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S293 VERTEBRAL PAIN SYNDOME IN ELDERLY PATIENTS
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POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
S291 CHRONIC PAIN, ASSOCIATED FACTORS AND INFLUENCE ON DAILY LIFE: THERE IS DIFFERENCE BETWEEN THE SEXES? E.B.D.M. Vieira1 , J.B.S. Garcia2 *, A.A.M. Silva2 , R.L.T.M. Araujo ´ 3, R.C.S. Jansen3 . 1 Pain and Palliative Care/Academic Pain League, 2 Anesthesiology, Pain and Palliative Care, 3 Academic Pain League, Federal University of Maranh˜ ao, S˜ ao Lu´ıs, Brazil Background and Aims: Chronic pain is a public health problem. Studies suggest that the increase of chronic pain is related mainly to the female sex and although most studies have found association, few epidemiological studies have compared pain experiences between men and women. This is a cross-sectional study, a pioneer in S˜ao Lu´ıs-Brazil in order to compare men and women with chronic pain by identifying the factors associated pain characterization and influence on daily life. Methods: Given the prevalence of 25% confidence level of 95% and precision of 3% was interviewed 1597 people selected at random from the conglomerate. We used Poisson regression to analyze the risk factors. Results: In the descriptive analysis was predominantly female (66.44%), aged 18 to 29 years and brown. The prevalence of chronic pain was higher in women compared to men. Increased age was a factor associated with chronic pain in both sexes (p < 0.001). In women, schooling from 12 years of education was associated with lower prevalence (PR 0.69; 95% CI 0.53–0.90; p = 0.006) and being divorced/widowed and unemployed to a greater prevalence of chronic pain (p < 0.001). The lumbar region for men (39.47%) and head for woman (40.46%) was the most mentioned as a place of pain. There was no gender difference regarding the time and pain intensity. Conclusions: Chronic pain had a greater influence in daily life of women and generated more sadness. Disclosure: None declared
S292 PUPILLOMETRY: THE INFLUENCE OF SEX AND ANXIETY IN RESPONSE TO PAIN A.L.X. Bertrand1 , J.B.S. Garcia2 *, E.B.D.M. Vieira3 , A.M. Santos4 . 1 Ophthalmology/Pain Service, 2 Anesthesiology, Pain and Palliative Care, 3 Pain and Palliative Care/Academic Pain League, 4 Public Health, Federal University of Maranh˜ ao, S˜ ao Lu´ıs, Brazil Background and Aims: The pupillometry can be used to assess acute pain perception, because the sympathetic pathway is triggered by a nocioceptive stimulus. Studies suggest that the pain response may be influenced by factors such as gender and anxiety. Our aim was to analyze the pupillometry as an objective indicator of acute pain perception, as well as to observe the influence of sex and anxiety. Methods: We studied 96 patients divided in six groups (n = 16) according to the sex and degree of anxiety (men and women with no, mild and moderate to severe anxiety), using Beck Questionnaire. They underwent pupillometry, through retinographer in photopic conditions, while painful stimulation of pressure equivalent to 1500 kPa was carried out in the middle phalanx of the middle finger of his right hand, with the pressure algometer. Results: There was an increase in pupil diameter in response to pain in all individuals regardless of gender and anxiety (p = 0.0251). There was no statistical difference between the sexes in the absence or presence of any degree of anxiety (p = 0.614). In the presence of moderate to severe anxiety, the average pupil was higher than those individuals who did not have or had a mild degree in both sexes (p = 0.019). Men had higher average pupil than women, in the presence of moderate to severe anxiety, although this value was not statistically significant (p = 0.072).
Conclusions: There was pupil dilation in response to pain stimulus similar in both sexes. Anxiety, moderate to severe, increases the mean pupil diameters, regardless the sex. Disclosure: None declared
S293 VERTEBRAL PAIN SYNDOME IN ELDERLY PATIENTS V. Povoroznyuk *, T. Orlyk. Department of Clinical Physiology and Pathology of Locomotor Apparatus, Institute of Gerontology AMS Ukraine, Kyiv, Ukraine Background and Aims: Aim of study was determining of peculiarities of vertebral pain syndrome in elderly patients with vertebral pain syndrome depending on sex. Methods: 44 women (average age – 63.1±9.1 years, average height – 160.2±6.7 cm, average weight – 75.5±14.4 kg, BMI – 29.4±5.3) and 32 men (average age – 62.7±11.3 years, average height – 172.9±5.4 cm, average weight – 83.2±11.4 kg, BMI 27.8±3.4) were examined. The following methods of study were used: visual analogue scale (VAS), determination of life quality by Roland-Morris questionnaire, EuroQol 5D scale. Results: The intensity of thoracic vertebral pain syndrome using VAS was not differ in women and men. In lumbar spine intensity of pain syndrome (VAS) was higher in women compared with men (women – 3.5±1.8; men – 2.6±1.5; F = 1.422, p = 0.03). The life quality, according to the EuroQol 5D scale, in women with was significantly increased in comparison with men (women – 4.5±1.5; men – 3.7±1.7; F = 1.308, p = 0.04). The daily activity using Roland-Morris questionnaire was not differ between women and men (women – 8.8±5.0; men – 6.6±5.2; F = 1.079, p = 0.07). Conclusions: The intensity of vertebral pain syndrome in elderly patients depends on sex. The intensity of thoracic vertebral pain syndrome was not differ; the intensity of lumbar vertebral pain syndrome was significantly higher in elderly women compared with elderly men. Disclosure: None declared
S294 POSTOPERATIVE OPIOID AROUND THE CLOCK ADMINISTRATION IS NOT BETTER THAN AS NEEDED IN A TEACHING HOSPITAL W. Waikakul *. Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Background and Aims: Principle of postoperative pain management is the continuation of analgesia in order to prevent peak and through effect. Around the clock opioid administration is preferred than as needed (prn) technique. However, in teaching hospital, postoperative pain medications are usually prescribed by surgical residents or fellows. It is not clear that they reevaluate and readjust the analgesic doses despite guidelines. In order to document effectiveness of various postoperative analgesic administration techniques in this teaching hospital, we did survey in postsurgical wards. Methods: Survey was done in 1216 postoperative patients at; Surgical (515, 42%), Orthopedic (265, 22%), OBGYN (265, 22%) and EENT (171, 14%) wards. Pain scores by verbal numerical rating scale were recorded during rest and movement on the operative day and next day. Results: Techniques of postoperative analgesia were: intravenous, oral, IV-PCA, epidural/spinal, and peripheral nerve/plexus infusion. Regarding IV or oral analgesia, percentages of patient who received around the clock: prn in their own group were: Surgery (43:43), Orthopedic (69:11), OBGYN (53:11), and EENT (12:86). At postoperative day 1 percentage of patients who had severe pain (NRS ≥ 7) in around the clock: prn groups were 55.8:33.2 and 53.1:32.1, at rest and on movement respectively.
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
S291 CHRONIC PAIN, ASSOCIATED FACTORS AND INFLUENCE ON DAILY LIFE: THERE IS DIFFERENCE BETWEEN THE SEXES? E.B.D.M. Vieira1 , J.B.S. Garcia2 *, A.A.M. Silva2 , R.L.T.M. Araujo ´ 3, R.C.S. Jansen3 . 1 Pain and Palliative Care/Academic Pain League, 2 Anesthesiology, Pain and Palliative Care, 3 Academic Pain League, Federal University of Maranh˜ ao, S˜ ao Lu´ıs, Brazil Background and Aims: Chronic pain is a public health problem. Studies suggest that the increase of chronic pain is related mainly to the female sex and although most studies have found association, few epidemiological studies have compared pain experiences between men and women. This is a cross-sectional study, a pioneer in S˜ao Lu´ıs-Brazil in order to compare men and women with chronic pain by identifying the factors associated pain characterization and influence on daily life. Methods: Given the prevalence of 25% confidence level of 95% and precision of 3% was interviewed 1597 people selected at random from the conglomerate. We used Poisson regression to analyze the risk factors. Results: In the descriptive analysis was predominantly female (66.44%), aged 18 to 29 years and brown. The prevalence of chronic pain was higher in women compared to men. Increased age was a factor associated with chronic pain in both sexes (p < 0.001). In women, schooling from 12 years of education was associated with lower prevalence (PR 0.69; 95% CI 0.53–0.90; p = 0.006) and being divorced/widowed and unemployed to a greater prevalence of chronic pain (p < 0.001). The lumbar region for men (39.47%) and head for woman (40.46%) was the most mentioned as a place of pain. There was no gender difference regarding the time and pain intensity. Conclusions: Chronic pain had a greater influence in daily life of women and generated more sadness. Disclosure: None declared
S292 PUPILLOMETRY: THE INFLUENCE OF SEX AND ANXIETY IN RESPONSE TO PAIN A.L.X. Bertrand1 , J.B.S. Garcia2 *, E.B.D.M. Vieira3 , A.M. Santos4 . 1 Ophthalmology/Pain Service, 2 Anesthesiology, Pain and Palliative Care, 3 Pain and Palliative Care/Academic Pain League, 4 Public Health, Federal University of Maranh˜ ao, S˜ ao Lu´ıs, Brazil Background and Aims: The pupillometry can be used to assess acute pain perception, because the sympathetic pathway is triggered by a nocioceptive stimulus. Studies suggest that the pain response may be influenced by factors such as gender and anxiety. Our aim was to analyze the pupillometry as an objective indicator of acute pain perception, as well as to observe the influence of sex and anxiety. Methods: We studied 96 patients divided in six groups (n = 16) according to the sex and degree of anxiety (men and women with no, mild and moderate to severe anxiety), using Beck Questionnaire. They underwent pupillometry, through retinographer in photopic conditions, while painful stimulation of pressure equivalent to 1500 kPa was carried out in the middle phalanx of the middle finger of his right hand, with the pressure algometer. Results: There was an increase in pupil diameter in response to pain in all individuals regardless of gender and anxiety (p = 0.0251). There was no statistical difference between the sexes in the absence or presence of any degree of anxiety (p = 0.614). In the presence of moderate to severe anxiety, the average pupil was higher than those individuals who did not have or had a mild degree in both sexes (p = 0.019). Men had higher average pupil than women, in the presence of moderate to severe anxiety, although this value was not statistically significant (p = 0.072).
Conclusions: There was pupil dilation in response to pain stimulus similar in both sexes. Anxiety, moderate to severe, increases the mean pupil diameters, regardless the sex. Disclosure: None declared
S293 VERTEBRAL PAIN SYNDOME IN ELDERLY PATIENTS V. Povoroznyuk *, T. Orlyk. Department of Clinical Physiology and Pathology of Locomotor Apparatus, Institute of Gerontology AMS Ukraine, Kyiv, Ukraine Background and Aims: Aim of study was determining of peculiarities of vertebral pain syndrome in elderly patients with vertebral pain syndrome depending on sex. Methods: 44 women (average age – 63.1±9.1 years, average height – 160.2±6.7 cm, average weight – 75.5±14.4 kg, BMI – 29.4±5.3) and 32 men (average age – 62.7±11.3 years, average height – 172.9±5.4 cm, average weight – 83.2±11.4 kg, BMI 27.8±3.4) were examined. The following methods of study were used: visual analogue scale (VAS), determination of life quality by Roland-Morris questionnaire, EuroQol 5D scale. Results: The intensity of thoracic vertebral pain syndrome using VAS was not differ in women and men. In lumbar spine intensity of pain syndrome (VAS) was higher in women compared with men (women – 3.5±1.8; men – 2.6±1.5; F = 1.422, p = 0.03). The life quality, according to the EuroQol 5D scale, in women with was significantly increased in comparison with men (women – 4.5±1.5; men – 3.7±1.7; F = 1.308, p = 0.04). The daily activity using Roland-Morris questionnaire was not differ between women and men (women – 8.8±5.0; men – 6.6±5.2; F = 1.079, p = 0.07). Conclusions: The intensity of vertebral pain syndrome in elderly patients depends on sex. The intensity of thoracic vertebral pain syndrome was not differ; the intensity of lumbar vertebral pain syndrome was significantly higher in elderly women compared with elderly men. Disclosure: None declared
S294 POSTOPERATIVE OPIOID AROUND THE CLOCK ADMINISTRATION IS NOT BETTER THAN AS NEEDED IN A TEACHING HOSPITAL W. Waikakul *. Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Background and Aims: Principle of postoperative pain management is the continuation of analgesia in order to prevent peak and through effect. Around the clock opioid administration is preferred than as needed (prn) technique. However, in teaching hospital, postoperative pain medications are usually prescribed by surgical residents or fellows. It is not clear that they reevaluate and readjust the analgesic doses despite guidelines. In order to document effectiveness of various postoperative analgesic administration techniques in this teaching hospital, we did survey in postsurgical wards. Methods: Survey was done in 1216 postoperative patients at; Surgical (515, 42%), Orthopedic (265, 22%), OBGYN (265, 22%) and EENT (171, 14%) wards. Pain scores by verbal numerical rating scale were recorded during rest and movement on the operative day and next day. Results: Techniques of postoperative analgesia were: intravenous, oral, IV-PCA, epidural/spinal, and peripheral nerve/plexus infusion. Regarding IV or oral analgesia, percentages of patient who received around the clock: prn in their own group were: Surgery (43:43), Orthopedic (69:11), OBGYN (53:11), and EENT (12:86). At postoperative day 1 percentage of patients who had severe pain (NRS ≥ 7) in around the clock: prn groups were 55.8:33.2 and 53.1:32.1, at rest and on movement respectively.