CHRONIC PAIN IN THE SPINAL-CORD INJURED - STATISTICAL APPROACH AND PHARMACOLOGICAL TREATMENT

被引：67

作者：

FENOLLOSA, P

PALLARES, J

CERVERA, J

PELEGRIN, F

INIGO, V

GINER, M

FORNER, V

机构：

[1] Pain Unit, Department of Aneasthesiology, University Hospital La Fe, Valencia, 46009

[2] Spinal Cord Injury Unit, Department of Physical Medicine and Rehabilitation, University Hospital La Fe, Valencia, 46009

来源：

PARAPLEGIA | 1993年 / 31卷 / 11期

关键词：

CHRONIC PAIN; SPINAL CORD INJURY; DEAFFERENTATION PAIN; SPINAL MORPHINE; SPINAL CORD STIMULATION;

D O I：

10.1038/sc.1993.114

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

We include in this article the results of a postal inquiry into chronic pain in SCI patients in Valencia (Spain), and our experience with their management. A mailed questionaire including lesion and chronic pain data was sent to all of the 380 SCI patients who live in the region of Valencia. We received 202 answers, with 145 questionaires being accurately answered and these were analysed for this study. The results show that chronic pain (that is, lasting more than 6 months) is very common (65.5.%). The most frequent type was deafferentation pain (phantom pain), described as burning or a painful numbness. Since 1988 we have been treating a sample of 33 patients suffering from resistant pain according to the following therapies: 1 amitryptiline + clonazepan + NSAID (nonsteroidal antiinflammatory drugs); 2 amitryptiline + clonazepan + 5-OH-tryptophane + TENS (transcutaneous electrical nerve stimulation); 3 amitryptiline + clonazepan + SCS (spinal cord stimulation); 4 morphine, by continuous intrathecal infusion. After almost 4 years using these therapies we can affirm that the results regarding analgesia reached 80% in all cases, and that morphine used by intrathecal route is very safe and useful in selected patients.

引用

页码：722 / 729

页数：8

共 41 条

[1] Nepomuceno C., Fine P.R., Richards S., Et al., Pain in patients with spinal cord injury, Arch Phrs Med Rehabil, 60, pp. 605-609, (1979)
[2] Maury M., About pain and its treatment in paraplegics, Paraplegia, 15, pp. 349-354, (1978)
[3] Lami S., Chia J.K., Kohli A., Et al., Chronic pain in spinal cord injury: Comparison between inpatients and outpatients, Arch Phys Med Rehabil, 66, pp. 777-778, (1985)
[4] Guttmann L., Disturbances of sensibility, Spinal Cord Injuries, (1976)
[5] Rossier A.B., Foo D., Shilito J., Dyro F.M., Posttraumatic cervical syringomyelia, Brain, 108, pp. 439-461, (1985)
[6] Melzack R., Loeser J.D., Phantom body pain in paraplegics: Evidence for a central 'pattern generating mechanism' for pain, Pain, 4, pp. 195-210, (1978)
[7] Garcia Fernandez L., Sabate L.C., Duarte E., Et al., Dolores en lesionados medulares, Rehabilitation, 17, pp. 267-272, (1983)
[8] Davar G., Maciewicz R.J., Deafferentation pain syndromes, Neurologic Clinics. Pain:Mechanisms and Syndromes, pp. 289-304, (1989)
[9] Climent J.M., Pallares J., Pallares M.J., Et al., Tratamientodel dolor crónico en el lesionado medular, Dolorl.C.& T., 2, pp. 97-100, (1987)
[10] Dimitrijevic M.M., Spinal cord stimulation for the control of spasticity in patients with chronic spinal cord injury, Cent Nerv Syst Trauma, 3, (1986)

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