The evaluation of diagnosis and treatment of the patients who referred to the pain clinic

Yıl 2020, , 159 - 164, 01.06.2020

Tülin Arıcı , Bora Uzuner

https://doi.org/10.21601/ortadogutipdergisi.668146

Öz

Aim: The aim in this study is to evaluate retrospectively the patients who referred to the pain clinic in our hospital with pain in 45 months period with regards to pain types, demographic characteristics and treatment methods.
Material and Methods: In our study, we investigated the records of patients with chronic pain in Saglik Bilimleri University Samsun Training and Research Hospital pain clinic between July 2015-March 2019 in a cross-sectional study. Pain types, demographic characteristics and treatment methods were evaluated retrospectively.
Results: During 45 months period, it was showed that 25288 patients with chronic pain referred to the pain clinic. 16046 (63.5%) patients were female and 9242 (36.5%) patients were male. The most common causes of non-cancer pain were back pain, myofascial pain and neuropathic pain. The number of patients with cancer pain were 674 (2.7%). We observed that all of the patients had medical treatment and 3635 (14.4%) patients had both medical and interventional pain treatment. The most common interventional pain treatments methods were trigger point injection, joint injection, transforaminal epidural injection and facet median nerve block.
Conclusion: We have shown that it has been referred numerous patients in our clinic at 45 months period and interventional pain treatment has been administered to 14.4% of these patients. For this reason, we believed that these results will be an important data source for chronic pain studies.

Anahtar Kelimeler

pain, pain clinic, interventional pain treatment

Algoloji kliniğine başvuran hastaların tanı ve tedavilerinin değerlendirilmesi

Öz

Amaç: Bu çalışmadaki amacımız, hastanemiz ağrı polikliniğine 45 aylık sürede ağrı şikayeti ile başvuran hastaların demografik özellikleri, ağrı tipleri ve tedavilerini geriye dönük olarak değerlendirmektir.
Gereç ve Yöntemler: Çalışmamızda Temmuz 2015-Mart 2019 tarihleri arasında Sağlık Bilimleri Üniversitesi Samsun Eğitim ve Araştırma Hastanesi ağrı polikliniğine kronik ağrı şikayeti ile başvuran hastaların dosyaları incelendi. Hastaların demografik özellikleri, ağrı tipleri ve uygulanan tedaviler geriye dönük, kesitsel çalışma olarak değerlendirildi.
Bulgular: 45 aylık sürede polikliniğimize 25288 kronik ağrılı hastanın başvurduğu görüldü. Hastaların 16046’sı kadın (%63,5), 9242’si erkek (%36,5) olarak tespit edildi. En sık kanser dışı ağrı nedenleri (KDA); bel ağrısı, miyofasial ağrı ve nöropatik ağrı idi. Kanser ağrısı (KA) nedeni ile başvuran hasta sayısı 674 (%2,7) idi. Hastaların tamamına medikal tedavi ve 3635 (%14,4) hastaya ek olarak girişimsel ağrı tedavisi uygulandığı tespit edildi. En sık yapılan girişimsel ağrı tedavi yöntemleri; tetik nokta enjeksiyonu, eklem içi enjeksiyon uygulaması, transforaminal epidural enjeksiyon ve faset median sinir bloğu uygulaması olarak saptandı.
Sonuçlar: 45 aylık sürede algoloji kliniğimize yoğun bir hasta başvurusu olduğu ve hastaların %14,4’lük kısmına girişimsel ağrı tedavisi uygulandığı görülmüştür. Merkezimizin bu sonuçlarının kronik ağrı çalışmaları için önemli bir veri kaynağı olacağını düşünmekteyiz.

Anahtar Kelimeler

ağrı polikliniği, ağrı, girişimsel ağrı tedavileri

Kaynakça

• Reddy A, Tayjasanant S, Haider A, Heung Y, Wu J, ve ark. The opioid rotation ratio of strong opioids to transdermal fentanyl in cancer patients. Cancer. 2016 Jan 1; 122(1): 149-56. doi: 10.1002/cncr.29688. Epub 2015 Oct 9.
• Jonsdottir T, Aspelund T, Jonsdottir H, Gunnarsdottir S. The relationship between chronic pain pattern, interference with life and health-related quality of life in a nationwide community sample. Pain Manag Nurs. 2014 Sep; 15(3): 641-51. doi: 10.1016/j.pmn.2013.07.005. Epub 2013 Oct 19.
• Akdeniz S, Kelsaka E, Güldoğuş, F. Retrospective evaluation of the patients with chronic pain admitted to the algology polyclinic between 2000-2010. AĞRI 2013; 25(3): 115-22. doi: 10.5505/agri.2013.89814.
• Florence CS, Zhou C, Luo F, Xu L. The economic burden of prescription opioid overdose, abuse and dependence in the United States, 2013. Med Care. 2016; 54(10): 901-6.
• Hah JM, Bateman BT, Ratliff J, Curtin C, Sun E. Chronic Opioid Use After Surgery: Implications for Perioperative Management in the Face of the Opioid Epidemic.Anesth Analg. 2017 Nov; 125(5): 1733-40. doi: 10.1213/ANE.0000 000000002458.
• Fregoso G, Wang A, Tseng K, Wang J. Transition from Acute to Chronic Pain: Evaluating Risk for Chronic Postsurgical Pain. Pain Physician. 2019 Sep; 22(5): 479-88.
• Karaman H, Kavak GÖ. An Annual Case Analysis of Our Pain Clinic. Pam Tıp Derg 2010; 3(1): 17-22.
• Da Luz RA, de Deus JM, Valadares AL, Conde DM. Evaluation of sexual function in Brazilian women with and without chronic pelvic pain.J Pain Res. 2018 Nov 8; 11: 2761-7. doi: 10.2147/JPR.S176851.
• Walker SM. Biological and neurodevelopmental implications of neonatal pain. Clin Perinatol. 2013 Sep; 40(3): 471-91. doi: 10.1016/j.clp.2013.05.002. Epub 2013 Jul 3.
• Verriotis M, Jones L, Whitehead K, Laudiano-Dray P, Panayotidis I, ve ark. The distribution of pain activity across the human neonatal brain is sex dependent. Neuroimage. 2018 May 12. pii: S1053-8119(18)30437-3. doi: 10.1016/j.neuroimage.2018.05.030.
• Arici T, Kilic E. Retrospective Evaluation of Chronic Pain Patients Attending to Pain Clinic: Our Two Years Experiences. Bozok Med J 2019; 9(1): 22-7.
• Jackson T, Thomas S, Stabile V, Han X, Shotwell M, McQueen K. Prevalence of chronic pain in low-income and middle-income countries: a systematic review and meta-analysis. Lancet. 2015 Apr 27; 385 Suppl 2: S10. doi: 10.1016/S0140-6736(15)60805-4.
• Vowles KE, Pielech M, Edwards KA, McEntee ML, Bailey RW. A Comparative Meta-Analysis of Unidisciplinary Psychology and Interdisciplinary Treatment Outcomes Following Acceptance and Commitment Therapy for Adults with Chronic Pain J Pain. 2019 Nov 1. pii: S1526-5900(19)30841-7. doi: 10.1016/j.jpain.2019.10.004. [Epub ahead of print]
• Scott W, Daly A, Yu L, McCracken LM.Treatment of Chronic Pain for Adults 65 and Over: Analyses of Outcomes and Changes in Psychological Flexibility Following Interdisciplinary Acceptance and Commitment Therapy (ACT). Pain Med. 2017 Feb 1; 18(2): 252-64. doi: 10.1093/pm/pnw073.
• Yao M, Lei Y, Li P, Ye Q, Liu Y. Shared sensitivity to physical pain and social evaluation. J Pain. 2019 Nov 1. pii: S1526-5900(19)30844-2. doi: 10.1016/j.jpain.2019.10.007. [Epub ahead of print]
• Jean-Toussaint R, Tian Y, Chaudhuri AD, Haughey NJ, Sacan A. Proteome characterization of small extracellular vesicles from spared nerve injury model of neuropathic pain. J Proteomics. 2019 Oct 24; 211: 103540. doi: 10.1016/j.jprot.2019.103540. [Epub ahead of print]
• Prudhomme M, Legras A, Delorme C, Lansaman T, Lanteri-Minet M. Management of neuropathic pain induced by surgery: Review of the literature by a group of experts specialized in pain management, anesthesia and surgery. J Visc Surg. 2019 Oct 24. pii: S1878-7886(19)30138-9. doi: 10.1016/j.jviscsurg.2019.09.004. [Epub ahead of print]
• Voigt AW, Gould HJ. Chronic Daily Headache: Mechanisms and Principles of Management. Curr Pain Headache Rep. 2016 Feb; 20(2): 10. doi: 10.1007/s11916-016-0542-3.
• Cummings M, Baldry P.Regional myofascial pain: diagnosis and management. Best Pract Res Clin Rheumatol. 2007 Apr; 21(2): 367-87.
• Lavelle ED, Lavelle W, Smith HS.Myofascial trigger points. Med Clin North Am. 2007 Mar; 91(2): 229-39.
• Van Boxem K, van Eerd M, Brinkhuizen T, Patijn J, van Kleef M, van Zundert J. Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence. Pain Pract. 2008 Sep-Oct; 8(5): 385-93. doi: 10.1111/j.1533-2500.2008.00227.x. Epub 2008 Aug 19.
• Moisset X, Lanteri-Minet M, Fontaine D. Neurostimulation methods in the treatment of chronic pain. J Neural Transm (Vienna). 2019 Oct 21. doi: 10.1007/s00702-019-02092-y. [Epub ahead of print]
• Tagliaferri SD, Miller CT, Owen PJ, Mitchell UH, Brisby H, ve ark. Domains of chronic low back pain and assessing treatment effectiveness: A clinical perspective. Pain Pract. 2019 Oct 14. doi: 10.1111/papr.12846. [Epub ahead of print]
• Urits I, Burshtein A, Sharma M, Testa L, Gold PA, ve ark. Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Curr Pain Headache Rep. 2019 Mar 11; 23(3): 23. doi: 10.1007/s11916-019-0757-1.