MEHMET EMİN ORHAN, Ferruh BİLGİN, Atilla ERGİN, Kamer DERE, Mustafa Erdal GÜZELDEMİR

Kanser hastalarında WHO analjezik basamak tedavisine göre ağrı tedavisi. Bir merkezin sekiz yıllık deneyimi

Bu çalışmada, anesteziyoloji ağrı bölümüne kabul edilen kanser hastalarının ağrı tedavisinde uygulanan Dünya Sağlık Örgütünün analjezik basamak tedavisi ve diğer tedavi yöntemlerinin sonuçlarını değerlendirdik. Hasta özellikleri, hastaların kanser patolojilerine göre dağılımı, analjezik basamak tedavisine göre ilk ve son dağılımları, diğer invaziv ve noninvaziv tedavi yöntemleri, tedaviye bağlı yan etkiler ve diğer veriler incelenmiştir. 475 hastanın 416’sı (% 87.5) WHO analjezik basmak tedavisi ile, 57 hasta ise (% 12) invaziv girişimlerle tedavi edildi. 1. basamakta 49 (% 11.77), II. basamakta 307 (% 73.79), III. basamakta ise 60 (% 14.42) hasta başarı ile tedavi edilmiştir. 416 hastanın 181’i (% 43.50) antikonvülsan veya nöroleptik, 341 (%81.97) hasta ise antideprasan kullanmıştır. 31 (%7.5) hastada, analjezik basamak tedavisinin etkinliğini artırmak için non invaziv veya invaziv tedavi yöntemleri basamak tedavisine eklendi. Tüm çalışma sürecinde hastaların % 17’si yan etki bildirdi. Hastaların ortalama takip süreleri 42 ± 109.7 gün, ortalama görüşme sayıları 5.6±7.6 kez, en uzun takip süresi 1380 gün, aynı hasta ile en çok görüşme sayısı ise 68 oldu. Sonuç olarak, Dünya sağlık örgüyü analjezik basamak tedavisine sadık kalınarak, uygun hasta için uygun analjezik ve adjuvanların uygun oral dozlarının verilmesi ile hastaların büyük çoğunluğu başarı ile tedavi edilebileceği kanısındayız.

Anahtar Kelimeler:

Analjezikler, Analjezikler, opioid, Neoplazmlar, Geriyedönük çalışma, Dünya Sağlık Örgütü, Ağrı yönetimi

Pain treatment practice according to the WHO analgesic ladder in cancer patients: Eight years experience of a single center.

In this study we evaluated the results of pain treatment practices according to the World Health Organization analgesic ladder treatment. and other treatment modalities in cancer patients who were admitted to an anesthesiology-based pain service. Patient characteristics, distribution of the patients according to the primary pathologic sites, initial and last distribution of the patients according to analgesic ladder treatment, other invasive or non-invasive treatment modalities, side effects, and other data related with the patients were examined. 416 of 475 (87.5%) patients were treated using the WHO analgesic ladder treatment, 57 patients (12 %) were treated by invasive techniques. The number of successfully treated patients in step I, II and III were 49 (11.77%), 307 (73.79%) and 60 (14.42) respectively. 181 of 416 (43.50%) patients used anticonvulsants or neuroleptics, 341 of 416 (81.97%) patients used antidepressants. In 31 of 416 patients (7.5%), non-invasive or invasive treatment modalities had become necessary to augment the WHO analgesic ladder treatment. Over the entire treatment period, side effects were reported in 17.05% of the patients. The follow-up time for the patients was 42 ± 109.7 days, the mean interview number was 5.6±7.6, the longest follow-up time was 1380 days, and the maximum number of the interviews made by the same patient was 68. In conclusion, we think that, using the World Health Organization analgesic ladder treatment and administering appropriate analgesics and adjuvants in appropriate oral doses determined for appropriate subjects could successfully treat a great number of these patients.

Keywords:

Analgesics, Analgesics, Opioid, Neoplasms, Retrospective Studies, World Health Organization, Pain Management,

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