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MINERVA UROLOGICA E NEFROLOGICA

A Journal on Nephrology and Urology


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  NEFROLOGY
XV CONGRESS OF THE SOCIETA' ITALIANA DI NEFROLOGIA SEZIONE PIEMONTE-VALLE D'AOSTA
(Verbania, October 4, 1997)


Minerva Urologica e Nefrologica 1999 June;51(2):85-7

language: Italian

Chronic pain in dialysis. Pharmacological therapy and its costs

Fortina F. 1, Agliata S. 1, Ragazzoni E. 1, Sacco A. 1, Cardillo V. 2, Travaglini S. 3, Brini P. 3, Cavagnino A. 1

1 Ospedale SS. Trinità - Borgomanero (Novara), Divisione di Nefrologia e Dialisi
2 Ospedale SS. Trinità - Borgomanero (Novara), Servizio di Terapia Antalgica
3 Ospedale SS. Trinità - Borgomanero (Novara), Servizio di Farmacia


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Background. There is very little research into the problem of chronic pain in dialysed patients, despite the fact that pain is a widely diffused phenomena amongst these patients.
This work proposes to evaluate the intensity of pain, supply a scale of levels of intervention, with an indication of the consuption and relative costs of pharmacological therapies.
Methods. 37 out of 100 patients undergoing haemodialysis suffer chronic pain. Aetiological research has shown that osteoarticular pain (24 cases), is the most common, peripheral vascular pain (3 cases), is subjectively and indirectly considered to be the most serious form.
Nine cases have presented pain of a neuromuscolar origin, whilst one case of a neoplastic origin. The degree of personal invalidity shows serious invalidity in 11 cases.
Results. The therapeutic file that forsaw four levels of pharmacological intervention (1st levels: FANS, 2nd level: Codeine+paracetamol, 3rd level: Buprenorphine, 4th level: Morphine for os), accompanied by instrumental and pharmacological support intervention, has proved to be indispensable is confronting the problem.
Through pharmacy data, we have noticed a progressive increase over the year in the use of analgesic medicines, of which we can confirm the effectiveness, tollerability, low level of side-effects, at low costs.
Conclusions. In our opinion chronic pain in dialysed patients should not be neglected. The perfectione of diagnostic techniques, the discovery of pain-killers with reduced side-effects, the pluridisciplinary approach, and reduced costs of treatment, are all valid arguments in favour of an intervention that improves the quality of life of these patients, already so compromised by the nature of the illness itself.

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