Management of chronic pain from the anesthesiologist’s perspective
Keywords:
Chronic pain, anesthesiology, disability, NSAIDs, opioidsAbstract
El dolor crónico (DC) es un problema de salud común, complejo y sumamente estresante que genera un impacto importante en la calidad de vida. Típicamente, el DC se presenta como resultado de una lesión o una enfermedad, como el cáncer. Sin embargo, el DC genera tal malestar que puede ser catalogado como una enfermedad por sí misma, y no simplemente un síntoma acompañante de otra condición, al punto de recibir su propia definición y clasificación. El DC es un verdadero problema de salud pública, generando malestar en la vida de los pacientes que lo sufren y en los sistemas de salud. El dolor es un motivo de consulta frecuente en atención primaria y que muchas veces puede ser solucionado por un médico general. Sin embargo, el DC supone un reto tanto diagnóstico como terapéutico, requiriendo en muchas ocasiones el manejo de especialistas, particularmente el anestesiólogo. Dado el gran acervo de alternativas terapéuticas tanto invasivas como no invasivas, cada caso de DC debe ser valorado de forma particular para determinar cuál es la alternativa ideal en cada paciente. El rol del anestesiólogo en esta problemática recae sobre sus amplios conocimientos en la fisiopatología del dolor, siendo el médico de referencia para el DC.
Downloads
References
Jackson TP, Stabile VS, McQueen KAK. The Global Burden of Chronic Pain. ASA Newsletter. 1 de junio de 2014;78(6):24-7.
World Health Organization. ICD-11 for Mortality and Morbidity Statistics [Internet]. 2021 [citado 3 de julio de 2021]. Disponible en: https://icd.who.int/browse11/l-m/en
Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. septiembre de 2017;390(10100):1211-59.
Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open. mayo de 2016;6(6):e010364.
Elliott AM, Smith BH, Hannaford PC, Smith WC, Chambers WA. The course of chronic pain in the community: results of a 4-year follow-up study. Pain. septiembre de 2002;99(1):299-307.
Dahlhamer J, Lucas J, Zelaya, C, Nahin R, Mackey S, DeBar L, et al. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep. 14 de septiembre de 2018;67(36):1001-6.
Gaskin DJ, Richard P. The Economic Costs of Pain in the United States. The Journal of Pain. agosto de 2012;13(8):715-24.
Briggsl EV, Carrl ECJ, Whittakerl MS. Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom. European Journal of Pain. septiembre de 2011;15(8):789-95.
Timerbaev VK, Genov PG. [ROLE OF ANESTHESIOLOGIST IN CHRONIC PAIN MANAGEMENT]. Anesteziol Reanimatol. abril de 2016;61(2):128-30.
Nieto FR, Vuckovic SM, Prostran MS. Editorial: Mechanisms and New Targets for the Treatment of Chronic Pain. Front Pharmacol. 29 de septiembre de 2020;11:600037.
Niederberger E. Novel Insights into Molecular Mechanisms of Chronic Pain. Cells. 1 de octubre de 2020;9(10):2220.
International Association for the Study of Pain. Proposed Pain Terminology [Internet]. 2018 [citado 3 de julio de 2021]. Disponible en: http://www.iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.cfm&ContentID=1728
Gold M, Gebhart G. Nociceptor sensitization in pain pathogenesis. Nat Med . 2010;16(11):1248-57.
Woolf CJ. Central sensitization: Implications for the diagnosis and treatment of pain. Pain. marzo de 2011;152(3):S2-15.
Walsh DA, Mapp PI, Kelly S. Calcitonin gene-related peptide in the joint: contributions to pain and inflammation: CGRP and arthritis. Br J Clin Pharmacol. noviembre de 2015;80(5):965-78.
von Hehn CA, Baron R, Woolf CJ. Deconstructing the Neuropathic Pain Phenotype to Reveal Neural Mechanisms. Neuron. febrero de 2012;73(4):638-52.
Courtney CA, Fernández-de-las-Peñas C, Bond S. Mechanisms of chronic pain – key considerations for appropriate physical therapy management. Journal of Manual & Manipulative Therapy. 27 de mayo de 2017;25(3):118-27.
Takai Y, Yamamoto-Mitani N, Abe Y, Suzuki M. Literature review of pain management for people with chronic pain: Nursing strategies for chronic pain. Japan Journal of Nursing Science. julio de 2015;12(3):167-83.
Striebel HW, Toussaint S, Raab C, Klöcker N. Non-invasive methods for PCA in pain management. Acute Pain. marzo de 1999;2(1):36-40.
American Society of Anesthesiologists Task Force on Chronic Pain Management, American Society of Regional Anesthesia and Pain Medicine. Practice Guidelines for Chronic Pain Management. Anesthesiology. 1 de abril de 2010;112(4):810-33.
Pak SC, Micalos PS, Maria SJ, Lord B. Nonpharmacological Interventions for Pain Management in Paramedicine and the Emergency Setting: A Review of the Literature. Evidence-Based Complementary and Alternative Medicine. 2015;2015:e873039.
Sturgeon J. Psychological therapies for the management of chronic pain. PRBM. abril de 2014;7:115-24.
Lee MS, Ernst E. Acupuncture for pain: An overview of Cochrane reviews. Chin J Integr Med. marzo de 2011;17(3):187-9.
Macintyre PE, Australian and New Zealand College of Anaesthetists, Faculty of Pain Medicine, National Health and Medical Research Council (Australia). Acute pain management: scientific evidence. Melbourne: Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine; 2010.
Simpson PM, Fouche PF, Thomas RE, Bendall JC. Transcutaneous electrical nerve stimulation for relieving acute pain in the prehospital setting: a systematic review and meta-analysis of randomized-controlled trials. European Journal of Emergency Medicine. 2014;21(1):10-7.
da Costa BR, Reichenbach S, Keller N, Nartey L, Wandel S, Jüni P, et al. Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. The Lancet. julio de 2017;390(10090):e21-33.
Abdel Shaheed C, Ferreira GE, Dmitritchenko A, McLachlan AJ, Day RO, Saragiotto B, et al. The efficacy and safety of paracetamol for pain relief: an overview of systematic reviews. Medical Journal of Australia. abril de 2021;214(7):324-31.
Nakhaee S, Hoyte C, Dart RC, Askari M, Lamarine RJ, Mehrpour O. A review on tramadol toxicity: mechanism of action, clinical presentation, and treatment. Forensic Toxicol. julio de 2021;39(2):293-310.
Dunn KE, Bergeria CL, Huhn AS, Strain EC. A Systematic Review of Laboratory Evidence for the Abuse Potential of Tramadol in Humans. Front Psychiatry. 26 de septiembre de 2019;10:704.
Sansone RA, Sansone LA. Tramadol: seizures, serotonin syndrome, and coadministered antidepressants. Psychiatry (Edgmont). abril de 2009;6(4):17-21.
Solmaz FA, Kovalak E. Comparison of tramadol/acetaminophen fixed-dose combination, tramadol, and acetaminophen in patients undergoing ambulatory arthroscopic meniscectomy. Acta Orthopaedica et Traumatologica Turcica. mayo de 2018;52(3):222-5.
Busse JW, Wang L, Kamaleldin M, Craigie S, Riva JJ, Montoya L, et al. Opioids for Chronic Noncancer Pain: A Systematic Review and Meta-analysis. JAMA. 18 de diciembre de 2018;320(23):2448.
Park HJ, Moon DE. Pharmacologic Management of Chronic Pain. Korean J Pain. 30 de junio de 2010;23(2):99-108.
Hero JO, McMurtry C, Benson J, Blendon R. Discussing Opioid Risks with Patients to Reduce Misuse and Abuse: Evidence From 2 Surveys. The Annals of Family Medicine. 1 de noviembre de 2016;14(6):575-7.
Shaikh S, Yaacob HB, Abd Rahman RB. Lamotrigine for trigeminal neuralgia: Efficacy and safety in comparison with carbamazepine. Journal of the Chinese Medical Association. junio de 2011;74(6):243-9.
Wiffen PJ, Derry S, Moore RA, Kalso EA. Carbamazepine for chronic neuropathic pain and fibromyalgia in adults. Cochrane Pain, Palliative and Supportive Care Group, editor. Cochrane Database of Systematic Reviews. 10 de abril de 2014;2014(04):CD005451.
Wiffen PJ, Derry S, Moore RA. Lamotrigine for chronic neuropathic pain and fibromyalgia in adults. Cochrane Pain, Palliative and Supportive Care Group, editor. Cochrane Database of Systematic Reviews. 3 de diciembre de 2013;2013(12):CD006044.
Bates D, Schultheis BC, Hanes MC, Jolly SM, Chakravarthy KV, Deer TR, et al. A Comprehensive Algorithm for Management of Neuropathic Pain. Pain Medicine. 1 de junio de 2019;20(Supplement 1):S2-12.
Choi EJ, Choi YM, Jang EJ, Kim JY, Kim TK, Kim KH. Neural Ablation and Regeneration in Pain Practice. Korean J Pain. 31 de enero de 2016;29(1):3-11.
Datta S, Manchikanti L, Falco FJE, Calodney AK, Atluri S, Benyamin RM, et al. Diagnostic utility of selective nerve root blocks in the diagnosis of lumbosacral radicular pain: systematic review and update of current evidence. Pain Physician. abril de 2013;16(2 Suppl):SE97-124.
Hsu M. Significance of Clinical Treatments on Peripheral Nerve and its Effect on Nerve Regeneration. J Neurol Disord. 2014;02(04):168.
Leggett LE, Soril LJ, Lorenzetti DL, Noseworthy T, Steadman R, Tiwana S, et al. Radiofrequency Ablation for Chronic Low Back Pain: A Systematic Review of Randomized Controlled Trials. Pain Research and Management. 2014;19(5):e146-53.
Buenaventura RM, Datta S, Abdi S, Smith HS. Systematic review of therapeutic lumbar transforaminal epidural steroid injections. Pain Physician. febrero de 2009;12(1):233-51.
Adler JA, Lotz NM. Intrathecal pain management: a team-based approach. JPR. noviembre de 2017;10:2565-75.
Wallace MS. Ziconotide: a new nonopioid intrathecal analgesic for the treatment of chronic pain. Expert Review of Neurotherapeutics. octubre de 2006;6(10):1423-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 AVFT – Archivos Venezolanos de Farmacología y Terapéutica
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
