Возможности обезболивания при фотодинамической терапии

The authors consider the possibilities of pain management during photodynamic therapy (PDT) of visible tumors based on the observation of 102 patients. Of the total number of patients, 62 had verified basal cell skin cancer, 10 people - squamous cell skin cancer, another 10 - oral and oropharynx mucosa cancer, 8 - oral leukoplakia and dysplasia, in 6 - lower lip cancer, in 4 - breast cancer, in 2 - other localizations of neoplasms. In 15 patients, nonsteroidal anti-inflammatory drugs (NSAID) were used as pain management, in 69 - a combination of NSAID with tramadol, in 14 - nerve block anesthesia, in 4 - PDT was performed under general anesthesia. The intensity of pain syndrome during laser irradiation of the tumor was assessed on the verbal rating scale (VRS). The absence of pain was recorded in 9% of cases. Mild pain was noted by 58% of patients, moderate pain - 20%, severe pain - 10%, very severe pain was noted by 3% of patients.The degree of expression of pain syndrome during PDT depends on the incidence of a lesion, histological form of tumor, and method of anesthesia. NSAID alone, or in combination with an opioid analgesic, allows effective control of pain syndrome in PDT of basal cell skin cancer in 89%, in PDT of squamous cell skin cancer in 66% of observations. Nerve block anesthesia allows stoping pain syndrome during PDT of oropharyngeal tumors.Авторы рассматривают возможности обезболивания при фотодинамической терапии (ФДТ) опухолей визуальных локализаций на основе анализа данных 102 пациентов. Среди пациентов, включенных в выборку, у 62 верифицирован базальноклеточный рак кожи, у 10 - плоскоклеточный рак кожи, у 10 - рак слизистой оболочки полости рта и ротоглотки, у 8 - лейкоплакия и дисплазия слизистой оболочки полости рта, у 6 - рак нижней губы, у 4 - рак молочной железы, у 2 - новообразования иных локализаций.У 15 пациентов для обезболивания применяли нестероидные противовоспалительные препараты (НПВС), у 69 - сочетание НПВС со слабыми опиоидами (трамадолом), у 14 - проводниковую анестезию, у 4 ФДТ проводили под общим обезболиванием. Интенсивность болевого синдрома оценивалась в процессе проведения лазерного облучения опухоли по шкале вербальных оценок (ШВО). Отсутствие болевых ощущений зафиксировано в 9% наблюдений. Слабую боль отмечали в 58% наблюдений, умеренную боль – в 20%, сильную боль - в 10%, очень сильную боль - в 3% наблюдений.Степень выраженности болевого синдрома при проведении ФДТ зависит от распространенности поражения, гистологической формы опухоли и способа обезболивания. НПВС в самостоятельном варианте или в сочетании с опиоидным анальгетиком позволяют эффективно контролировать болевой синдром при ФДТ базальноклеточного рака кожи в 89%, плоскоклеточного рака кожи – в 66% наблюдений. Проводниковая анестезия позволяет купировать болевой синдром при проведении ФДТ опухолей орофарингеальной области

Possibilities of pain management during photodynamic therapy

The authors consider the possibilities of pain management during photodynamic therapy (PDT) of visible tumors based on the observation of 102 patients. Of the total number of patients, 62 had verified basal cell skin cancer, 10 people - squamous cell skin cancer, another 10 - oral and oropharynx mucosa cancer, 8 - oral leukoplakia and dysplasia, in 6 - lower lip cancer, in 4 - breast cancer, in 2 - other localizations of neoplasms. In 15 patients, nonsteroidal anti-inflammatory drugs (NSAID) were used as pain management, in 69 - a combination of NSAID with tramadol, in 14 - nerve block anesthesia, in 4 - PDT was performed under general anesthesia. The intensity of pain syndrome during laser irradiation of the tumor was assessed on the verbal rating scale (VRS). The absence of pain was recorded in 9% of cases. Mild pain was noted by 58% of patients, moderate pain - 20%, severe pain - 10%, very severe pain was noted by 3% of patients.The degree of expression of pain syndrome during PDT depends on the incidence of a lesion, histological form of tumor, and method of anesthesia. NSAID alone, or in combination with an opioid analgesic, allows effective control of pain syndrome in PDT of basal cell skin cancer in 89%, in PDT of squamous cell skin cancer in 66% of observations. Nerve block anesthesia allows stoping pain syndrome during PDT of oropharyngeal tumors