervous root,using the fluoroscopic images, the impedance valuesand a sensory stimulation of a 50 Hz current. This cur-rent evokes paraesthesias on the metameric area related.

At this point we can proceed to the selective infusionof drugs and/or PRF.

Poster Presentations / Clinical – Other Treatments / European Journal of Pain 11(S1) (2007) S59–S207 S187