medigraphic.com

2006, Number 1

<< Back Next >>

Rev Mex Anest 2006; 29 (1)

Trends in the diagnosis and treatment of neuropathic pain in Mexico

Guevara-López U, Covarrubias-Gómez A, Hernández-Jiménez S, Palapa GR, Acosta-Alanís FJ, Aragón G, Amescua C, Carrasco-Rojas A, Carrillo-Esper R, Cervantes P, Collado-Corona MA, Coyado G, Font-Reáulx RE, Lille FR, García-Ramos G, Guajardo-Rosas J, Hernández SR, Martínez A, Ochoa-Carrillo F, Pérez-Lascas EL, Plancarte SR, Robles-Elías J, Velásquez-Ramos J, Rodríguez-Cabrera R, Tenopala VS

Language: Spanish
References: 28
Page: 9-14
PDF size: 161.48 Kb.


ABSTRACT

Background: Neuropathic pain is difficult to define. It is associated to various conditions and injuries to the nervous system, with signs and symptoms that may or may not be related to the injured site, which makes its diagnosis more difficult. Objective: To identify the trends in diagnosis and treatment of neuropathic pain among Mexican physicians. Method: A questionnaire was submitted to a sample of 105 Mexican physicians from different specialties, living in several states across the country. Results: Out of the respondents, 61% reported treating patients with neuropathic pain, and 17% considered this the most common type of pain in their practice. Allodynia was reported as the predominant clinical feature (50%), followed by hyperesthesia (12.8%) and hyperalgesia (8.6%). As a «first line» drug treatment, 57.1% preferred anticonvulsants; 32.8%, antidepressants; 20%, NSAIDs; 18.5% weak opioids; and 5.7%, stronger opioids (the answer could include more than one type of drugs). Conclusions: Neuropathic pain is a common condition, often difficult to diagnose and to treat. Therefore, the availability of general practice guidelines for a correct clinical diagnosis and treatment would greatly improve its management.


REFERENCES

  1. Merskey H. Pain terms: A list with definitions and notes on usage. Recommended by the Subcommittee on Taxonomy. Pain 1979;6:249–52.

  2. Backonja MM. Defining neuropathic pain. Anesth Analg 2003;97:785-790.

  3. Bridges D, Thompson SWN, Rice ASC. Mechanisms of neuropathic pain. B J Anaesth 2001;87:12-26.

  4. Dworkin RH, et al. Advances in neuropathic pain. Arch Neurol 2003;60:1524-1524.

  5. Jensen TS, et al. The clinical picture of neuropathic pain. Eur J Pharmacol 2001;429:1-11.

  6. Dworkin RH. An overview of neuropathic pain: Syndromes, symptoms, signs, and several mechanisms. Clin J Pain 2002;18:343-349.

  7. Backonja MM. Painful neuropathies. En Loeser JD ed. Bonica’s: Management of pain. 3a. edition. Washington. Lippincott Williams and Wilkins. 2002:371-387.

  8. Bennett GJ. Neuropathic pain: an overview. In: Borsook D ed. Molecular neurobiology of pain. Seattle, WA: IASP Press, 1997:109–13.

  9. Schmader KE. The epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. Clin J Pain 2002;18:350–4.

  10. Bowsher D. The lifetime occurrence of herpes zoster and prevalence of postherpetic neuralgia: a retrospective survey in an elderly population. Eur J Pain 1999;3:335–42.

  11. Grond S, et al. Assessment and treatment of neuropathic cancer pain following WHO guidelines. Pain. 1999;79:15-20.

  12. U.S. Preventive Services Task Force Ratings: Strength of Recommendations and Quality of Evidence. Guide to Clinical Preventive Services, Third Edition: Periodic Updates, 2000-2003. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/3rduspstf/ratings.htm

  13. Larkins R, et al. Acute pain management: Scientific evidence. National Health and Medical Research Council. Commonwealth of Australia. 1999.

  14. Guyat GH, et al. Users’ Guides to the Medical Literature: IX. A Method for Grading Health Care Recommendations. JAMA 1995;274:1800-1804.

  15. Moreno-Altamirano L. Medicina Actual: Epidemiología y diabetes. Rev Fac Med UNAM 2001;44:35-37.

  16. Shaw JE, Zimmet PZ. The epidemiology of diabetic neuropathy. Diabetes Rev 1999;7:245-252.

  17. Loeser JD. Medical evaluation of the patient with pain. En: Bonica’s management of pain. Loeser JD, ed. LWW. Seattle. 2001:267-278.

  18. Mendell JR, Sahenk Z. Painful sensory neuropathy. New Engl J Med 2003;248:1243-1255.

  19. Millan MJ. The induction of pain: An integrative review. Prog Neurobiol 1999;57:1-164.

  20. Byers MR, Bonica JJ. Peripheral pain mechanisms and nociceptor plasticity. En: Banica’s management of pain. Loeser JD, ed. 3rd ed. LWW. Philadelphia. 2001:26-73.

  21. Sabine M, Katzenchlanger S, Scharbert G, Kozek-Langenecker S, Szeles J, et al. The short-and long-Term benefit in chronic low Back Pain through adjuvant electrical versus manual auricular acupuncture. Anesth Analg 2004;98:1359-64.

  22. Astin JA. Mind-Body Therapies for the management of Pain. Clin J Pain 2004;20:27-32.

  23. Ghoname EA, Craig WF, White PF, Ahmed HE, Hamza MA, et al. Percutaneous Electrical nerve stimulation for low Back Pain: A Randomized Crossover study. JAMA 1999;281:818-23.

  24. Eisenberg DM, Davis RB, Etner SL, et al. Trends in alternative medicine use in United States. JAMA 1998;280:1569-75.

  25. Astin JA. Complemmentary and alternative medicine and the need medicine for evidence-based criticism. Academic Med 2002;9:864-8.

  26. McQuay H, et al. Anticonvulsant drugs for management of pain: A systematic review. BMJ 1995;311:1047-1052.

  27. Backonja MM, Serra J. Pharmacologic Management Part 1: Better-Studied Neuropathic Pain Diseases. Pain Med 2004;5:s1-s24.

  28. Dellemijn P. Are opioids effective in neuropathic pain? Pain 1999;80:453-462.




2020     |     www.medigraphic.com