Schmerz最新文献

{"title":"[Influence of health care crises on the treatment of cancer pain: a presentation using the example of the COVID-19 pandemic from the provider's perspective].","authors":"Frederik Dombrowski, Stefan Wirz, Hannes Hofbauer, Pascal Kowark, Joachim Erlenwein, Ulrike Stamer, Kristin Kieselbach","doi":"10.1007/s00482-024-00826-w","DOIUrl":"https://doi.org/10.1007/s00482-024-00826-w","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to significantly restricted access to pain medicine services. Patients with cancer-related pain are considered a vulnerable group in terms of care deficits. A questionnaire among providers providing treatment to this group was used to assess limitations and solutions in this critical situation.</p><p><strong>Materials and methods: </strong>The online survey, developed by the 'Tumour Pain Working Group' of the German Pain Society using the Delphi method, included questions on site structure, pandemic-related care problems, and burdens experienced by those treating patients. It was distributed several times via the mailing lists of the German Pain Society and the 'Palliative Medicine Working Group' of the German Society of Anaesthesiology and Intensive Care Medicine.</p><p><strong>Results: </strong>In all, 175 fully completed questionnaires were analysed. Over 75% of participants reported pandemic-related staff shortages and closures of pain medicine facilities, with 32% of facilities temporarily not treating elective pain patients and 13% not treating any emergencies. Care was hampered by numerous logistical problems such as very frequent pandemic-related cancellations by patients or in the transmission of prescriptions. Alternative forms of consultation by telephone or telemedicine, rarely used before the pandemic, were reported by 79 and 31% of respondents respectively, but deficiencies were noted. In addition, 52.1% of respondents complained of severe and 26.8% of moderate psychological stress due to the pandemic, and 74.1% evaluated working conditions as moderately to severely difficult. Medical training was still possible for 86% through format changes.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic revealed numerous deficits in the care of patients with cancer-related pain, as well as burdens on healthcare providers. The development of new concepts could help to ensure better care in future crisis situations.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment of trigeminal neuralgia: more evidence urgently needed].","authors":"Ruth Ruscheweyh, Janne Gierthmühlen, Dennis M Hedderich, Gudrun Goßrau, Stefan Leis","doi":"10.1007/s00482-024-00821-1","DOIUrl":"https://doi.org/10.1007/s00482-024-00821-1","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Additional experience with medicinal treatment of trigeminal nerve pain].","authors":"Wolfgang Liedtke","doi":"10.1007/s00482-024-00820-2","DOIUrl":"https://doi.org/10.1007/s00482-024-00820-2","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Conservative combination therapy of sciatica due to lumbar disc herniation with mechanical physiotherapy (McKenzie), gabapentin, and transforaminal epidural injections].","authors":"Manuela Jäntsch-Rieckert, Oliver Rommel, Verena Kästner, Lotte Maercklin-Rommel, Georg Jäger","doi":"10.1007/s00482-024-00824-y","DOIUrl":"https://doi.org/10.1007/s00482-024-00824-y","url":null,"abstract":"<p><strong>Background: </strong>Treatment of sciatica due to lumbar disc herniation can be surgical or conservative. Conservative management has been described to be effective in 90% of patients; however, in most studies no consistent treatment concept was used.</p><p><strong>Objectives: </strong>In the present study, we evaluated the effect of a combined nonsurgical management (McKenzie physiotherapy, gabapentin, and periradicular injections) in 40 patients during a 10-day inpatient treatment.</p><p><strong>Methods: </strong>In addition to the neuro-orthopedic examination, pain severity at rest and after walking were assessed. The Oswestry pain disability scale, the pain severity scale, and the painDETECT scale were examined to assess neuropathic pain components. The duration of incapacity for work and the requirement of a later surgery were recorded. Examinations were performed on the day of admission, on days 3, 6, 10, and 84, 3 months after discharge.</p><p><strong>Results: </strong>During conservative treatment, a continuous reduction of pain and an improvement of the straight leg raise test as well as finger-to-floor distance could be documented. As the three treatment options were introduced with a time delay, it could be demonstrated that all significantly contributed to the improvement. All treatments were tolerated without side-effects and persistent improvement after 12 weeks. On admission, 32% of patients revealed a neuropathic pain component which decreased to 7% at the follow-up. A total of 28 patients showed impaired muscle strength on admission, which decreased to 7 patients on follow-up. Electromyography revealed pathological results in 70% of patients examined. A significant improvement of quality of life (Oswestry Disability Index [ODI]) could be observed and the patients returned to work after 5.8 weeks. Only 3/40 patients required surgical management due to persistent pain.</p><p><strong>Conclusion: </strong>The combined nonsurgical operative treatment program is effective and well tolerated.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tetrahydrocannabinol (THC) in patients with fibromyalgia syndrome (FMS) : A retrospective study of changes in pain, psychometric variables, and analgesic consumption during inpatient interdisciplinary multimodal pain therapy (IMPT)].","authors":"Horst Bettstetter, Arne Schäfer","doi":"10.1007/s00482-023-00727-4","DOIUrl":"10.1007/s00482-023-00727-4","url":null,"abstract":"<p><strong>Background: </strong>Since March 1, 2017, medical cannabis (MC) can be prescribed nationwide in Germany. To date, there have been a number of qualitatively different studies on the effectiveness of MC in fibromyalgia syndrome (FMS).</p><p><strong>Objective: </strong>The aim of the study was to investigate the effectiveness of THC in the course of interdisciplinary multimodal pain therapy (IMPT) on pain and several psychometric variables.</p><p><strong>Materials and methods: </strong>For the study, in the period 2017-2018, all patients in the pain ward of a clinic who were suffering from FMS and were treated in a multimodal interdisciplinary setting were selected based on inclusion criteria. The patients were examined separately according to groups with and without THC about pain intensity, various psychometric parameters and analgesic consumption during the stay.</p><p><strong>Results: </strong>Of the 120 FMS patients included in the study, 62 patients (51.7%) were treated with THC. In the parameters of pain intensity, depression, and quality of life, there was a significant improvement in the entire group during the stay (p < 0.001), which was significantly greater through the use of THC. In five of the seven analgesic groups examined, the dose was reduced or the drug discontinued significantly more often in the patients treated with THC.</p><p><strong>Conclusion: </strong>The results provide indications that THC can be considered as a medical alternative in addition to the substances previously recommended in various guidelines.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9964589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Benefits and harms of cannabis-based medicines from the viewpoint of patients with chronic pain and their physicians : A cohort study in three pain centers of the German federal state Saarland].","authors":"Claudia Böttge-Wolpers, Patric Bialas, Sven Gottschling, Stephanie Juckenhöfel, Dieter Konietzke, Albrecht Madlinger, Patrick Welsch, Winfried Häuser","doi":"10.1007/s00482-022-00688-0","DOIUrl":"10.1007/s00482-022-00688-0","url":null,"abstract":"<p><strong>Background: </strong>There are no studies available that have simultaneously assessed the benefits and harms of cannabis-based medicines from the viewpoint of patients and their physicians.</p><p><strong>Methods: </strong>All chronic pain patients at three pain centres in the German federal state of Saarland who had received at least one prescription of cannabis-based medicines (CbMs) in the past from the study centre were included in a cross-sectional study from January 1 to December 31, 2021. Patients and their physicians completed a self-developed questionnaire separately.</p><p><strong>Results: </strong>All 187 contacted patients participated in the study. Since the start of CbM therapy, 44.9% of patients reported to be much or very much, 43.3% to be moderately and 8.0% to be slightly improved overall. A total of 2.7% reported no change and 1.1% a moderate deterioration of overall wellbeing. From the patients' point of view, the symptoms most frequently reported to have substantially improved were sleep problems (36.4%), muscle tension (25.1%) and appetite problems (22.1%). The most frequent bothersome side effects were sweating (6.4%), concentration problems (4.2%) and nausea (4.1%). Physicians noted substantial pain relief in 60.7%, improvement of sleep in 65.7% and of mental well-being in 34.3%. A complete cessation of opioids was achieved in 64.7%, of anticonvulsants in 57.9% and of antidepressants in 60% of patients that had received these medications before the start of CbM therapy.</p><p><strong>Conclusions: </strong>CbMs can contribute to a clinically relevant reduction in pain, sleep problems and muscle tension and can improve daily functioning in carefully selected and supervised patients with chronic pain. CbM can contribute to the reduction or complete cessation of other pain medications (antidepressants, anticonvulsants, opioids).</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9116046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ganglionic opioid analgesia (GLOA) with sufentanil?]","authors":"Helmut Gockel, Philipp Stude, Christoph Maier","doi":"10.1007/s00482-024-00816-y","DOIUrl":"10.1007/s00482-024-00816-y","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Der Schmerz-education and research].","authors":"Hans-Georg Schaible, Lukas Radbruch","doi":"10.1007/s00482-024-00818-w","DOIUrl":"https://doi.org/10.1007/s00482-024-00818-w","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Adaptions of mirror therapy for phantom limb pain with telescoping phenomenon].","authors":"Marina M Finnern, Josepha Zimmer, Herta Flor","doi":"10.1007/s00482-023-00745-2","DOIUrl":"10.1007/s00482-023-00745-2","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10151518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Patient-reported outcomes in chronic diseases under treatment with cannabis medicines : Analysis of the results of the Copeia survey].","authors":"Knud Gastmeier, André Ihlenfeld, Anne Gastmeier, Garvin Hirt, Assaf Landschaft, Stefan Wirz","doi":"10.1007/s00482-024-00802-4","DOIUrl":"10.1007/s00482-024-00802-4","url":null,"abstract":"<p><strong>Background: </strong>The survey of Copeia captured early 2022 patient-reported outcomes (PRO) in Germany under cannabis medicinal product (CAM) therapy, with particular attention to symptoms, symptom changes, indications, side effects, dosages, and cost bearers.</p><p><strong>Goal: </strong>This study investigated the question of whether associations emerge from the results that could play a role in the indication and treatment monitoring of CAM in chronically ill patients.</p><p><strong>Materials and methods: </strong>A standardized questionnaire was administered online nationwide in dialogue form over a 15-week period to collect itemized symptoms and PRO. Recruitment was supported by pharmacies, prescribing physicians, and patient associations. Inclusion criteria included physician-prescribed CAM therapy.</p><p><strong>Results and discussion: </strong>Of 1582 participants, 1030 data sets (65%) could be completely analyzed. There was a heterogeneous patient population, whose common feature was disease chronicity. The frequency distribution of symptoms showed a homogeneous pattern for the respective indications, in which the most frequent six (pain 71%, sleep disturbance 64%, stress/tension 52%, inner restlessness 52%, depressive mood 44% and muscle tension 43%) seem to have a special significance. According to subjective assessment, quality of life improved significantly in 84% of all participating patients.</p><p><strong>Conclusion: </strong>A symptom matrix (SMX) composed of different symptoms seems to play a special role in CAM therapy to improve the quality of life of chronically ill patients, regardless of the underlying disease. The SMX could contribute to the identification of an indication and to targeted treatment monitoring.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}