Radbruch L, Sonntag B, Elsner F, Loick G, Schmeisser N, Kiencke P, Sabatowski R
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Universität zu Köln.
Z Arztl Fortbild Qualitatssich. 2000 Jun;94(5):373-8.
Pain management by general practitioners often is inadequate. Guidelines for pain management are either not observed or not known at all. Opioids are not prescribed adequately. Differential diagnoses influencing the therapeutic regimen such as drug-induced headache are not sufficiently known. Monotherapies with analgesic drugs are enforced for patients with chronic lower back pain in spite of low efficacy. Improving pain management can be difficult for the general practitioner having no special knowledges or support from pain specialists. However, the general practitioner should remain the patient-coordinator for the patient with chronic pain. Networks with general practitioners and specialised units in the hospital may offer possibilities for improvement of pain management deficits.
全科医生的疼痛管理往往不足。疼痛管理指南要么未被遵守,要么根本不为人知。阿片类药物的处方不足。影响治疗方案的鉴别诊断,如药物性头痛,尚未得到充分了解。尽管疗效不佳,但对于慢性下背痛患者仍强制采用单一镇痛药治疗。对于没有专业知识或缺乏疼痛专科医生支持的全科医生来说,改善疼痛管理可能很困难。然而,全科医生仍应作为慢性疼痛患者的协调人。全科医生与医院专科单位之间的网络可能为改善疼痛管理缺陷提供机会。