Interventional Pain Management in Multidisciplinary Chronic Pain Clinics: A Prospective Multicenter Cohort Study with One-Year Follow-Up (original) (raw)

Interventional Management of Chronic Pain

Journal of Oral and Maxillofacial Surgery, 2009

Chronic non-cancer pain is a common clinical condition affecting a significant part of the population. This article aims to review the interventional options for non-cancer pain. Multiple searches using Medline were carried out and additional searches were made using reference lists of published papers and book chapters. The article discussed procedures ranging from selective nerve root or zygapophyseal (facet) joint block with local anaesthetics to irreversible neurodestruction with radiofrequency energy or neurolytic agents and neuromodulation with spinal cord stimulation. Other techniques include intraspinal delivery of analgesics. There is evidence that these interventional procedures are valuable both diagnostically and therapeutically.

Chronic Non-cancer Pain Management in a Tertiary Pain Clinic Network: a Retrospective Study

Pain and Therapy

Introduction: Chronic pain is a distressing condition that should be treated in specialized pain clinics. Pain clinics offer a holistic, evidence-based approach, including pharmacological, complementary, and invasive treatments. This study aimed to provide preliminary information regarding chronic pain treatments and identify reasons for accessing an important hub-spoke pain clinic network. Methods: A retrospective multicenter crosssectional study was carried out. A total of 1606 patients' records were included. Patients were selected from the 26 pain clinics of a single region in Italy. Univariate and multivariate logistic regression models were used. Results: Multivariate models showed that the use of opioids were considered effective for severe or moderate pain [odds ratio (OR) 0.41; 95% 0.33-0.51], while the use of invasive treatments (OR 2.45; 95% 1.95-3.06) and the use of complementary therapy (OR 1.87; 95% 1.38-2.51) were associated with severe or moderate pain. Overall, age, sex, nonsteroidal

Assessment of the Management of Patients with Chronic Pain Referred to a Specialized Pain Unit: A Cross-Sectional Multicenter Study (the DUO Project)

Journal of Clinical Medicine

A multicenter cross-sectional study was designed to assess the quality of treatment of 1190 patients with chronic pain at the time of referral to a specialized pain unit. A total of 119 physicians from 77 pain units throughout Spain collected 23 indicators of the quality of care from 10 consecutive clinical records of chronic pain patients (5 men, 5 women). Degenerative spinal diseases (38.6%) and lumbosciatic pain (29.8%) were the most common etiologies. At the time of referral to the pain unit, 9.8% of patients were not receiving any analgesic treatment. Treatment was modified in 88.1% of the patients by adding adjuvant drugs, adding opioids or increasing the doses of analgesic medications, and using analgesic techniques. Women had higher percentages of osteoarthritis, headache and fibromyalgia as the cause of pain, longer duration of pain and severe pain intensity, and a higher proportion of changes in the diagnosis of the underlying condition with which they had been referred to...

An Update on Resources, Procedures and Healthcare Provision in Pain Units: A Survey of Spanish Practitioners

International Journal of Environmental Research and Public Health

Multidisciplinary pain treatment units are recommended to provide comprehensive diagnosis and treatment of chronic pain, a complex clinical syndrome and one of the leading causes of disability worldwide. The objective of this study was to provide updated results on the situation of pain treatment units in Spain and to determine compliance with recommendations proposed by de Spanish Ministry of Health (SMH). A cross-sectional, prospective, multicenter survey was performed, collecting data on resources, procedures and healthcare provision. Between March and May 2019, the Spanish Pain Society sent an invitation letter to 183 pain units with a link to the questionnaire. Sixty-nine units from 13 regions agreed to participate. According to the International Association for the Study of Pain criteria, only 12 units were classified as multidisciplinary pain centers. Most (95.7%) were in hospitals, 82.6% from the public sector, and 46.4% had protocols to coordinate with primary care. Intervi...

Bhatia Review on US for chronic pain interventions A A 2013

BACKGROUND: Modern ultrasound (US) is an attractive alternative to anatomical landmark-,nerve stimulation-, and fluoroscopic-guided techniques for interventional procedures performed to treat chronic pain syndromes. METHODS: In this review, we evaluated the effects of US guidance compared with traditional guidance techniques on performance, efficacy, and safety outcomes for interventional chronic pain procedures. We identified 46 studies, including 41 case series and 5 randomized trials of intermediate-to-good quality that investigated the use of US guidance for a diverse variety of chronic pain procedures. RESULTS: Our results suggest that US guidance can match or improve performance- and safety-related outcomes compared with many anatomic landmark-, nerve stimulation-, and fluoroscopic-guided techniques for treating chronic pain. CONCLUSIONS: There are presently insufficient data to support improved efficacy with procedures performed with US guidance for relieving both short- and long-term chronic pain. (Anesth Analg 2013)

Pain assessment index: Evaluationfollowing multidisciplinary pain treatment

Journal of Pain and Symptom Management, 1987

The Pain Assessment Index is a weighted composite of MMPI scales which has been shown to be useful in predicting surgical outcome for chronic pain patients, hz this stud)~ 48 patients treated at a nonsurgical multidisciplinary pain clinic were categorized into predicted success (N = 23) or predicted failure (N = 25) groups based on their PAl scores. The groups did not differ on any of the pretreatment variables, and they differed on only one follow-up outcome measure. More patients in the predicted failure group reported using narcotics than did their predicted success group counterparts, hnplicatious of these results and recommendations for future research are discussed.

Practice Guidelines Interventional Techniques in the Management of Chronic Pain: Part 1.0 From The Association of Pain Management Anesthesiologists

The practice guidelines for interventional techniques in the management of chronic pain are systematically developed statements to assist practitioner and patient decisions about appropriate health care related to chronic pain. These guidelines are professionally derived recommendations for practices in the diagnosis and treatment of chronic or persistent pain. They were developed utilizing a combination of evidence and consensus to improve quality of care, increase patient access, improve patient outcomes, improve appropriateness of care, improve efficiency and effectiveness, and achieve cost containment.

Assessment and treatment at a pain clinic: A one-year follow-up of patients with chronic pain

Scandinavian Journal of Pain, 2017

Background and aims Pain is one of the most common reasons for patients to seek primary health care. Pain relief is likely to be achieved for patients suffering from acute pain, but for individuals with chronic pain it is more likely that the condition will persist. These patients have the option of being referred to specialised pain clinics. However, the complexity surrounding chronic pain patients is not well studied in these settings. This study aimed to describe patients with chronic pain referred to a pain clinic by using the information submitted during their first visit and one year later and also to identify associations between baseline characteristics and improvements in health-related quality of life in the follow-up. Methods This was a longitudinal observational study of a sample consisting of 318 patients referred to a pain clinic. One group of patients containing 271 individuals (median age 48, 64% females) was assessed and received conventional pain treatment (CPT gro...

A clinical audit of interventional pain procedures performed as part of the newly initiated pain service in a local neurosurgical centre

The Medical journal of Malaysia, 2016

Interventional Pain Procedures (IPPs) is a relatively new treatment modality for chronic pain in Malaysia. The Interventional Pain Service (IPS) newly set up in our institution is led by a pain neurosurgeon and provides a whole package of multimodal pain management including different range of IPPs. This clinical audit is to examine the quality of IPPs performed within the IPS in our institution since its initiation. A total of 87 IPPs were performed on 56 chronic pain patients over 3-year duration. As high as 81.8% of the procedures were effective and 81.5% of patients were satisfied. Only one minor transient complication occurred after an intradiscal procedure but none resulted in death or permanent disability. Thus, safe and effective IPPs can be provided as part of IPS in a local neurosurgical pain centre to bring more comprehensive and less fragmented care for chronic pain patients.