Kliniğimizde kronik ağrı tedavisi için uygulanan girişimsel tekniklerin analizi: ilk yıl değerlendirmesi

Amaç: Kuruluşunun birinci yılında girişimsel ağrı tedavisi uygulanan hastaların kayıtlarını inceleyerek verilen hizmetleri saptamak, böylelikle hem Türkiye' de hem de dünyada yapılan diğer ağrı çalışmaları ile benzerlik ve farklılıkları ortaya koymayı amaçladık.Metod: 2009 yılında kurulan ağrı kliniğinin ilk yılında kronik ağrı tedavisi için kliniği ziyaret eden 4104 hasta içerisinden girişimsel invaziv teknik kullanılanlar tarandı. İnvaziv girişimler minor ve major olarak iki gruba ayrıldı. Poliklinikte uygulanan basit invaziv işlemler minor, ameliyathanede fluroskopi eşliğinde yapılanlar ise major olarak adlandırıldı.Bulgular: toplam 1299 hastaya girişimsel invaziv teknik uygulandı. Bunları 492 (%37.88)' si minör, 807 (%62.12)' si major invaziv teknikti. Tüm girişimsel işlemler içerisinde en sık yapılan ilk 3 işlem sırasıyla lomber epidural enjeksiyon, tetik nokta enjeksiyonu ve diz içi enjeksiyonlar olarak belirlendi (hasta sayıları sırasıyla, 364, 316 ve 238).Sonuç: Türkiye' de yaşam süresinin uzaması ile kronik ağrı çeken hasta sayısı artacağından girişimsel ağrı tedavisi uygulayan merkezlerin açılması ve yine bu tür tedavileri uygulayan hekim sayısının artırılması ağrı çeken hastalar için bir umut olacaktır.

Anahtar Kelimeler:

Girişimsel işlem, kronik ağrı, ağrı merkezi, tedavi, Türkiye

Analysis of invasive techniques used for chronic pain management in our clinic: evaluation of the first year

Purpose: We aimed to identify the services provided by our institute during one year after its inauguration reviewing the medical records of the patients given invasive pain management, and therefore, we aimed to bring forward the similarities and differences between our data and the results of pain studies performed both in Turkey and worldwide.Method: Among 4104 patients who applied to the clinic for chronic pain treatment during the first year after inauguration of the pain clinic in 2009, those performed invasive techniques were reviewed. The invasive procedures were divided into two groups-minor and major interventions. The simple invasive procedures that were performed to the ambulatory patients in policlinics were called minor interventions and those, which were performed with the help of fluoroscopy in the operating room were considered as major invasive procedures.Results: Totally 1299 patients were treated with invasive techniques. Of these invasive methods, 492 (37.88%) were minor and 807 (62.12%) were major invasive procedures. Among all invasive procedures, the most common one was the lumbar epidural injection followed by trigger point injection and intra-articular knee joint injection (numbers of patients were 364, 316 and 238, respectively).Conclusion: Since the number of patients suffering from chronic pain becomes greater as average life-span increases in Turkey, inauguration of new centers, which offer invasive pain management and enhancing the number of physicians practicing such treatment procedures, would be a prospect for the patients suffering from pain.

Keywords:

Invasive procedure, chronic pain, pain center, treatment, Turkey.,

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Ayvat PU, Aydin ON, Oğurlu M. [Sociodemographic properties and pain prevalence of patients applying to the Algology Department polyclinic of Adnan Menderes University Medical Faculty]. Agri. 2011; 23(1):28-39.
Crook J, Rideout E, Browne G. The prevalence of pain complaints in a general population. Pain. 1984; 18(3):299-314.
Badley EM, Tennant A. Changing profile of joint disorders with age: findings from a postal survey of the population of Calderdale, West Yorkshire, United Kingdom. Ann Rheum Dis. 1992; 51(3):366-71.
Cleeland CS. Undertreatment of cancer pain in elderly patients. JAMA. 1998 17; 279(23):1914-5.
Manchikanti L, Staats PS, Singh V, Schultz DM, Vilims BD, Jasper JF et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2003; 6(1):3-81.
Kaye AD, Baluch A, Scott JT. Pain management in the elderly population: a review. Ochsner J. 2010; 10(3):179-87.
Rogers MT. Development of interdisciplinary spinal interventional pain centers. Pain Physician. 2003; 6(4):527-35.
Bitton R. The economic burden of osteoarthritis. Am J Manag Care 2009; 15:230-5.
Şimşek TT, Yumin ET, Öztürk A, Serel M, Yumin M. [The Relationship Between Pain and Health Status, Mobility and Daily Life Activities in Community-Living elderly Healthy Volunteers]. Turk J Phys Med Rehab 2011; 57: 216-20.
Sawyer P, Bodner EV, Ritchie CS, Allman RM. Pain and pain medication use in community-dwelling older adults. Am J Geriatr Pharmacother 2006;4:316-24.
Miro J, Paredes S, Rull M, Queral R, Miralles R, Nieto R, et al. Pain in older adults: A prevelance study in the Meditarranean region of Catalonia. Eur J Pain 2007;11:83-92.
Bodur H. [Current review on osteoarthitis in Turkey and the world; epidemiology and socioeconomic aspect]. Turkish Journal of Geriatrics 2011 14; Suppl 1: 7-14.
Pampati S, Cash KA, Manchikanti L. Accuracy of diagnostic lumbar facet joint nerve blocks: a 2-year follow-up of 152 patients diagnosed with controlled diagnostic blocks. Pain Physician. 2009; 12(5):855-66.
Karaman H, Kavak GÖ. [An annual case analysis of our pain clinic]. Pam Med J 2010; 3(1):17-22.
Manchikanti L, Singh V, Pampati V, Smith HS, Hirsch JA. Analysis of growth of interventional techniques in managing chronic pain in the Medicare population: a 10-year evaluation from 1997 to 2006. Pain Physician. 2009; 12(1):9-34.
Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA. The epidemiology of chronic pain in the community. Lancet. 1999 9;354(9186):1248-52.
Portenoy RK, Ugarte C, Fuller I, Haas G. Population-based survey of pain in the United States: differences among white, African American, and Hispanic subjects. J Pain. 2004; 5(6):317-28.