Chronic pain is a serious problem in Spain. This multicenter, epidemiological 3-month follow-up study investigates pain management efficacy in Spanish centers using patient satisfaction criteria. 3,414 eligible adult patients (65,6% female) with moderate to severe chronic pain from 146 pain centers were included. Patient satisfaction was assessed based onto question 18 of Spanish healthcare barometer-CSI. Pain evolution (Brief Pain Inventory-Short Form (BPI-SF) and visual analog scale (VAS)), quality of life/EuroQol-5, and pain control expectations fulfillment were also assessed. Mean age was 61.3 years. 64.4% of participating centers employed multidisciplinary pain management approach. After 3 months, mean patient satisfaction was 7.8 (1–10) on the CIS barometer. Medical staff received the highest scores, whereas waiting for tests, appointment request to appointment date time, and waiting times at the center the lowest. Mean pain decreased from 7.4 to 4.0; BPI-SF intensity decreased from 6.5 to 3.8; pain control expectations were met in 78.7% of patients; EuroQoL-5D utility index increased from 0.37 to 0.62, p < 0.001, and health status (VAS) from 40.6 to 61.9, p < 0.001. Chronic pain patients (90%) are satisfied with Spanish centers care; 80% had their pain control expectations met. Quality of life improved remarkably: 71% felt moderately to significantly better. However, waiting times need improvement.
We describe a case of a thoracic epidural abscess after epidural catheter insertion in a patient undergoing lobar segmentectomy. The patient described a "pulsatile" back pain the sixth day after surgery, and purulent material at the entry site of the catheter was observed. The image of the nuclear magnetic resonance confirmed an epidural abscess that was treated conservatively with antibiotics after a consensus decision among neurosurgery, infectious diseases an anesthesia services. The abscess was reabsorbed completely with no sequelae.
Objective: the objective of this study was to evaluate the efficacy of the lidocaine patch 5% in different types of neuropathic pain. Methods: a prospective, longitudinal, observational study on a sample of 16 patients who consulted for neuropathic pain. A lidocaine patch 5% was applied to the painful area and as primary endpoint, the severity of the pain was studied using the Verbal Numeric Rating Scale (VNRS). Secondary quality of life-related endpoints were sleep during the night, mood and patient global impression of the treatment. Results: demographic data: 62.5% female and 37.5% male; mean age 55.31 ± 13.9 years; time since onset of the pain 8.4 months; and classified into 4 diagnosis groups: post-herpetic neuralgia 18.8%; complex regional pain syndrome 25%; surgical wound 50%; and others 6.3%. There was a reduction of more than 2 points in pain on the VNRS (median 6.5 to 3.5; p = 0.001), an improvement in sleep during the night, mood and relief (p < 0.05), less use of analgesics, no complications and over 30% of subjects reported improvement of over 50%. Conclusions: The lidocaine patch 5% could be a useful tool for the control of neuropathic pain, not only for post-herpetic neuralgia, and it has a good safety and tolerability profile.
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