Dolor y emoción, una reflexión para el profesional en ciencias de la salud / Pain and emotion, a reflection for the health practitioner

En esta revisión se propone reflexionar sobre el papel que juegan las emociones en relación con una experiencia desagradable para el ser humano denominada dolor. El estímulo doloroso provoca situaciones de discapacidad en mayor o menor medida, según como sea evaluado y afrontado, llegando a provocar alteraciones emocionales y cognitivas que generan una disminución en la calidad de vida de la persona/paciente, en aspectos funcionales, psicológicos, laborales y sociales. Se realiza entonces una revisión de la literatura que permite entregar al profesional de la salud una reflexión sobre el manejo integral del paciente que consulta por un síntoma, que de no ser manejado apropiadamente desencadenará un síndrome doloroso que interferirá en su diario vivir y terminará amenazando su existencia.

This review proposes to reflect on the role that emotions play in relation to an unpleasant experience for the human being called pain. The painful stimulus causes situations of disability to a greater or lesser extent, depending on how it is evaluated and addressed, leading to emotional and cognitive alterations that generate a lower quality of life in the person/patient, from functional, psychological, occupational and social aspects. A bibliographic review is carried out, which allows the health professional to reflect on the integral management of the patient who consults for a symptom, that, if not managed properly, will trigger a painful syndrome that interferes and threatens its existence.

The Effect of Chemical Lumbar Sympathetic Neurolysis in Peripheral Arterial Occlusive Disease: Buerger's Disease vs. Arteriosclerosis Obliterans / 대한마취과학회지

BACKGROUND: A non-randomized, uncontrolled study was undertaken with a retrospective medical record review to evaluate the effect of pain relief of chemical lumbar sympathectomy in patients with peripheral vascular occlusive disease. This was conducted to assess whether the long term outcome of ischemic limbs could be changed and to identify predictable medical factors of patients who would be helped by this procedure. METHODS: A total of 47 patients with Buerger's disease (n = 20) and arteriosclerosis obliterans (n = 17) referred by vascular surgery for the management of ischemic pain were enrolled. All other conservative and surgical management efforts had already failed and were not indicated. The following were evaluated before and after the neurolytic lumbar sympathetic blocks: the stages of disease by Fontaine classification, main sites and numbers of occlusion, pain scores before and after the procedure, physical findings, amputation sites, and medications as well as amounts given and other risk factors. RESULTS: Buerger's disease tends to progress rapidly and aggressively. It is more painful than arteriosclerosis obliterans and is peripherally involved, with higher incidences of complications. Chemical sympathectomy has significant pain relief effects in both groups. Differences in long term outcome measured by amputation could not be found in both groups. No significant risk factors could be identified. No side effects were reported in both groups. CONCLUSIONS: Chemical lumbar sympathectomy has a good analgesic effect for pain in walking. This, however showed no long-term limb-saving effect.

Effect of Mixed Administration of Thiopental Sodium on Vascular Pain Associated with Intravenous Propofol Injection / 대한마취과학회지

BACKGROUND: Propofol is a rapidly acting intravenous anesthetic agent used for the induction of anesthesia with a low incidence of side effects. But propofol has a high incidence of pain during intravenous injection, and many methods have been used to minimize the incidence and severity of this pain. The aim of this study was to compare the use of thiopental and lidocaine mixed with propofol for the reduction of pain during the injection of propofol. METHODS: Sixty healthy ASA physical status I or II patients scheduled for general anesthesia were randomly divided into three groups. Each patient received mixed propofol solution (normal saline 1 cc, thiopental 0.5 mg/kg, lidocaine 0.5 mg/kg) via 20 G angiocatheter inserted at the antecubital fossa. The assessment of pain was done at the induction of anesthesia and at the recovery room. The severity of pain was classified as none, mild, moderate, and severe. RESULTS: The severity and incidence of pain diminished significantly in the thiopental group and the lidocaine group compared with control group at the induction of anesthesia (p<0.05), and there was no significant difference between the thiopental and the lidocaine group. Recall of pain during intravenous injection at the recovery room has no significant difference among three groups. CONCLUSIONS: Mixd administration of thiopental or lidocaine could significantly reduce the severity and incidence of pain for intravenous injection of propofol.