Influence of achronic pain and its treatment on subjective assessment of quality of life in patients with advanced cancer disease

Background. Appropriate clinical assessment of pain in cancer patients is a necessary requirement for establish an adequate pain management. Quality of life in the terminally ill cancer patients is used to measure as well as to show direction of operation of therapeutic group. Material and methods. In the period from July 2006 to July 2007 in the Department of Chronic Pain Treatment, Palliative Care and Clinical Pharmacology of the Jagiellonian University Medical College a group of 34 patients in the terminal phase of cancer were analyzed. Intensity of experienced pain was measured with Numeric Rating Scale (NRS) and Verbal Rating Scale (VRS). Fear, depression and aggression occurrence was measured with HADS - M scale. By the use of Rotterdam List general evaluation of quality of life and individual dimensions of quality of life. Results. Statistically significant relation between cancer pain intensity level measured and individual dimensions of quality of life. Conclusions. Our results confirmed the presence of warning a relation between intensity of pain and quality of life. They have called attention on problems of pain in a multi-directional manner and take many aspects into consideration, in order to improve care and quality of life.Background. Appropriate clinical assessment of pain in cancer patients is a necessary requirement for establish an adequate pain management. Quality of life in the terminally ill cancer patients is used to measure as well as to show direction of operation of therapeutic group. Material and methods. In the period from July 2006 to July 2007 in the Department of Chronic Pain Treatment, Palliative Care and Clinical Pharmacology of the Jagiellonian University Medical College a group of 34 patients in the terminal phase of cancer were analyzed. Intensity of experienced pain was measured with Numeric Rating Scale (NRS) and Verbal Rating Scale (VRS). Fear, depression and aggression occurrence was measured with HADS - M scale. By the use of Rotterdam List general evaluation of quality of life and individual dimensions of quality of life. Results. Statistically significant relation between cancer pain intensity level measured and individual dimensions of quality of life. Conclusions. Our results confirmed the presence of warning a relation between intensity of pain and quality of life. They have called attention on problems of pain in a multi-directional manner and take many aspects into consideration, in order to improve care and quality of life

Comparison of the efficacy of dexketoprofen and diclofenac in treatment of non-specific low back pain

Work-related loads, improper lifestyle, increasing obesity, and lack of adequate prophylaxy render low back pain (LBP) one of the most common causes of chronic pain worldwide. Objective. The aim of the study was to compare the effect of two analgesic drugs on the effectiveness of therapy measured by pain intensity. and the degree of disability during treatment of chronic low back pain syndrome Material and method. The retrospective analysis involved 185 patients undergoing treatment for chronic low back pain syndrome with dexketoprofen (DEX) and diclofenac (DIC). Patients’ gender. place of residence. cause of the pain as well as pain intensity in the visual-analogue scale (VAS) and the disability degree (Oswestry Disability Index – ODI) were analysed. Results. From the first week of treatment to the end of the observation. the DEX group exhibited significantly lower values of pain intensity on the disability index. The correlation coefficients between the parameters were significantly higher in the DEX group. Analysis of variance demonstrated that the choice of NSAIDs was the most significant factor determining the effectiveness of the treatment. Discussion. The cause of the pain and place of residence did not have any impact on the treatment efficacy. The pharmacological properties of dexketoprofen contribute to its beneficial effect on the therapy used. which validates the potential use of DEX in LBP management. Summary. The significantly increased correlation between the aforementioned parameters suggests that administration of dexketoprofen in the management of non-specific low back pain results in a more rapid return to full physical activity and therefore more prompt return to work

Subcutaneous and intravenous administration of analgesics in palliative medicine

Pain is one of the most frequent complaints reported by cancer patients. In their terminal periods, the proportion of patients suffering from pain reaches 75%. Even, the most convenient route of administration of medicines is the oral route, not every clinical situation permits the oral therapy. Alternative routes of administration of medicines, especially in palliative medicine, involve multiple injections or continuous infusions, both subcutaneous and intravenous. Most opioids (morphine, diamorphine in small doses, oxycodon, pethidine, fentanyl, tramadol) can be administered subcutaneously. There are no significant differences between the subcutaneous and intravenous (i.v.) application of medicines in terms of their absorption, efficacy and the frequency of side effects. The titration of i.v. opioids is not only an effective and rapid method of pain relief, but also is safe and unrelated to increased risk of respiratory centre depression. The role of intravenous administration of medicines increase especially at the terminal stages of cancer patients’ life. An appropriate choice of administration route or its exchange to an alternative one may in a number of cases improve the comfort and quality of life of patients receiving palliative care.Pain is one of the most frequent complaints reported by cancer patients. In their terminal periods, the proportion of patients suffering from pain reaches 75%. Even, the most convenient route of administration of medicines is the oral route, not every clinical situation permits the oral therapy. Alternative routes of administration of medicines, especially in palliative medicine, involve multiple injections or continuous infusions, both subcutaneous and intravenous. Most opioids (morphine, diamorphine in small doses, oxycodon, pethidine, fentanyl, tramadol) can be administered subcutaneously. There are no significant differences between the subcutaneous and intravenous (i.v.) application of medicines in terms of their absorption, efficacy and the frequency of side effects. The titration of i.v. opioids is not only an effective and rapid method of pain relief, but also is safe and unrelated to increased risk of respiratory centre depression. The role of intravenous administration of medicines increase especially at the terminal stages of cancer patients’ life. An appropriate choice of administration route or its exchange to an alternative one may in a number of cases improve the comfort and quality of life of patients receiving palliative care

Anatomical aspects of epidural and spinal analgesia

Regional anaesthesia seems to be the future of the anaesthesia in this century. The knowledge of the anatomy of the epidural and other spinal spaces seems to play the crucial role in success of regional anaesthesia. It's important in perioperative medicine and cancer pain treatment. Up to date there is not too many datas considering anatomy of these compartments. Many of the results obtained by researchers in the past are still not mentioned in the clinical textbooks. This article is an attempt to resolve this problem.Regional anaesthesia seems to be the future of the anaesthesia in this century. The knowledge of the anatomy of the epidural and other spinal spaces seems to play the crucial role in success of regional anaesthesia. It's important in perioperative medicine and cancer pain treatment. Up to date there is not too many datas considering anatomy of these compartments. Many of the results obtained by researchers in the past are still not mentioned in the clinical textbooks. This article is an attempt to resolve this problem