ABSTRACT
Aims: Pain diagnoses in the 10th version of the International Classification of Diseases (ICD-10) did not adequately support the current management of pain. Therefore, we aimed to review the new 11th revision (ICD-11) in order to analyze its usefulness for the management, coding, research and education of chronic pain from a Latin American perspective. Methods: The Latin American Federation of Associations for the Study of Pain convened a meeting of pain experts in Lima, Peru. Pain specialists from 14 Latin American countries attended the consensus meeting. Results: In ICD-11, chronic pain is defined as pain that persists or recurs longer than 3 months and is subdivided into seven categories: chronic primary pain and six types of chronic secondary pain. Chronic primary pain is now considered a disease in itself, and not a mere symptom of an underlying disease. Conclusion: The novel definition and classification of chronic pain in ICD-11 is helpful for better medical care, research and health statistics. ICD-11 will improve chronic pain management in Latin American countries, for both the pain specialist and the primary care physician.
Chronic pain is one of the most frequent reasons for medical consultation in Latin America. In the tenth revision of the International Classification of Diseases and Related Health Problems (ICD-10), chronic pain was not adequately defined and individual pain diagnoses were poorly defined. For the first time in Latin America, a meeting of pain experts analyzed and reviewed the 11th version of the International Classification of Diseases (ICD-11), when the Latin America Federation of Associations for the Study of Pain organized a meeting of experts from 14 Latin American countries. In ICD-11, chronic pain is recognized as a biopsychosocial phenomenon and defined as pain that continues or returns for more than 3 months. It is split into seven types: chronic primary pain and six types of chronic secondary pain. In ICD-11, chronic primary pain is now considered a disease in itself, not a mere manifestation of other disease. Our article is the first to address the problems, challenges and benefits of using ICD-11 from a Latin American perspective. It will help to facilitate and disseminate the use of this new classification of chronic pain. This will improve chronic pain treatment, statistics, research and development of better health strategies for pain management in Latin America.
Subject(s)
Chronic Pain , Humans , Chronic Pain/diagnosis , Consensus , International Classification of Diseases , Latin AmericaABSTRACT
Las cefaleas post punción de la duramadre (CPPD) pueden presentarse tras la anestesia espinal, especialmente en pacientes jóvenes y obstétricas. Enfatizándose que su incidencia disminuye con el uso de agujas espinales de diámetro pequeño y puntas de lápiz atraumáticas conocidas como agujas de Whitacre. Se estudiaron 50 pacientes embarazadas ASA II y III a quienes se les practicó operación cesárea bajo anestesia subaracnoidea, con bupivacaína pesada al 0.5 por ciento, usando agujas de Whitacre punta de lápiz en 25 de ellas y la tradicional aguja de Quincke punta de diamante en las otras 25. Se comparó la incidencia de CPPD entre ambos grupos, a las 24, 48 y 72 horas, encontrándose 8 por ciento de cefaleas después de 24 horas en el grupo Whitacre y de 16 por ciento en el grupo Quincke, concluyéndose que el uso de la aguja Whitacre es menos traumático a los tejidos de la duramadre, por su diseño no cortante en punta de lápiz, ocasionando menos perdida de líquido cefalorraquídeo y por lo tanto menor incidencia de CPPD...
