The Role of acupuncture in pain management. Guide to pain management in low-resource settings

390 Pages·2013·6.3 MB·English

Guide to Pain Management in Low-Resource Settings
Edited by Andreas Kopf and Nilesh B. Patel
INTERNATIONAL ASSOCIATION FOR THE STUDY OF PAIN®

Guide to Pain Management in Low-Resource Settings
Educational material written for general distribution
to health care providers by a multidisciplinary
and multinational team of authors
Editors
Andreas Kopf, MD
Department of Anesthesiology
Charité Medical University
Berlin, Germany
Nilesh B. Patel, PhD
Department of Medical Physiology
University of Nairobi
Nairobi, Kenya
IASP® • SEATTLE
®
© 2010 IASP
®
International Association for the Study of Pain
All rights reserved. Th is material may be used for educational and training purposes with proper citation of the source.
Not for sale or commercial use.
Timely topics in pain research and treatment have been selected for publication, but the information provided and opinions
expressed have not involved any verifi cation of the fi ndings, conclusions, and opinions by IASP®. Th us, opinions expressed in
Guide to Pain Management in Low-Resource Settings do not necessarily refl ect those of IASP or of the Offi cers and Councilors.
No responsibility is assumed by IASP for any injury and/or damage to persons or property as a matter of product liability, neg-
ligence, or from any use of any methods, products, instruction, or ideas contained in the material herein. Because of the rapid
advances in the medical sciences, the publisher recommends that there should be independent verifi cation of diagnoses and
drug dosages. Th e mention of specifi c pharmaceutical products and any medical procedure does not imply endorsement or
recommendation by the editors, authors, or IASP in favor of other medical products or procedures that are not covered in the
text. Errors and omissions are expected.
Supported by an educational grant from the International Association for the Study of Pain
A preliminary version of this text was printed in 2009
Contents
Foreword vii
Introduction ix
Basics
1. History, Defi nitions, and Contemporary Viewpoints 3
Wilfried Witte and Christoph Stein
2. Obstacles to Pain Management in Low-Resource Settings 9
Olaitan A Soyannwo
3. Physiology of Pain 13
Nilesh B. Patel
4. Psychological Factors in Chronic Pain 19
Harald C. Traue, Lucia Jerg-Bretzke, Michael Pfi ngsten, and Vladimir Hrabal
5. Ethnocultural and Sex Infl uences in Pain 27
Angela Mailis-Gagnon
6. Pharmacology of Analgesics (Excluding Opioids) 33
Kay Brune
7. Opioids in Pain Medicine 39
Michael Schäfer
8. Principles of Palliative Care 47
Lukas Radbruch and Julia Downing
9. Complementary Th erapies for Pain Management 59
Barrie Cassileth and Jyothirmai Gubili
Physical and Psychological Patient Evaluation
10. Pain History and Pain Assessment 67
Richard A. Powell, Julia Downing, Henry Ddungu, and Faith N. Mwangi-Powell
11. Physical Examination: Neurology 79
Paul Kioy and Andreas Kopf
12. Physical Examination: Orthopedics 87
Richard Fisher
13. Psychological Evaluation of the Patient with Chronic Pain 93
Claudia Schulz-Gibbins
Management of Acute Pain
14. Pain Management after Major Surgery 103
Frank Boni
15. Acute Trauma and Preoperative Pain 115
O. Aisuodionoe-Shadrach
16. Pain Management in Ambulatory/Day Surgery 119
Andrew Amata
17. Pharmacological Management of Pain in Obstetrics 123
Katarina Jankovic
iii
iv Contents
Management of Cancer Pain
18. Abdominal Cancer, Constipation, and Anorexia 137
Andreas Kopf
19. Osseous Metastasis with Incident Pain 147
M. Omar Tawfi k
20. Lung Cancer with Plexopathy 155
Rainer Sabatowski and Hans J. Gerbershagen
21. Lung Cancer with Breathing Problems 163
Th omas Jehser
22. Hematologic Cancer with Nausea and Vomiting 169
Justin Baker, Paul Ribeiro, and Javier Kane
Management of Neuropathic Pain
23. Painful Diabetic Neuropathy 179
Gaman Mohammed
24. Management of Postherpetic Neuralgia 183
Maged El-Ansary
25. Central Neuropathic Pain 189
Maija Haanpää and Aki Hietaharju
26. Th e Management of Pain in Adults and Children Living with HIV/AIDS 195
Glenda E. Gray, Fatima Laher, and Erica Lazarus
Management of Chronic Noncancer Pain
27. Chronic Nonspecifi c Back Pain 207
Mathew O.B. Olaogun and Andreas Kopf
28. Headache 213
Arnaud Fumal and Jean Schoenen
29. Rheumatic Pain 221
Ferydoun Davatchi
Diffi cult Th erapeutic Situations and Techniques
30. Dysmenorrhea, Pelvic Pain, and Endometriosis 229
Susan Evans
31. Pain Management Considerations in Pregnancy and Breastfeeding 235
Michael Paech
32. Pain in Sickle Cell Disease 245
Paula Tanabe and Knox H. Todd
33. Complex Regional Pain Syndrome 249
Andreas Schwarzer and Christoph Maier
34. Pain Management in Children 255
Dilip Pawar and Lars Garten
35. Pain in Old Age and Dementia 269
Andreas Kopf
36. Breakthrough Pain, the Pain Emergency, and Incident Pain 277
Gona Ali and Andreas Kopf
37. Pain Management in the Intensive Care Unit 283
Josephine M. Th orp and Sabu James
38. Diagnostic and Prognostic Nerve Blocks 293
Steven D. Waldman
Contents v
39. Post-Dural Puncture Headache 299
Winfried Meissner
40. Cytoreductive Radiation Th erapy 303
Lutz Moser
41. Th e Role of Acupuncture in Pain Management 307
Natalia Samoilova and Andreas Kopf
Planning and Organizing Pain Management
42. Setting up a Pain Management Program 317
M.R. Rajagopal
43. Resources for Ensuring Opioid Availability 321
David E. Joranson
44. Setting up Guidelines for Local Requirements 329
Uriah Guevara-Lopez and and Alfredo Covarrubias-Gomez
Pearls of Wisdom
45. Techniques for Commonly Used Nerve Blocks 337
Corrie Avenant
46. Psychological Pearls in Pain Management 341
Claudia Schulz-Gibbins
47. Clinical Physiology Pearls 345
Rolf-Detlef Treede
48. Herbal and Other Supplements 349
Joel Gagnier
49. Profi les, Doses, and Side Eff ects of Drugs Commonly Used in Pain Management 351
Barbara Schlisio
Appendix
Glossary 359
Andreas Kopf

Foreword
Th e belief that pain treatment is a human right has been therefore, that 91% said that lack of education was the
accepted by many for a long time, but in 2004 the state- main barrier to good pain management in their part of
ment that “the relief of pain should be a human right” the world.
was felt to be of suffi cient importance for it to be pub- It is clear that in many developing countries, re-
lished following the launch of the fi rst Global Campaign lief of pain is not a priority, and that concern with infec-
Against Pain in Geneva in 2004 by the International tious diseases such as malaria, tuberculosis, and above
Association of Pain (IASP), the European Federation all HIV/AIDS takes precedence. In fact, 75% of those
of Chapters of the IASP (EFIC), and the World Health who responded to the IASP survey considered a lack of
Organization (WHO). Unfortunately, however, a large government priorities for pain management as the sec-
number of those who suff er pain, and especially the ond most common barrier to good treatment. Almost as
people of developing countries, do not receive treat- many reported that a fear of addiction to opioids among
ment for acute and, more especially, chronic pain. doctors, nurses, and health providers was a barrier to
Th ere are various reasons for this problem, the availability and use of those drugs, although, in fact,
which include a lack of adequately trained health pro- such fear is primarily a consequence of poor education.
fessionals, the unavailability of drugs, especially opi- Th e production of this manual is timely because
oids, and a fear of using opioids because there is an it will fi ll a major gap in the knowledge of those who
erroneous belief that inevitably the use of these drugs deal with people in pain in developing countries. It cov-
will cause addiction. Th e fi rst major step in improv- ers the basic science of pain, and perhaps uniquely, the
ing services for pain patients is to provide an educated rationale for the use of natural medicines. It also pro-
workforce in developing countries—not only doctors vides background knowledge and advice on the man-
and nurses, but district offi cers and other health work- agement of the major painful disorders occurring in de-
ers. A survey by IASP in 2007 revealed that among its veloping countries, including the two major scourges of
members in developing countries, very few believed the present time—cancer and HIV/AIDS.
they had received an adequate education in the under- Th is is a book that should be available to all
standing and management of pain as undergraduates. who are responsible for providing treatment for pain,
In most regions of the world, less than half had been whether acute or chronic, and whether they work in
trained in pain management, even though it was a sig- cities, towns, or in a much more rural settings, because
nifi cant part of their daily work. It is not surprising, all will fi nd it an invaluable aid to their practice.
Professor Sir Michael Bond
Glasgow, Scotland
August 2009
vii