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S505 ASSOCIATION BETWEEN COLD PAIN SENSITIVITY AND PERSISTENT POST-SURGICAL PAIN. THE TROMSØ STUDY
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POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
lymphodema), 53% muscular or, bones pain and 17% felt pain during sexual intercourse. Univariate and multivariate analyses show that medical, physical and psychological factors are associated with self reported pain experience. Conclusion: Half breast cancer survivors experienced long term chronic pain. Our data suggest that physicians have to take into account during follow-up social and psychological factors that could generate and maintain pain experience in cancer survivors.
S506 FREQUENCY AND CHARACTERISTICS OF BREAKTHROUGH PAIN IN PATIENTS WITH CHRONIC NON-CANCER PAIN P.B. Malieno1 , K.A.S.L. Ferreira1,2,3 *, R.B. Costa1 , M.J. Teixeira1 . 1 Multidisciplinary Pain Center – Department of Neurology, Hospital das Clinicas – School of Medicine – University of S˜ ao Paulo, 2 School of Nursing, University of Guarulhos (UnG), 3 Instituto do Cancer do Estado de S˜ ao Paulo (ICESP), S˜ ao Paulo, Brazil
Disclosure: None declared
Background: The breakthrough pain (BTP), also called incidental or episodic pain, is reported by 40–80% of cancer patients. The frequency and characteristics of BTP in patients with chronic noncancer pain (CNCP) is not well known. Aims: To evaluate the frequency and characteristics of BTP in patients with CNCP. Methods: A cross-sectional study was conducted with 40 outpatients at the Multidisciplinary Pain Center-Hospital das Clinicas, School of Medicine-University of S˜ao Paulo. Pain assessment: Brief Pain Inventory and the McGill Pain Questionnaire. Results: The mean age was 54.7 years (SD = 13.6). BTP was reported by 40% of patients. Most of them have a diagnosis of some neuropathic pain syndrome. The duration vary from minutes to hours (mean = 41.56 min.; range = 10–120 min.). The median number of episodes was 3 pains/day (P25 = 2 and P75 = 3). The mean intensity of BTP was 9.1 (SD = 1.6; range: 6–10). The most frequently words used to describe the DBT, according to MPQ were: cutting (72.7%), suffocating (76.9%), throbbing (69.2%), exhausting (61.5%), tender (58.3%), jumping (53.8%), tingling (53.8%), radiating (53.8%), cold (66.7%), burning (50%), tugging (42.9%), electric-shock (38.5%), pricking (38.5%), and boring (30.8%). BTP location: upper and lower limbs (12.5% each) and spine (7.5%). Only pharmacological interventions were employed to manage the pain, mainly nonopioid analgesics, opioids, NSAID, neuroleptics, and anticonvulsants. Most of these drugs were used without a specific prescription to manage BTP. Regarding the perceived BTP interference, the highest pain interference was reported to following areas of life: sleep, general activities, and mood. Conclusions: BTP showed a high frequency in patients with CNCP. It was usually intense and had a significant negative impact on life. It is a real problem.
S505 ASSOCIATION BETWEEN COLD PAIN SENSITIVITY AND PERSISTENT POST-SURGICAL PAIN. THE TROMSØ STUDY A. Johansen1 *, C.S. Nielsen2 , R.B. Olsen3 , A. Stubhaug4 . 1 Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, 2 Department of Mental Health, Norwegian Institute of Public Health, 3 Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, 4 Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway Background and Aims: Literature suggests a possible association between pain sensitivity and post-surgical pain. Our aim was to test this association in a population-based study. Methods: Questionnaire data were collected in a cross sectional study in Northern Norway in 2007–8: N 12,982 (www.tromsostudy.com). Individuals who had undergone surgery 3–36 months before the survey, were asked to rate current pain in the area of surgery, using a 0–10 Numeric Rating Scale (NRS). Cold pain sensitivity was assessed with the Cold pressor test: 3o C water for up to 106 seconds. Participants rated pain intensity every 9 seconds, applying NRS. We quantified pain sensitivity by z-transforming the NRS-scores at each time point and then averaging across all time points. Results: Linear regression of persistent pain on cold pain sensitivity, adjusted for age and sex, showed that higher cold pain sensitivity score was associated with a linear increase in NRS-ratings for persistent pain in the area of surgery (b = 0.18, 95% CI 0.07–0.30, p = 0.02), with the scores 9 and 10 significantly different from zero (Fig. 1). These two groups comprise 1.8% of the total sample.
Disclosure: None declared
S507 EPIDEMIOLOGIC FEATURES OF BREAKTHROUGH PAIN IN CANCER AND NON CANCER PATIENTS WITH CHRONIC PAIN B.G. Samolsky Dekel *, A. Vasarri, M. Tomasi, A. Gori, A. Braghittoni, F. Remondini, G. Di Nino, R.M. Melotti. Department of Surgery Specialties and Anesthesiology Sciences, University of Bologna, Bologna, Italy
Fig. 1. Cold pain sensitivity and persistent post-surgical pain (PSP).
Conclusions: There is a modest, but statistically significant association between higher cold pain sensitivity and increased persistent post surgical pain. Acknowledgements: This work was funded by The Norwegian Research Council, South-Eastern Norway Regional Health Authority (Helse Sør-Øst RHF), Northern Norway Regional Health Authority (Helse Nord RHF), and The Norwegian Health Association. Disclosure: None declared
Background and Aims: Breakthrough pain (BTP) is a transitory (≈30 min) pain exacerbation that occurs in patients with moderate/severe chronic pain otherwise controlled by opiates [1]. BTP may be spontaneous or incident and is associated with stronger chronic pain, worsened physical function and psychological distress [2]. The aim of the study is to assess BTP epidemiologic features among consecutive in- and out-patients. Methods: Inclusion criteria were: age ≥18 years, therapy with opiates, informed consent. Screening tool was an ad hoc questionnaire (q-BTP) that was under validation. Baseline pain was evaluated with SVS. Results: Among N = 104 enrolled patients 25% presented chronic cancer-pain, while 75% non-cancer pain. BTP features were found in 58% of cases. Proportions of BTP among both cancer or noncancer patients were 58%, respectively, while those of incidentBTP were 31% (n = 8) and 42% (n = 33), respectively. SpontaneousBTP was found in 35% of cancer and 26% of non-cancer patients.
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
lymphodema), 53% muscular or, bones pain and 17% felt pain during sexual intercourse. Univariate and multivariate analyses show that medical, physical and psychological factors are associated with self reported pain experience. Conclusion: Half breast cancer survivors experienced long term chronic pain. Our data suggest that physicians have to take into account during follow-up social and psychological factors that could generate and maintain pain experience in cancer survivors.
S506 FREQUENCY AND CHARACTERISTICS OF BREAKTHROUGH PAIN IN PATIENTS WITH CHRONIC NON-CANCER PAIN P.B. Malieno1 , K.A.S.L. Ferreira1,2,3 *, R.B. Costa1 , M.J. Teixeira1 . 1 Multidisciplinary Pain Center – Department of Neurology, Hospital das Clinicas – School of Medicine – University of S˜ ao Paulo, 2 School of Nursing, University of Guarulhos (UnG), 3 Instituto do Cancer do Estado de S˜ ao Paulo (ICESP), S˜ ao Paulo, Brazil
Disclosure: None declared
Background: The breakthrough pain (BTP), also called incidental or episodic pain, is reported by 40–80% of cancer patients. The frequency and characteristics of BTP in patients with chronic noncancer pain (CNCP) is not well known. Aims: To evaluate the frequency and characteristics of BTP in patients with CNCP. Methods: A cross-sectional study was conducted with 40 outpatients at the Multidisciplinary Pain Center-Hospital das Clinicas, School of Medicine-University of S˜ao Paulo. Pain assessment: Brief Pain Inventory and the McGill Pain Questionnaire. Results: The mean age was 54.7 years (SD = 13.6). BTP was reported by 40% of patients. Most of them have a diagnosis of some neuropathic pain syndrome. The duration vary from minutes to hours (mean = 41.56 min.; range = 10–120 min.). The median number of episodes was 3 pains/day (P25 = 2 and P75 = 3). The mean intensity of BTP was 9.1 (SD = 1.6; range: 6–10). The most frequently words used to describe the DBT, according to MPQ were: cutting (72.7%), suffocating (76.9%), throbbing (69.2%), exhausting (61.5%), tender (58.3%), jumping (53.8%), tingling (53.8%), radiating (53.8%), cold (66.7%), burning (50%), tugging (42.9%), electric-shock (38.5%), pricking (38.5%), and boring (30.8%). BTP location: upper and lower limbs (12.5% each) and spine (7.5%). Only pharmacological interventions were employed to manage the pain, mainly nonopioid analgesics, opioids, NSAID, neuroleptics, and anticonvulsants. Most of these drugs were used without a specific prescription to manage BTP. Regarding the perceived BTP interference, the highest pain interference was reported to following areas of life: sleep, general activities, and mood. Conclusions: BTP showed a high frequency in patients with CNCP. It was usually intense and had a significant negative impact on life. It is a real problem.
S505 ASSOCIATION BETWEEN COLD PAIN SENSITIVITY AND PERSISTENT POST-SURGICAL PAIN. THE TROMSØ STUDY A. Johansen1 *, C.S. Nielsen2 , R.B. Olsen3 , A. Stubhaug4 . 1 Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, 2 Department of Mental Health, Norwegian Institute of Public Health, 3 Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, 4 Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway Background and Aims: Literature suggests a possible association between pain sensitivity and post-surgical pain. Our aim was to test this association in a population-based study. Methods: Questionnaire data were collected in a cross sectional study in Northern Norway in 2007–8: N 12,982 (www.tromsostudy.com). Individuals who had undergone surgery 3–36 months before the survey, were asked to rate current pain in the area of surgery, using a 0–10 Numeric Rating Scale (NRS). Cold pain sensitivity was assessed with the Cold pressor test: 3o C water for up to 106 seconds. Participants rated pain intensity every 9 seconds, applying NRS. We quantified pain sensitivity by z-transforming the NRS-scores at each time point and then averaging across all time points. Results: Linear regression of persistent pain on cold pain sensitivity, adjusted for age and sex, showed that higher cold pain sensitivity score was associated with a linear increase in NRS-ratings for persistent pain in the area of surgery (b = 0.18, 95% CI 0.07–0.30, p = 0.02), with the scores 9 and 10 significantly different from zero (Fig. 1). These two groups comprise 1.8% of the total sample.
Disclosure: None declared
S507 EPIDEMIOLOGIC FEATURES OF BREAKTHROUGH PAIN IN CANCER AND NON CANCER PATIENTS WITH CHRONIC PAIN B.G. Samolsky Dekel *, A. Vasarri, M. Tomasi, A. Gori, A. Braghittoni, F. Remondini, G. Di Nino, R.M. Melotti. Department of Surgery Specialties and Anesthesiology Sciences, University of Bologna, Bologna, Italy
Fig. 1. Cold pain sensitivity and persistent post-surgical pain (PSP).
Conclusions: There is a modest, but statistically significant association between higher cold pain sensitivity and increased persistent post surgical pain. Acknowledgements: This work was funded by The Norwegian Research Council, South-Eastern Norway Regional Health Authority (Helse Sør-Øst RHF), Northern Norway Regional Health Authority (Helse Nord RHF), and The Norwegian Health Association. Disclosure: None declared
Background and Aims: Breakthrough pain (BTP) is a transitory (≈30 min) pain exacerbation that occurs in patients with moderate/severe chronic pain otherwise controlled by opiates [1]. BTP may be spontaneous or incident and is associated with stronger chronic pain, worsened physical function and psychological distress [2]. The aim of the study is to assess BTP epidemiologic features among consecutive in- and out-patients. Methods: Inclusion criteria were: age ≥18 years, therapy with opiates, informed consent. Screening tool was an ad hoc questionnaire (q-BTP) that was under validation. Baseline pain was evaluated with SVS. Results: Among N = 104 enrolled patients 25% presented chronic cancer-pain, while 75% non-cancer pain. BTP features were found in 58% of cases. Proportions of BTP among both cancer or noncancer patients were 58%, respectively, while those of incidentBTP were 31% (n = 8) and 42% (n = 33), respectively. SpontaneousBTP was found in 35% of cancer and 26% of non-cancer patients.