Kronik Ağrılı Hastalarda Spinal Kord Stimülasyonu Uygulamasının Uyku, Yaşam Kalitesi, Anksiyete ve Depresif Semptomlar Üzerine Etkisi

Year 2024, Volume: 3 Issue: 2, 19 - 25, 25.08.2024

Sertaç Zengil , İbrahim Hakkı Tör

https://doi.org/10.61745/jsmsau.1464941

Abstract

Amaç: Bu çalışmanın amacı, bir nöromodülasyon tekniği olan omurilik stimülasyonunun (SCS) kronik ağrılı hastalarda işlem öncesi ve sonrasında uyku, yaşam kalitesi, anksiyete ve depresif belirtilerde herhangi bir değişikliğe neden olup olmadığını araştırmaktır.
Yöntem: Çalışma, tedaviye dirençli kronik nöropatik ağrı nedeniyle SCS yapılması planlanan ve tedavi öncesi konsültasyon için psikiyatri polikliniğine başvuran 14 hasta ile tamamlandı. Hastalar tedaviden önce ve tedaviden 1 ay sonra olmak üzere iki kez değerlendirildi. Hastalar LANNS Ağrı Ölçeği, Hamilton Depresyon Ölçeği (Ham-D), Hamilton Anksiyete Ölçeği (HAM-A), Pittzburg Uyku Kalitesi Envanteri (PUKI), Yaşam Kalitesi Ölçeği Kısa Formu (WHOQOL-Bref) ile değerlendirildi. Tedavi öncesi ve tedavi sonrası ölçek puanları bağımlı iki örnekli t testi kullanılarak karşılaştırıldı.
Bulgular: Olguların %85,8'inde depresif bozukluk, %71,5'inde anksiyete bozukluğu, %78,6'sında uyku bozukluğu saptandı. Olguların LANSS ağrı skalası skorları tedavi öncesi 19,00±5,11, tedavi sonrası 7,57±4,59 idi ve aradaki fark istatistiksel olarak anlamlıydı (P=,001). Ön test ve son test HAM-D, HAM-A, PUKİ, yaşam kalitesi (QoL), genel sağlık, QoL fiziksel sağlık veya QoL psikolojik sağlık puanları arasında anlamlı farklılıklar gözlendi (P=,002, P=,014, P= ,002, P=,002, P=,002 ve P=,001 sırasıyla). Ancak ön test ve son test QoL sosyal ilişkiler veya QoL çevre sağlığı puanları arasında anlamlı farklılık saptanmadı (sırasıyla P=,160 ve P=,831)
Sonuç: Bu çalışmadaki verilerimiz, SCS'nin tedaviye dirençli kronik ağrıda sadece ağrıyı etkili bir şekilde azaltmakla kalmadığını, aynı zamanda uyku kalitesi, anksiyete ve depresif durumlarda da önemli iyileşmelere aracılık ettiğini göstermektedir.

Keywords

Kronik Ağrı, Omurilik Stimülasyonu, Uyku, Yaşam Kalitesi, Anksiyete

The Effects of Spinal Cord Stimulation on Sleep, Quality of Life and Anxiety and Depressive Symptoms in Patients with Chronic Pain

Abstract

Objective: The aim of this study was to investigate whether spinal cord stimulation (SCS), a neuromodulation technique, causes any changes in sleep, quality of life, anxiety and depressive symptoms before and after the procedure in patients with chronic pain.
Methods: The study was completed with 14 patients who were planned to undergo SCS for treatment-resistant chronic neuropathic pain and who applied to the psychiatry outpatient clinic for pre-treatment consultation. Patients were evaluated twice, before and 1 month after treatment. Patients were evaluated with LANNS Pain Scale, Hamilton Depression Scale (Ham-D), Hamilton Anxiety Scale (HAM-A), Pittzburg Sleep Quality Inventory (PUKI), and Quality of Life Scale Short Form (WHOQOL-Bref). Scale scores before and after the treatment were compared using a two-sample dependent t-test.
Results: Depressive disorder was detected in 85.8% of the cases, anxiety disorder in 71.5%, and sleep disorder in 78.6%. The cases’ LANSS pain scale scores were 19.00±5.11 pre-treatment and 7.57±4.59 post-treatment, the difference being statistically significant (P=0.001). Significant differences were observed between pre- and post-test HAM-D, HAM-A, PSQI, quality of life (QoL) general health, QoL physical health, or QoL psychological health scores (P=.002, P=.014, P=.002, P=.002, P=.002, and P=.001, respectively). However, no significant differences were determined between pre- and post-test QoL social relationships or QoL environmental health scores (P=.160 and P=.831, respectively)
Conclusion: Our data in this study suggest that SCS not only effectively reduces pain in treatment-resistant chronic pain, but also mediates significant improvements in sleep quality, anxiety and depressive states.

Keywords

Chronic Pain, Spinal Cord Stimulation, Sleep, Quality of Life, Anxiety

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