Validation of the Thai Version of Brief Pain Inventory (BPI-T) in cancer patients.

BACKGROUND: Pain is one of the most frequent and deleterious symptoms for patients with advanced cancer. Pain assessment is important because it is used for detecting severity of disease and the response to treatment. To provide the adequate treatment for pain relief in cancer patients, an assessment tool should be used for pain evaluation. Moreover, suitable tools for pain evaluation should be validated in local language to obtain better pain information. OBJECTIVE: The objective of the present study was to demonstrate validity and reliability of the Thai version of the Brief Pain Inventory (BPI-T), which is a simple and concise instrument for pain assessment. MATERIAL AND METHOD: The available data were obtained from 520 patients with cancer pain. The data included pain severity, which patients reported using Thai version of Brief Pain Inventory (BPI-T). The pain severity and pain information were reported three times with 2-week intervals between each assessment time point. Results: Factor analysis of the Thai version of the Brief Pain Inventory resulted in two factors, pain severity and pain interference, showing valid structures consistent with other language versions of the instrument. Cronbach's alphas, computed for pain interference and pain severity item were 0.88 and 0.89, 0.01 and 0.92, and 0.93 and 0.94, for first, second, and third assessment time, respectively. CONCLUSION: Thai version of the Brief Pain Inventory is a reliable and valid instrument for cancer pain assessment in Thailand

Cross-cultural adaptation to the Thai language of the neuropathic pain diagnostic questionnaire (DN4).

OBJECTIVE: To cross-culturally adapt the neuropathic pain diagnostic questionnaire (DN4) to Thai language MATERIAL AND METHOD: Phase 1: Forward and backward translation followed by assessment of semantic equivalence. Phase 2: Testing of the questionnaire in 30 neuropathic pain patients who were seen and diagnosed by experts, followed by modifications to produce a final version. RESULTS: All the Thai translated pain descriptors except 'tingling' got high percentages of understanding among neuropathic pain patients in the first round of testing. After some adaptation of the Thai word for 'tingling' had been made, the new translated word was retested, and all subjects doing the retest understood the word very well. CONCLUSION: The Thai DN4 questionnaire was systematically translated and validated. This offers a simple Thai neuropathic pain diagnostic tool for clinical use.

Anesthetic pain management in Siriraj Hospital: a retrospective review.

Neural blockade has been used as the single method to anesthetize a part of the body or used in combination with general anesthesia to lessen perioperative pain. Currently, nerve blocks are used for diagnostic, prognostic, therapeutic and prophylactic proposes for management of chronic, acute and cancer pain in a Pain Clinic. Reviewing the records of the 3,349 patients at Siriraj Pain Clinic, we found 2,662 and 687 cases had chronic and acute pain problems respectively, and only 646 patients were treated with anesthetic interventions during 1990 to 1998. They consisted of 317 male and 329 female. The techniques included stellate ganglion block, paravertebral nerve block, celiac plexus block, hypogastric plexus block, mesenteric plexus block, sacral nerve block, epidural steroid, lumbar sympathectomy, first and second thoracic sympatholysis, facet joints injection, sacroiliac joint injection, intravenous regional block with guanethidine or ketanserin, continuous opioid infusion, intravenous lidocaine infusion, and a phentolamine test. The common problems of pain included brachial plexus injury, chronic spinal pain, herpetic neuralgia, ischemic pain, central post-stroke pain, and causalgia. This retrospective review showed that 38 per cent of them reported 50 per cent pain relief with temporary effect. 34 per cent experienced good and satisfactory pain relief while 9 per cent reported excellent pain relief. 17 per cent did not gain benefit from any technique of pain relief and about 2 per cent could not be evaluated due to they did not return for follow-up. One serious complication after thoracic sympatholysis was brachial plexus injury. The neural blockade is proven to be one of the useful adjunct in the management of chronic pain but the selection of the technique is subjected to its critical appraisal.

Acupuncture treatment in perennial rhinitis.

The investigation for clinical effectiveness and immunological response of perennial rhinitis after acupuncture treatment was performed at the Acupuncture Unit, Department of Anesthesiology, Faculty of Medicine Siriraj Hospital. Twenty-four patients with perennial rhinitis and 49 healthy controls were included in the study. The patients were divided into allergic (11 cases) and non-allergic (13 cases) groups. All patients had never had immuno therapy and had eye and nose symptoms for more than 1 year before the treatment. After courses of acupuncture treatment, the clinical symptoms improved in 63 percent of patients in the allergic group and 46 percent in the non-allergic group. The amount of antihistamine tablets was also decreased significantly. The levels of serum IgE in the allergic group showed no significant change when compared with levels before treatment. The preliminary results suggest that the therapeutic efficacy of acupuncture in this disease probably functions via the autonomic nervous system rather than the immune system.