de Andrés José, de la Calle José-Luis, Pérez María, López Vanessa
Anesthesia, Critical Care, and Multidisciplinary Pain Management Department, Valencia University General Hospital, Valencia University Medical School, Valencia, Spain.
Pain Unit, Hospital Ramón y Cajal, Madrid, Spain.
Pain Res Treat. 2014;2014:518716. doi: 10.1155/2014/518716. Epub 2014 May 5.
Background. The aim of this report was to evaluate the clinical profile and previous management of patients with uncontrolled neuropathic pain who were referred to pain clinics. Methods. We included adult patients with uncontrolled pain who had a score of ≥4 in the DN4 questionnaire. In addition to sociodemographic and clinical data, we evaluated pain levels using a visual analog scale as well as anxiety, depression, sleep, disability, and treatment satisfaction employing validated tools. Results. A total of 755 patients were included in the study. The patients were predominantly referred to pain clinics by traumatologists (34.3%) and primary care physicians (16.7%). The most common diagnoses were radiculopathy (43%) and pain of oncological origin (14.3%). The major cause for uncontrolled pain was suboptimal treatment (88%). Fifty-three percent of the patients were depressed, 43% had clinical anxiety, 50% rated their overall health as bad or very bad, and 45% noted that their disease was severely or extremely interfering with their daily activities. Conclusions. Our results showed that uncontrolled neuropathic pain is a common phenomenon among the specialties that address these clinical entities and, regardless of its etiology, uncontrolled pain is associated with a dramatic impact on patient well-being.
背景。本报告旨在评估转诊至疼痛诊所的未控制的神经性疼痛患者的临床特征及既往治疗情况。方法。我们纳入了DN4问卷评分≥4分的未控制疼痛的成年患者。除社会人口统计学和临床数据外,我们使用视觉模拟量表评估疼痛程度,并使用经过验证的工具评估焦虑、抑郁、睡眠、残疾情况及治疗满意度。结果。共有755例患者纳入本研究。患者主要由创伤科医生(34.3%)和初级保健医生(16.7%)转诊至疼痛诊所。最常见的诊断为神经根病(43%)和肿瘤源性疼痛(14.3%)。疼痛未得到控制的主要原因是治疗不充分(88%)。53%的患者有抑郁,43%有临床焦虑,50%将其总体健康状况评为差或非常差,45%指出其疾病严重或极其严重地干扰了他们的日常活动。结论。我们的结果表明,未控制的神经性疼痛在处理这些临床病症的专科中是一种常见现象,并且无论其病因如何,未控制的疼痛对患者的幸福感都有巨大影响。