Original Article

Turk J Anaesth Reanim 2014; 42: 33-9

DOI: 10.5152/TJAR.2013.58

Effects of Metastasis on Pain Treatment in Patients with Cancer-Related Pain: A Retrospective Study Yücel Zülfi Kurşun1, Fuat Yıldız2, Ömer Kaymaz3, Selami Ateş Önal4 Clinic of Anaesthesiology and Reanimation, Bingöl State Hospital, Bingöl, Turkey Clinic of Anaesthesiology and Reanimation, Harput State Hospital, Elazığ, Turkey 3 Clinic of Anaesthesiology and Reanimation, Kovancılar State Hospital, Elazığ, Turkey 4 Department of Anaesthesiology and Reanimation, Field of Algology, Faculty of Medicine, Fırat University, Elazığ, Turkey 1

Abstract

2

Objective: The goal of this study was to investigate the effect of the presence of metastases on pain treatment in patients with cancer-related pain. Methods: Of the 1736 patients who were treated in Firat University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Algology Section, for cancer-related pain between January 1997 and December 2010, 1467 with complete medical records were evaluated. Patients were grouped as having no metastasis (Group I), a single organ metastasis (Group II), or multiple organ metastasis (Group III). Results: There was no difference between the groups with regard to age. Visual Analog Pain (VAS) scores at admission were higher in Group III compared to the other groups, and significantly higher in Group I than in Group II. Analgesic ladder treatment was given to 85.5% of patients, and 14.5% were treated using additional minimally invasive analgesic intervention (MIAI) methods. In Group II and Group III, the rates of treatment in Step I and II were lower compared to Group I, while the rates of treatment in Step III were higher. Implementation of MIAI was higher in Group III than in the other groups, and higher in Group II than in Group I. Conclusion: The presence of metastases causes more severe pain, which becomes more difficult to treat, and increases the analgesia step and the consumption of opioids in patients with cancer-related pain. Key Words: Cancer, pain, metastasis, analgesics

Introduction

F

or many patients and their families diagnosed with cancer, probability of suffering from pain is the third leading feared feature of cancer after probability of incurability and death (1).

Cancer-related pain may occur with nociceptive or neuropathic mechanism and may appear as serious cancer-related pain syndrome. It may display psychiatric progression including psychological and behavioural disorders. Moreover, cancer-related pain may appear due to pre-existing chronic pain problem that resulted from tumour metastasis and cancer treatment (2, 3). In the subjects with metastasis, complications such as increase in the number of involved areas, metastasis-related neurological disorders, and vertebra fractures lead to extensive pain syndrome and increase in the intensity of pain (4). There are various therapeutic options in the treatment of cancer-related pain. The widely accepted principle recommended by the World Health Organization (WHO) is to follow the “Analgesic Stepwise Treatment” protocol within the frame of Cancer-Related Pain Treatment Program (5, 6). It has been stated that pain control is achieved with appropriate pharmacological therapy in more than 80%-85% of cancer patients and with invasive methods in the remaining in case stepwise system is accurately implemented. Thus, the goal of “none of the cancer patients should live or die with uncontrollable pain” can be achieved (6-9).

33

Address for Correspondence: Dr. Yücel Zülfi Kurşun, Clinic of Anaesthesiology and Reanimation, Bingöl State Hospital, Bingöl, Turkey Phone: +90 505 490 30 48 E-mail: [email protected] ©Copyright 2014 by Turkish Anaesthesiology and Intensive Care Society - Available online at www.jtaics.org

Received : 25.02.2013 Accepted : 01.04.2013 Available Online Date : 29.08.2013

Turk J Anaesth Reanim 2014; 42: 33-9 The present study aimed to investigate the effect of metastasis on pain treatment in oncology patients followed-up and treated for cancer-related pain.

Methods The present study was approved by the Ethics Committee for Human Researches of Fırat University Medical Faculty (Date: 10.03.2011, No: 75). The follow-up and treatment files of 1,736 patients, who presented to the Algology Section of the Anaesthesiology and Reanimation Department of Fırat University Medical Faculty between January 1997 and December 2010 for malignancy-related pain, were reviewed. Considering patient privacy, consents were obtained from the patients in order that their records could be used in the study. After excluding 269 patients due to missing data, a total of 1,467 patients were included in the study. The patients were divided into three groups according to the metastasis.

analysis of numerical data (age, presenting VAS score). Analysis of non-numerical data was performed using chi-square test. The difference between the groups was determined using Tukey HSD test as the Post-Hoc test. A p

Effects of Metastasis on Pain Treatment in Patients with Cancer-Related Pain: A Retrospective Study.

The goal of this study was to investigate the effect of the presence of metastases on pain treatment in patients with cancer-related pain...
105KB Sizes 0 Downloads 11 Views