Comparison of invasive and non-invasive treatment approaches in neuropathic pain
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE, cilt.12, sa.4, ss.4064-4069, 2019 (SCI-Expanded)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 12 Sayı: 4
- Basım Tarihi: 2019
- Dergi Adı: INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED)
- Sayfa Sayıları: ss.4064-4069
- Hacettepe Üniversitesi Adresli: Evet
Özet
Patients with neuropathic pain account for 30-50% of the patients referring to pain clinics. The treatment of neuropathic pain is a difficult clinical situation in which classical analgesics and treatment methods remain inadequate and which requires interdisciplinary treatment. Neuropathic pain is usually refractory to treatment and clinicians frequently use drug combinations and sometimes invasive interventions. The aim of the present study was to measure the efficacy of invasive and non-invasive methods in patients with neuropathic pain by comparing VAS scores at the baseline of treatment, at 1st month, 2nd months, and 6th months. A total of 127 patients older than 15 who were referred to the algology section of Hacettepe University Faculty of Medicine Anesthesiology and Reanimation Department between 2005 and 2008 and who underwent treatment with invasive and non-invasive methods were included in the study. Group 1: Non-invasive group (n: 76) includes patients undergoing treatment with non-pharmacological methods such as exercise and psychotherapy and pharmacological methods such as tricyclic antidepressants, anticonvulsants, SSRI, topical and I.V. lidocain, opioids, canabinoids, NSAI, and NMDA receptor antagonists. Group 2: Invasive group (n: 51): includes patients who underwent treatment with epidural or perineural injections of local anesthetics and corticosteroids, implantation of epidural intrathecal drug administration systems, and neural ablative systems (glycerol injection to gasser ganglion or gamma knife treatment. In the distribution of VAS levels according to group during follow up period, there was no statistically significant difference between medical and invasive groups at any time interval (P>0.01), while significant intra-group differences were found in both groups at all time intervals from the baseline to 2nd year (P<0.01). In the medical treatment group, VAS levels decreased compared to baseline in all time intervals. There was significant difference between all time intervals (P<0.001). In invasive treatment group VAS levels decreased compared to baseline at all time intervals. In addition, there was significant difference between all time intervals (P<0.001). Results of the present study indicate that pharmacological options exerting analgesic effect on pain and invasive methods are essential in relieving in neuropathic pain and improving functionality and quality of life by themselves with proper indications or in combination.