Pain Management in Patients with Peripheral Arterial Disease

Yıl 2020, Cilt: 7 Sayı: 1, 12 - 17, 31.03.2020

Buket Özyaprak , Nail Kahraman , Kurtbey Anarat , Mehmet Gamlı , Gönül Erkan , Ahmet Eroğlu

https://doi.org/10.34087/cbusbed.648815

Öz

Introduction-Aim:
A chronic disease with increasing
frequency, peripheral arterial disease occurs due to atherosclerosis. Fontaine
and Rutherford classifications are common staging methods in peripheral
arterial disease. Resting pain caused by ischemia (Fontaine 3-4) adversely
affect the patient's life and their treatment is as important as the treatment
of the disease. Accurate assessment of pain also provides the right approach.
The Visual Analogue Scale and verbal descriptive pain scale are among the
various scales used in pain measurement. We aim to contribute to the literature
by evaluating our patients who were treated with pain due to peripheral
arterial disease in our hospital.

Materials
and Methods: Patients with peripheral arterial
disease who were treated for pain between January 2014 and September 2018 were
investigated retrospectively. Those with resting pain due to ischemia (Fontaine
stage 3-4) were included in the study, while Fontaine stage 1-2 patients
without pain were excluded. The data were obtained from the patient files and
hospital registry.

Results:
The mean age of the 15 patients who had pain treatment for peripheral arterial
disease was 69.13 ± 8.11 years. The patients included 7 females and 8 males. Six
stage 3 and nine stage 4 patients were identified based on Fontaine
classification. According to the verbal descriptive pain scale, 5 had mild, 7
had moderate and 3 had severe pain. One patient underwent epidural catheter
placement for administration of patient-controlled analgesia while 14 patients
received pharmacological treatment.

Conclusion:
Accurate assessment is important for appropriate
pain treatment in peripheral arterial disease. Communication with the patient
is important in this regard. Risks that may occur in the treatment of pain
should be undertaken with a multidisciplinary approach. 

Anahtar Kelimeler

: Peripheral arterial disease, pain, verbal descriptive pain scale

Kaynakça

• 1. Hirsch AT, Crigui MH, Treat-Jacobson, Regensteiner JG, Creager MA, Olin JW, Krook SH, Hunnighake DB, Comerota AJ, Walsh ME, McDermott MM, Hiatt WR. Peripheral arterial disease detection, awareness and treatment in primary care. JAMA 2001; 286 (11):1317-24.
• 2. Fried RE. Diagnosis and treatment of peripheral arterial disease. JAMA 2002; 287 (3): 315-6.
• 3. Stoffers HE, Rinkers PE, Kester AD, Kaiser V, Knottnerus JA. The prevalence of asymptomatic and unrecognized peripheral arterial occlusive disease. Int J Epideol 1996; 25 (2): 282-290.
• 4. Karabay Ö, Karaçelik M, Yılık L, Tekin N, Birtan İriz A, Kumdereli S, Gürbüz A, Çalkavur T. İskemik periferik arter hastalığı: Bir tarama çalışması. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2012;20(3): 450-457.
• 5. Bozoğlan O. Diyabetes mellitus ve periferik arter hastalığı. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 2015; 10(2): 64-67.
• 6. Yakubov SJ, Bope ET. Cardiovascular disease. In: Rakel RE (ed). Textbook of family practice. 6th edition. Philadelphia: W.B. Saunders; 2002.784.
• 7. Akdemir R, Vatan MB. 2017 Avrupa Kardiyoloji Derneği periferik arter hastalığı tanı ve tedavi klavuzunun getirdiği yenilikler. Türk Kardiyoloji Derneği Arşivi 2017; 45 (8): 681-686.
• 8. Mavioğlu L, Mungan U, Özeke Ö, Çağatay E, Özatik MA. Atipik tutulum gösteren Buerger hastalığı (tromboanjitis obliterans): Olgu sunumu. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2013;21 (4): 1039-1042.
• 9. Cattabriga I, Pacini D, Lamazza G, Talarico F, Di Bartolomeo R, Grillone G, Bacchi-Reggiani L. Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial. European Journal of Cardio-thoracic Surgery 2007: 32(3) :527-531.
• 10. Schofield P. Pain management of older people in care homes: a pilot study. Br J Nurs. 2006; 15(9): 509-14.
• 11. Türk Anesteziyoloji ve Reanimasyon Derneği (TARD) Anestezi Uygulama Klavuzları Postoperatif Ağrı Tedavisi Mart 2006.
• 12. Uyar M. Postoperatif ağrılı hastanın değerlendirilmesi, ağrı ölçümü. Yücel A. Postoperatif Analjezi. Mavimer matbacılık, İstanbul 2004,27-36.
• 13. Eti Aslan F. Ağrı değerlendirme yöntemleri. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi 2002 (6): 9-16.
• 14. Woo KY, Abbott LK, Librach L. Evidence-based approach to manage persistent wound-related pain. Current opinion in supportive and palliative care. 2013;7 (1): 86-94.
• 15. Coşkun Ö, Uzun G, Dal D, Yıldız Ş, Sönmez YA, Yurttaş Y, Güler A, Mutluoğlu M, Tekindur Ş, Sarı S, Şahin MA, Zor F, Tanyüksel M. Kronik yarada tedavi yaklaşımları. Gülhane Tıp Dergisi 2016;58: 207-228.
• 16. Takmaz SA. Girişimsel yöntemler ve antikoagülanlar. Ağrı Bülteni 2017; (2): 1-9.
• 17. Caraceni A, Hanks G, Kaasa S, Bennett MI, Brunelli C, Cherny N, Dale O, De Conno, F Fallon M, Hanna M, Haugen DF, Juhl G, King S, Klepstad P, Laugsand EA, Maltoni M, Mercandante S, Nabal M, Pigni A, Radbruch L, Reid C, Sjogren P, Stone PC, Tassinari D, Zeppetella G . Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC The Lancet Oncology. 2012; 13 (2): 58-68.
• 18. Manchikanti L, Falco FJ, Benyamin RM, Caraway DL, Kaye AD, Helm S,et al. Assesment of bleeding risk of interventional techniques: a best evidence synthesis of practice patterns and perioperative management of anticoagulant and antithrombotic therapy. Pain Physician 2013; 16 (2 Suppl): SE261-318.
• 19. Aubrun F, Kalfon F, Mottet P, Bellanger A,Langeron O, Coriat P, Riou B. Adjunctive analgesia with intravenous propacetamol does not reduce morphine British Journal of Anaesthesia; Mar 2003; 90,3; 314-9.
• 20. Remy C, Marret E, Bonnet F. Effects of acetaminophen on morphine side-effects and consuption after major surgery: meta-analysis of randomized controlled trials. British journal of anaesthesia, Apr 2005; 94 (4): 505-513.
• 21. Yonemitsu Y, Matsumoto T, Itoh H, Okazaki J, Uchiyama M, Yoshida K, et al. DVC1-0101 to treat peripheral arterial disease: A Phase I/IIa Open-label Dose escalation Clinical Trial. Moleculer therapy: The Journal of the American Society of Gene Therapy.2013: 21 (3): 707-714.
• 22. Belch J, Hiatt WR, Baumgartner I, Driver IV, Nikol S, Norgren L, et al. Effect of fibroblast growth factor NV1FGH on amputation and death: a randomised placebo-controlled trial of gene therapy in critical limb ischemia. Lancet. 2011; 377 (9781): 1929-37.