Şebnem RUMELİ, Gülçin GAZİOĞLU TÜRKYILMAZ

Türkiye’deki algolog hekimlerin, COVID-19 pandemi döneminde kronik ağrı tedavisindeki tutum değişiklikleri

Amaç: Koronavirüs hastalığı (COVID-19) pandemisi bütün dünyada kronik ağrı hastalarının ayaktan tedavi ve elektif girişimsel prosedürlerinin azaltılmasına veya kesintiye uğratıl-masına neden oldu. Bu çalışmada, pandemi döneminde Türkiye’deki algolog hekimlerin kronik ağrı hastalarının tedavilerindeki tutum değişiklikleri ve bu değişikliklerin yayımlanan kılavuzlara uygunluklarının araştırılması amaçlandı. Gereç ve Yöntem: Türkiye’de çevrim içi olarak ulaşım sağlanabilen 113 algoloji hekimine isteğe bağlı doldurulmak üzere anket gönderildi. Bulgular: Anketin ulaştırıldığı ağrı hekimlerinin %61’i (n=69) anketi cevapladı. Hiçbir girişimsel işlem öncesi hastalarından COVID- 19 polimeraz zincir reaksiyonu testi istemeyen hekimlerin oranı %48 (n=33) idi. Opiyoid reçetelerken immünsüpresif etkiyi önemsemeyen ve opiyoid dozunu azaltmayan hekimlerin oranı %42 (n=29) idi. Girişimsel işlemlerde uyguladıkları kortikosteroid dozunu azaltmayan hekimlerin oranı %61 (n=42) idi. Pandemi döneminde faset eklem median dal radyofrekans denervasyon uygulayan hekimlerin %49,1’inin (n=28) pandemi öncesine göre uyguladıkları tanısal blok sayısını azalttığı belirlendi. Bu dönemde geniküler sinir radyofrekans denervasyon uygulayan hekimlerin %51’inin (n=24) hiç tanısal blok uygulamadıkları tespit edildi. Sonuç: Ülkemizdeki ağrı hekimlerinin çoğunun pandemi döneminde kronik ağrı hastalarının tedavisinde kullandıkları opiyoid ve kortikosteroid ilaçların doz ve/veya türlerindeki tercihlerini değiştirmedikleri ancak faset eklem median dal radyofrekans denervasyon/geniküler sinir radyofrekans denervasyon girişimleri öncesi uyguladıkları tanısal blok sayılarını azaltma eğiliminde oldukları saptandı.

Attitude changes toward chronic pain management of pain physicians in Turkey during the COVID-19 pandemic

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has led to a decrease or interruption of outpatient and elective interventional procedures of patients with chronic pain worldwide. This study aims to investigate the attitude changes of pain physicians in Turkey in the treatment of chronic pain patients and the compliance of these changes with the published guidelines. Methods: A total of 113 pain physicians were sent an online questionnaire forms to be completed voluntarily. Results: The questionnaire was completed by 61% (n=69) of the total physicians to whom it was sent to. The rate of physicians who did not request the COVID-19 polymerase chain reaction test from their patients before any interventional procedure was 48% (n=33). The rate of physicians who ignored the immunosuppressive effect and while prescribing opioids and did not reduce the opioid dose was 42% (n=29). The rate of physicians who did not reduce the corticosteroid dose they used in their interventional procedures was 61% (n=42). It was determined that 49.1% (n=28) of physicians who applied facet joint medial branch radiofrequency denervation (RFD) during the pandemic period decreased the number of diagnostic blocks they applied compared to the pre-pandemic period. It was found that 51% (n=24) of the physicians who applied genicular nerve RFD during this period did not perform any diagnostic blocks. Conclusion: It was found that the majority of physicians did not change their preferences in the dose and/or type of opioid and corticosteroid drugs, but they tended to reduce the number of diagnostic blocks they applied before facet joint medial branch/genicular RFD procedures.

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