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508 PERSISTING PAIN 3 AND 6 MONTH AFTER UROLOGICAL SURGERY
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European Journal of Pain 2006, Vol 10 (suppl S1)
30 s. Hand pain intensity was rated by VAS (0–100) during 7 randomised stimuli without and with heterotopic foot stimulation. IBS patients with pain thresholds <95% CI of controls were defined as hypersensitive. Results: IBS patients showed somatic hypersensitivity compared to controls (ANOVA p < 0.05). 86% of IBS patients were hypersensitive to either somatic stimulation. Heterotopic stimulation decreased hand pain in controls (p < 0.05), but not in IBS. The mean change (95% CI) in hand pain due to heterotopic stimulation was +0 (−5.4– 4.4) in all IBS, +3.7 (−3.6–10.4) in hypersensitive IBS patients and −8.6 (−16.4–0) in controls (p < 0.05 vs both IBS groups). Hypersensitivity on hand, foot and abnormal heterotopic pain modulation all correlated (R > 0.91, p < 0.0001). Conclusions: A majority of IBS patients demonstrated abnormal endogenous modulation of somatic pain and somatic hypersensitivity. C30 OTHER 506 GENERALISED PAIN IS ASSOCIATED WITH MORE NEGATIVE CONSEQUENCES THAN LOCAL OR REGIONAL PAIN: A STUDY OF CHRONIC WHIPLASH ASSOCIATED DISORDERS B. B¨orsbo1,2 ° , M. Peolsson1,4 , B. Gerdle1,3 . 1 Department of Rehabilitation Medicine, INR, Faculty of Health Sciences, Link¨oping; 2 Clinical Department of Rehabilitation Medicine, County Hospital Ryhov, J¨onk¨oping; 3 Pain and Rehabilitation Centre, University Hospital, Link¨oping; 4 School for Technology and Health, Royal Institute of Technology, Stockholm, Sweden Background and Aims: The medical consequences of a whiplash trauma can be labelled whiplash-associated disorders (WAD). Persons who develop acute symptoms commonly develop a chronic condition. The aims of the present cross-sectional study were to investigate if chronic WAD with widespread pain had worse consequences with respect to other symptoms and different aspects of perceived health than chronic WAD patients with local/regional pain. Methods: 275 consecutive chronic pain patients with whiplash-associated disorders referred to a university hospital. A questionnaire covering background data, pain in different regions, symptoms not directly related to pain, Beck depression inventory, Coping Strategy Questionnaire, Life Satisfaction checklist (LiSat-11), SF-36 Health Survey and EuroQol instrument. Results: The patients were divided into three subgroups based on number of predefined anatomical regions with pain (group 1: 0–3, group 2: 4– 7 and group 3: 8–11). Spreading of pain was associated with negative consequences with respect to pain intensity, prevalence of other symptoms including depressive symptoms, some aspects of coping, life satisfaction/quality and general health. Conclusion: Our results indicate that the widespread pain subgroup of chronic WAD in different ways had a more fragile life situation than those with more local or regional pain. Based on our results we argue that a preventive perspective might be urgent. Prospective studies investigating the effect of early enhanced pain relieving efforts of local/regional pain in WAD in order to prevent pain generalization and negative consequences might be interesting. From a rehabilitation perspective a broad assessment, including spreading of pain and other symptoms, appears relevant. 507 THE RELATIONSHIP OF PAIN, FATIGUE AND QUALITY OF LIFE IN HOSPITALIZED CANCER PATIENTS S. Eyigor1 ° , O.K. Korkmaz1 , H. Karapolat1 , B. Durmaz1 , R. Uslu2 , T. K¨ose3 . 1 Ege University Faculty of Medicine Physical Therapy and Reh Dept; 2 Ege University Faculty of Medicine Tulay Aktas Oncology Hospital; 3 Ege University Faculty of Medicine Biostatistic Dept, Turkey Background and Aims: Most study of cancer pain has focused on regional pain problems. The purpose of this study was to compare the pain characteristics, fatigue and quality of life of hospitalized cancer patients with regional pain versus those with widespread pain.
Abstracts, 5th EFIC Congress, Free Presentations Methods: 122 hospitalized cancer patients were included to this study. Demographics, characteristics of the disease, as well as standardized questionnaires that measured pain (visual analog scale [VAS], verbal scale), sleep quality, disease impact (Fibromyalgia Impact Questionnaire – FIQ), fatigue (Brief Fatigue Inventory – BFI), quality of life (Short Form 36 – SF36, the European Organisation for Research and Treatment of Cancer – EORTC QLQ-C30) were gathered. Results: There were no significant differences between the pain groups on any demographic variable and characteristics of the cancer, with the exception of the metastatic patients (p > 0.05). A significant differences were found between the pain groups on sleep quality, pain severity, tender points number, EORTC QLQ-C30, FIQ and SF36 (except physical and emotional role) and fatigue scores (p < 0.05). A significant differences were also found between the different cancer types on EORTC QLQ-C30, FIQ, BFI and SF36 (mental and vitality) scores (p < 0.05). A significant relationships were found between FIQ, BFI, SF36 and EORTC QLQ-C30 scores (p < 0.05). Conclusions: This study suggest that the hospitalized cancer patients in this study who experienced widespread pain had significantly more severity of pain, fatique and pain impact and lower quality of life status than those with regional pain. A similar differences were also found between the different cancer types. 508 PERSISTING PAIN 3 AND 6 MONTH AFTER UROLOGICAL SURGERY ¨ ur2 , T. Rothe1 , F. Petzke1 , H.J. Gerbershagen1 ° , O. Dagtekin1 , E. Ozg¨ R. Sabatowski1 . 1 Department of Anesthesiology, University of Cologne; 2 Department of Urology, University of Cologne, Germany Background: Prevalence of chronic postoperative pain is high. Prevalence rates – considering the severity and burden of these pains – have not been reported. Preoperative acute and chronic pains as risk factors have not yet been studied. Methods: Urological patients completed an extensive epidemiological pain questionnaire exploring preoperative acute and chronic pains in 21 body regions. The severity of pain was determined using von Korff ’s Pain Grading Questionnaire (CPGQ). Pain chronicity was estimated employing the well validated Mainz Pain Chronicity Staging System (MPSS). Anxiety and depressive symptoms were identified with the HADS. Health related quality of life was measured using the SF-12. Results: 207 patients (age 61±11.67 years; 89.4% male). 78.7% reported on preoperative pain. Acute pain (17%) was attributed to urological disease in 28.5%. Severe dysfunctional pain identified by pain grades 3 and 4 of the CPGQ and advanced pain chronicity (MPSS) characterized by pain stages II and III were present in 46% and 10%, respectively. Chronic postsurgical pain (CPSP) defined as pain not existing preoperatively and persisting for more than 2 month after surgery, had prevalence rates of 25.3% and 13.9% after 3 and 6 month, respectively. Significant risk factors for CPSP were the intensity of pain in the immediate postoperative period, preoperative advanced pain chronicity, pain severity (dysfunctional pain grades), marked anxiety and depressive symptoms and reduced physical and mental functioning. Conclusion: The prevalence of preoperative acute and chronic pain is high. Preoperative pain and mental and physical health may be important predictors of chronic post surgical pain. 509 DIFFICULT AIRWAY – CASE REPORT K.T. Janeva ° . General Hospital Stip Macedonia, Department of Anesthesia and Intensive Care, Stip, Macedonia A difficult airway is defined as the clinical situation in which a conventionally trained anesthesiologist experiences difficulty with mask ventilation, difficulty with tracheal intubation or both. In our case we have a boy 7 years old. The boy has Dysmorphic syndrome with small mouth prognatio and lucky face and he had fiberoptic tracheal intubation when he had been operated.
European Journal of Pain 2006, Vol 10 (suppl S1)
30 s. Hand pain intensity was rated by VAS (0–100) during 7 randomised stimuli without and with heterotopic foot stimulation. IBS patients with pain thresholds <95% CI of controls were defined as hypersensitive. Results: IBS patients showed somatic hypersensitivity compared to controls (ANOVA p < 0.05). 86% of IBS patients were hypersensitive to either somatic stimulation. Heterotopic stimulation decreased hand pain in controls (p < 0.05), but not in IBS. The mean change (95% CI) in hand pain due to heterotopic stimulation was +0 (−5.4– 4.4) in all IBS, +3.7 (−3.6–10.4) in hypersensitive IBS patients and −8.6 (−16.4–0) in controls (p < 0.05 vs both IBS groups). Hypersensitivity on hand, foot and abnormal heterotopic pain modulation all correlated (R > 0.91, p < 0.0001). Conclusions: A majority of IBS patients demonstrated abnormal endogenous modulation of somatic pain and somatic hypersensitivity. C30 OTHER 506 GENERALISED PAIN IS ASSOCIATED WITH MORE NEGATIVE CONSEQUENCES THAN LOCAL OR REGIONAL PAIN: A STUDY OF CHRONIC WHIPLASH ASSOCIATED DISORDERS B. B¨orsbo1,2 ° , M. Peolsson1,4 , B. Gerdle1,3 . 1 Department of Rehabilitation Medicine, INR, Faculty of Health Sciences, Link¨oping; 2 Clinical Department of Rehabilitation Medicine, County Hospital Ryhov, J¨onk¨oping; 3 Pain and Rehabilitation Centre, University Hospital, Link¨oping; 4 School for Technology and Health, Royal Institute of Technology, Stockholm, Sweden Background and Aims: The medical consequences of a whiplash trauma can be labelled whiplash-associated disorders (WAD). Persons who develop acute symptoms commonly develop a chronic condition. The aims of the present cross-sectional study were to investigate if chronic WAD with widespread pain had worse consequences with respect to other symptoms and different aspects of perceived health than chronic WAD patients with local/regional pain. Methods: 275 consecutive chronic pain patients with whiplash-associated disorders referred to a university hospital. A questionnaire covering background data, pain in different regions, symptoms not directly related to pain, Beck depression inventory, Coping Strategy Questionnaire, Life Satisfaction checklist (LiSat-11), SF-36 Health Survey and EuroQol instrument. Results: The patients were divided into three subgroups based on number of predefined anatomical regions with pain (group 1: 0–3, group 2: 4– 7 and group 3: 8–11). Spreading of pain was associated with negative consequences with respect to pain intensity, prevalence of other symptoms including depressive symptoms, some aspects of coping, life satisfaction/quality and general health. Conclusion: Our results indicate that the widespread pain subgroup of chronic WAD in different ways had a more fragile life situation than those with more local or regional pain. Based on our results we argue that a preventive perspective might be urgent. Prospective studies investigating the effect of early enhanced pain relieving efforts of local/regional pain in WAD in order to prevent pain generalization and negative consequences might be interesting. From a rehabilitation perspective a broad assessment, including spreading of pain and other symptoms, appears relevant. 507 THE RELATIONSHIP OF PAIN, FATIGUE AND QUALITY OF LIFE IN HOSPITALIZED CANCER PATIENTS S. Eyigor1 ° , O.K. Korkmaz1 , H. Karapolat1 , B. Durmaz1 , R. Uslu2 , T. K¨ose3 . 1 Ege University Faculty of Medicine Physical Therapy and Reh Dept; 2 Ege University Faculty of Medicine Tulay Aktas Oncology Hospital; 3 Ege University Faculty of Medicine Biostatistic Dept, Turkey Background and Aims: Most study of cancer pain has focused on regional pain problems. The purpose of this study was to compare the pain characteristics, fatigue and quality of life of hospitalized cancer patients with regional pain versus those with widespread pain.
Abstracts, 5th EFIC Congress, Free Presentations Methods: 122 hospitalized cancer patients were included to this study. Demographics, characteristics of the disease, as well as standardized questionnaires that measured pain (visual analog scale [VAS], verbal scale), sleep quality, disease impact (Fibromyalgia Impact Questionnaire – FIQ), fatigue (Brief Fatigue Inventory – BFI), quality of life (Short Form 36 – SF36, the European Organisation for Research and Treatment of Cancer – EORTC QLQ-C30) were gathered. Results: There were no significant differences between the pain groups on any demographic variable and characteristics of the cancer, with the exception of the metastatic patients (p > 0.05). A significant differences were found between the pain groups on sleep quality, pain severity, tender points number, EORTC QLQ-C30, FIQ and SF36 (except physical and emotional role) and fatigue scores (p < 0.05). A significant differences were also found between the different cancer types on EORTC QLQ-C30, FIQ, BFI and SF36 (mental and vitality) scores (p < 0.05). A significant relationships were found between FIQ, BFI, SF36 and EORTC QLQ-C30 scores (p < 0.05). Conclusions: This study suggest that the hospitalized cancer patients in this study who experienced widespread pain had significantly more severity of pain, fatique and pain impact and lower quality of life status than those with regional pain. A similar differences were also found between the different cancer types. 508 PERSISTING PAIN 3 AND 6 MONTH AFTER UROLOGICAL SURGERY ¨ ur2 , T. Rothe1 , F. Petzke1 , H.J. Gerbershagen1 ° , O. Dagtekin1 , E. Ozg¨ R. Sabatowski1 . 1 Department of Anesthesiology, University of Cologne; 2 Department of Urology, University of Cologne, Germany Background: Prevalence of chronic postoperative pain is high. Prevalence rates – considering the severity and burden of these pains – have not been reported. Preoperative acute and chronic pains as risk factors have not yet been studied. Methods: Urological patients completed an extensive epidemiological pain questionnaire exploring preoperative acute and chronic pains in 21 body regions. The severity of pain was determined using von Korff ’s Pain Grading Questionnaire (CPGQ). Pain chronicity was estimated employing the well validated Mainz Pain Chronicity Staging System (MPSS). Anxiety and depressive symptoms were identified with the HADS. Health related quality of life was measured using the SF-12. Results: 207 patients (age 61±11.67 years; 89.4% male). 78.7% reported on preoperative pain. Acute pain (17%) was attributed to urological disease in 28.5%. Severe dysfunctional pain identified by pain grades 3 and 4 of the CPGQ and advanced pain chronicity (MPSS) characterized by pain stages II and III were present in 46% and 10%, respectively. Chronic postsurgical pain (CPSP) defined as pain not existing preoperatively and persisting for more than 2 month after surgery, had prevalence rates of 25.3% and 13.9% after 3 and 6 month, respectively. Significant risk factors for CPSP were the intensity of pain in the immediate postoperative period, preoperative advanced pain chronicity, pain severity (dysfunctional pain grades), marked anxiety and depressive symptoms and reduced physical and mental functioning. Conclusion: The prevalence of preoperative acute and chronic pain is high. Preoperative pain and mental and physical health may be important predictors of chronic post surgical pain. 509 DIFFICULT AIRWAY – CASE REPORT K.T. Janeva ° . General Hospital Stip Macedonia, Department of Anesthesia and Intensive Care, Stip, Macedonia A difficult airway is defined as the clinical situation in which a conventionally trained anesthesiologist experiences difficulty with mask ventilation, difficulty with tracheal intubation or both. In our case we have a boy 7 years old. The boy has Dysmorphic syndrome with small mouth prognatio and lucky face and he had fiberoptic tracheal intubation when he had been operated.