Psychosomatic Evaluation of Chronic Pain in Patients with Malignancy and Non Malignant Pain
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 2
Abstract
Definition of chronic pain is “pain that extends beyond the expected period of healing”. Chronic pain affects the psyche of an individual apart from the physical agony that it gives [1]. The objective of this study was to evaluate the somatic and psychological aspects of chronic pain of cancer and non cancer pain using Visual Analogue Scale (VAS) [2] and General Health Questionnaire (GHQ-28) [3] and treating the psychological aspect when GHQ-28 was more than 9 with an anti depressant (imipramine) along with neurolytic blocks and analgesics (morphine for cancer patients and Pregablin for non cancer pain) A prospective study comprising of thirty patients of cancer pain (Group – C) (head and neck malignancy) and thirty patients of non cancer pain (Group N)(Trigeminal Neuralgia) of either sex between 21-90 years of age were selected. After detailed history, physical examination and proper pain mapping patients were evaluated for physical component with VAS and psychological component with GHQ-28. They were subjected to neurolytic block as per presentation and then given either morphine 30 mg b.i.d. (group C) or Tab Pregablin 75 mg b.i.d. and were followed on 3,7 and 10th day of block with VAS and GHQ-28. Tab. Imipramine 150 mg o.d. was added if GHQ-28 was found to be more than 9 on first follow up visit. There was improvement in VAS in both the groups on 2nd 3rd and 4th follow up visit. Group C showing VAS improvement of 33.61±21.9, 50.53 ±2 5.32 and 67.05 ± 23.91 while Group N showed 27.34 ± 20.86, 73.53 ± 6.58 and 89.77±25.3 respectively and these changes were statistically significant (p<0.01). The percentage improvement in GHQ-28 at subsequent sittings was 16.87±12.77, 30.87±12.88 and 41.47±14.27 for Group C (p<0.01) while in Group N it was 2.05±7.33 at all subsequent sittings (p>0.05) (absence of psychological component) VAS being a sensitive tool for assessing the improvement in pain relief and GHQ-28 helpful in detecting diagnosable changes in mental health with sensitivity of 77% and specificity of 67% in depressive disorders in patients with chronic pain are both quite helpful in assessing the severity of chronic pain and thereby helping us to guide for further action in guided management of chronic pain
Authors and Affiliations
Ashok Vats
Keywords
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- EP ID EP466174
- DOI 10.21088/ijaa.2349.8471.42(pt-II)17.7
- Views 92
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