Importance of fluoroscopic assessment technique in chronic pain treatment

Abstract:

Chronic pain is the main cause of consultation at primary care medicine and the WHO estimates that it represents 80% of daily complaints; out of them, 50% are severe pain. Chronic pain originated in the spine is the most frequently observed, producing difficulties for patient daily activities; the former concept this pain is spontaneously solved in 6 weeks has been questioned because commonly relapses. According to the International Society of the Study of the Pain (IASP) a proper clinical history of the patient must be done, together with a physical examination that includes a neurological exploration as a key evaluation of the patient. Some other studies are required to identify the pain cause for making an adequate treatment approach. In chronic pain treatment the first attempt is non-invasive, including pharmacological and non-pharmacological measures. Patients suffering chronic pain, when submitted for the neural blockaded and surgical intervention are patients in great suffering and accordingly should be treated by experienced physicians. The American Society of Intervention Pain Physicians, produced in 2001 the guidelines for every procedure employed in pain treatment. Nerve blockades has been used since 1884 and should be performed under patient's consent, with an intravenous line, ECG and blood pressure monitoring, pulse oxymetry and compulsory fluoroscopic imaging with proper physician protection against Rx emissions. Lumbar epidural injections of steroids are regularly used in chronic lumbar pain and this procedure should be fluoroscopically guided to reduce the risk of accidental subarachnoidal or intravascular injection. Sacroiliac joint injection is susceptible to mistakes if it is not image-guided, as also Is the intrafacetary vertebral injection. The blockade of sympathetic ganglia requires precise fluoroscopic guidance, TAC or ecograhic images in order to accomplish this procedure with anatomic accuracy.

Año de publicación:

2009

Keywords:

• Pain
• infiltration
• Analgesia
• Fluoroscopy

Fuente:

scopus