Abdul-Razzak Amane, Murray Alison, Duplessis Stephan
Division of Palliative Medicine, Department of Oncology, University of Calgary, Calgary, Alberta, Canada
Division of Palliative Medicine, Department of Oncology, University of Calgary, Calgary, Alberta, Canada.
BMJ Support Palliat Care. 2022 Jul;12(e2):e171-e173. doi: 10.1136/bmjspcare-2019-001886. Epub 2019 Aug 31.
A young woman was admitted to our palliative care unit with severe pain to her right hip and leg. Her pain was uncontrolled despite aggressive use of opioids, adjuvant pain medications and spinal analgesia. She experienced significant psychological and social distress, but engaging in therapies with our multidisciplinary team proved difficult. Surgical cordotomy was pursued, which improved the physical pain and allowed her to re-engage in social and familial roles and meaningful activities. This case gives context to discuss the complex interactions between physical pain and psychosocial suffering. It is challenging to determine the relative contributions of physical, psychological, existential and social suffering, and this case highlights the complex relationships between these domains. In this case, managing the physical pain by means of a surgical cordotomy allowed the patient the opportunity to address other domains of suffering.
一名年轻女性因右髋部和腿部剧痛被收治入我们的姑息治疗病房。尽管积极使用了阿片类药物、辅助性止痛药物和脊髓镇痛法，她的疼痛仍无法得到控制。她经历了严重的心理和社会困扰，但事实证明，让她参与我们多学科团队的治疗很困难。于是进行了手术切断脊髓后根，这减轻了身体疼痛，使她能够重新承担起社会和家庭角色，并参与有意义的活动。这个案例为讨论身体疼痛与心理社会痛苦之间的复杂相互作用提供了背景。确定身体、心理、生存和社会痛苦的相对影响具有挑战性，而这个案例凸显了这些领域之间的复杂关系。在这个案例中，通过手术切断脊髓后根来控制身体疼痛，让患者有机会应对其他痛苦领域。
