题名

新冠肺炎疫情下的慢性疼痛處置考量

并列篇名

Clinical Considerations in Chronic Pain Management during the Era of COVID-19 Pandemic

DOI

10.53106/168232812022033201002

作者

林旺生(Wang-Sheng Lin);蘇府蔚(Fu-Wei Su);張祜銘(Hu-Ming Chang);王偉全(Wei-Chuan Wang);楊振亞(Chen-Ya Yang)

关键词

新冠肺炎 ; 慢性疼痛 ; 鴉片類藥物 ; 新型冠狀肺炎病毒 ; analgesics ; chronic pain ; COVID-19 ; opioid ; SARS-CoV-2

期刊名称

台灣家庭醫學雜誌

卷期/出版年月

32卷1期(2022 / 03 / 01)

页次

8 - 18

内容语文

繁體中文

中文摘要

新冠肺炎疫情自2019年末以來,自中國武漢地區迅速蔓延至世界各地,對各國的公衛和醫療量能造成巨大威脅。醫療資源的整合和重新分配成為公共衛生的一大課題,所以許多慢性疾病的處置,在疫情之下有著不同的面貌。保持社交距離和減少不必要的外出,在疫情期間是許多國家廣泛採取的防疫措施,也因此,病人因非急迫性醫療至醫院就診的意願大幅下降。慢性疼痛為一普遍的健康問題,在處理上往往需要長期的使用藥物及非藥物的治療方式,且必須定期地監控各項治療所帶來的療效和潛在副作用。疫情席捲各國的當下,就面對慢性疼痛病人的第一線醫護人員而言,是一個全新的挑戰。本篇旨在藉由文獻回顧,協助醫師和健康相關從業人員能在疫情期間,讓慢性疼痛病人持續地得到適切且有效的治療和追蹤。

英文摘要

Chronic pain is a major public health concern which not only results in impaired quality of life on the individual level but also poses a tremendous burden on the healthcare system and economy on a national scale. As the COVID-19 pandemic has greatly impacted the world since 2019, the operation of healthcare systems has changed to accommodate non-pharmacologic interventions against the COVID-19 outbreak. As a result, chronic conditions have been managed differently since the medical resources are less accessible. Chronic pain requires continuous and concerted medical attention to carefully assess the possible adverse events associated with pharmacologic interventions and to adjust the regimen accordingly. The indication for procedural interventions should also be evaluated since the pain is often fluctuating. In this article, we aim to review updated evidence-based practices of pharmacologic and non-pharmacologic interventions with a focus on clinical considerations for chronic pain management. A feasible framework is proposed for telemedicine and interdisciplinary teamwork to help facilitate continuous care during this trying time.

主题分类 醫藥衛生 > 社會醫學
参考文献
  1. Bates, D,Schultheis, BC,Hanes, MC(2019).A Comprehensive Algorithm for Management of Neuropathic Pain.Pain Med,20(Suppl 1),S2-s12.
  2. Bluthenthal, RN,Simpson, K,Ceasar, RC,Zhao, J,Wenger, L,Kral, AH(2020).Opioid withdrawal symptoms, frequency, and pain characteristics as correlates of health risk among people who inject drugs.Drug Alcohol Depend,211,107932.
  3. Brennan, F,Carr, D,Cousins, M(2016).Access to pain management-still very much a human right.Pain Med,17,1785-1789.
  4. Buhrman, M,Gordh, T,Andersson, G(2016).Internet interventions for chronic pain including headache: A systematic review.Internet Interv,4,17-34.
  5. Chakravarthy, K,Strand, N,Frosch, A(2021).recommendations and guidance for steroid injection therapy and COVID-19 vaccine administration from the American Society of Pain and Neuroscience (ASPN).J Pain Res,14,623-629.
  6. Chen, JS,Alfajaro, MM,Chow, RD(2021).Non-steroidal anti-inflammatory drugs dampen the cytokine and antibody response to SARS-CoV-2 infection.J Virol,95,e00014-e00021.
  7. Chou, R,Gordon, DB,de Leon-Casasola, OA(2016).Management of Postoperative Pain: A Clinical Practice Guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council.J Pain,17,131-157.
  8. Cimmino, MA,Ferrone, C,Cutolo, M(2011).Epidemiology of chronic musculoskeletal pain.Best Pract Res Clin Rheumatol,25,173-183.
  9. Devan, H,Farmery, D,Peebles, L,Grainger, R(2019).Evaluation of self-management support functions in apps for people with persistent pain: systematic review.JMIR Mhealth Uhealth,7,e13080.
  10. Dong, E,Du, H,Gardner, L(2020).An interactive web-based dashboard to track COVID-19 in real time.Lancet Infect Dis,20,533-534.
  11. Edwards, L,Thomas, C,Gregory, A(2014).Are people with chronic diseases interested in using telehealth? A cross-sectional postal survey.J Med Internet Res,16,e123.
  12. El-Tallawy, SN,Nalamasu, R,Pergolizzi, JV,Gharibo, C(2020).Pain Management During the COVID-19 Pandemic.Pain Ther,9,453-466.
  13. Fayaz, A,Ayis, S,Panesar, SS,Langford, RM,Donaldson, LJ(2016).Assessing the relationship between chronic pain and cardiovascular disease: A systematic review and meta-analysis.Scand J Pain,13,76-90.
  14. Franchi, S,Moschetti, G,Amodeo, G,Sacerdote, P(2019).Do all opioid drugs share the same immunomodulatory properties? a review from animal and human studies.Front Immunol,10,2914.
  15. Gaskin, DJ,Richard, P(2012).The economic costs of pain in the United States.J Pain,13,715-724.
  16. Goesling, J,Clauw, DJ,Hassett, AL(2013).Pain and depression: an integrative review of neurobiological and psychological factors.Curr Psychiatry Rep,15,421.
  17. Habib, G,Khazin, F,Jabbour, A(2014).Simultaneous bilateral knee injection of methylprednisolone acetate and the hypothalamic-pituitary adrenal axis: a single-blind case-control study.J Investig Med,62,621-626.
  18. Hassett, AL,Aquino, JK,Ilgen, MA(2014).The risk of suicide mortality in chronic pain patients.Curr Pain Headache Rep,18,436.
  19. Herbolsheimer, F,Ungar, N,Peter, R(2018).Why is social isolation among older adults associated with depressive symptoms? the mediating role of out-of-home physical activity.Int J Behav Med,25,649-657.
  20. Huang, YL,Tsay, WI,Her, SH(2020).Chronic pain and use of analgesics in the elderly: a nationwide population-based study.Arch Med Sci,16,627-634.
  21. Lee, H,Punt, JA,Miller, DC(2021).Do corticosteroid injections for the treatment of pain influence the efficacy of mrna COVID-19 vaccines?.Pain Med,22,994-1000.
  22. Malcangio, M(2019).Role of the immune system in neuropathic pain.Scand J Pain,20,33-37.
  23. Mellon, RD,Bayer, BM(1998).Evidence for central opioid receptors in the immunomodulatory effects of morphine: review of potential mechanism(s) of action.J Neuroimmunol,83,19-28.
  24. Melzack, R(2001).Pain and the neuromatrix in the brain.J Dent Educ,65,1378-1382.
  25. Mills, SEE,Nicolson, KP,Smith, BH(2019).Chronic pain: a review of its epidemiology and associated factors in population-based studies.Br J Anaesth,123,e273-e283.
  26. Nah, SY,Lee, JH,Lee, JH(2018).Effects of epidural steroid injections on bone mineral density and bone turnover markers in patients taking anti-osteoporotic medications.Pain Physician,21,E435-e447.
  27. Nahin, RL(2015).Estimates of pain prevalence and severity in adults: United States, 2012.J Pain,16,769-780.
  28. Organization WH: Pneumonia of unknown cause—China. 2020. who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/. Accessed April 1, 2020.
  29. Pergolizzi, J,Böger, RH,Budd, K(2008).Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone).Pain Pract,8,287-313.
  30. Plein, LM,Rittner, HL(2018).Opioids and the immune system - friend or foe.Br J Pharmacol,175,2717-2725.
  31. Quinten, C,Coens, C,Mauer, M(2009).Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials.Lancet Oncol,10,865-871.
  32. Rosenblum, A,Marsch, LA,Joseph, H,Portenoy, RK(2008).Opioids and the treatment of chronic pain: controversies, current status, and future directions.Exp Clin Psychopharmacol,16,405-416.
  33. Sacerdote, P(2006).Opioids and the immune system.Palliat Med,20(Suppl 1),s9-s15.
  34. Schug, SA,Palmer, GM,Scott, DA,Halliwell, R,Trinca, J(2016).Acute pain management: scientific evidence, fourth edition, 2015.Med J Aust,204,315-317.
  35. Shanthanna, H,Busse, JW,Thabane, L(2016).Local anesthetic injections with or without steroid for chronic non-cancer pain: a protocol for a systematic review and meta-analysis of randomized controlled trials.Syst Rev,5,18.
  36. Smith, J,Faux, SG,Gardner, T(2019).Reboot online: a randomized controlled trial comparing an online multidisciplinary pain management program with usual care for chronic pain.Pain Med,20,2385-2396.
  37. Soegaard Ballester, JM,Scott, MF,Owei, L,Neylan, C,Hanson, CW,Morris, JB(2018).Patient preference for time-saving telehealth postoperative visits after routine surgery in an urban setting.Surgery,163,672-679.
  38. Song, XJ,Xiong, DL,Wang, ZY,Yang, D,Zhou, L,Li, RC(2020).Pain Management During the COVID-19 Pandemic in China: Lessons Learned.Pain Med,21,1319-1323.
  39. Sytsma, TT,Greenlund, LK,Greenlund, LS(2018).Joint corticosteroid injection associated with increased influenza risk.Mayo Clin Proc Innov Qual Outcomes,2,194-198.
  40. Tsai, YF,Tsai, HH,Lai, YH,Chu, TL(2004).Pain prevalence, experiences and management strategies among the elderly in taiwanese nursing homes.J Pain Symptom Manage,28,579-584.
  41. Vallejo, R,Barkin, RL,Wang, VC(2011).Pharmacology of opioids in the treatment of chronic pain syndromes.Pain Physician,14,E343-E360.
  42. Van Boxem, K,Rijsdijk, M,Hans, G(2019).Safe use of epidural corticosteroid injections: Recommendations of the WIP Benelux Work Group.Pain Pract,19,61-92.
  43. Wang, C,Pan, R,Wan, X(2020).Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China.Int J Environ Res Public Health,17,1729.
  44. Webster, F,Rice, K,Bhattacharyya, O,Katz, J,Oosenbrug, E,Upshur, R(2019).The mismeasurement of complexity: provider narratives of patients with complex needs in primary care settings.Int J Equity Health,18,107.