OBJECTIVE: The objective of this study was to examine the incidence and therapy of chronic pain in a group of older patients with cystic fibrosis (CF). PATIENTS: We identified two groups of patients followed at the CF Center at Children's Hospital (Boston); the first group consisted of all patients above the age of 5 years who died between 1984 and 1993, and the second was a cohort of 23 additional CF patients who had been referred to the Pain Treatment Service. DESIGN: Medical charts were reviewed for the etiology and therapy of all pain episodes requiring medical intervention. RESULTS: The incidence of chronic pain in this population increased sharply in the last 6 months of life. Headaches (55% of patients) and chest pain (65%) were frequently reported, although back pain (19%), abdominal pain (19%), and limb pain (16%) were also reported. In patients with headache, the main etiologies were hypercarbia or hypoxia, migraine, and sinusitis. The majority of chest pain was musculoskeletal, with pleuritis, pneumothorax, and rib fracture also reported as the cause of chest pain. INTERVENTIONS: A variety of nonpharmacological and pharmacological therapies were reported. Forty-one patients (53%) had pain severe enough to require opioid treatment, and 10 patients (13%) received opioids for more than 3 months. In eight patients with more severe pain, regional analgesia was found to be particularly effective. CONCLUSIONS: Chronic pain is a common problem in CF, particularly as the patient population ages. When administered with caution, opioids have proven to be effective and safe in this population; regional anesthesia can be used to preserve pulmonary toilet while adequately treating severe pain.
OBJECTIVE: The objective of this study was to examine the incidence and therapy of chronic pain in a group of older patients with cystic fibrosis (CF). PATIENTS: We identified two groups of patients followed at the CF Center at Children's Hospital (Boston); the first group consisted of all patients above the age of 5 years who died between 1984 and 1993, and the second was a cohort of 23 additional CF patients who had been referred to the Pain Treatment Service. DESIGN: Medical charts were reviewed for the etiology and therapy of all pain episodes requiring medical intervention. RESULTS: The incidence of chronic pain in this population increased sharply in the last 6 months of life. Headaches (55% of patients) and chest pain (65%) were frequently reported, although back pain (19%), abdominal pain (19%), and limb pain (16%) were also reported. In patients with headache, the main etiologies were hypercarbia or hypoxia, migraine, and sinusitis. The majority of chest pain was musculoskeletal, with pleuritis, pneumothorax, and rib fracture also reported as the cause of chest pain. INTERVENTIONS: A variety of nonpharmacological and pharmacological therapies were reported. Forty-one patients (53%) had pain severe enough to require opioid treatment, and 10 patients (13%) received opioids for more than 3 months. In eight patients with more severe pain, regional analgesia was found to be particularly effective. CONCLUSIONS:Chronic pain is a common problem in CF, particularly as the patient population ages. When administered with caution, opioids have proven to be effective and safe in this population; regional anesthesia can be used to preserve pulmonary toilet while adequately treating severe pain.
Authors: Elisabeth P Dellon; Mitchell D Shores; Katherine I Nelson; Joanne Wolfe; Terry L Noah; Laura C Hanson Journal: J Pain Symptom Manage Date: 2010-09-17 Impact factor: 3.612
Authors: Christian Denne; Anna E Vogl-Voswinckel; Harald Wurmser; Marc Steinborn; Manfred Spaeth; Armin Gruebl; Stefan Burdach Journal: J Med Case Rep Date: 2011-09-06
Authors: Brenda M Button; Christine Wilson; Ruth Dentice; Narelle S Cox; Anna Middleton; Esta Tannenbaum; Jennifer Bishop; Robyn Cobb; Kate Burton; Michelle Wood; Fiona Moran; Ryan Black; Summar Bowen; Rosemary Day; Julie Depiazzi; Katherine Doiron; Michael Doumit; Tiffany Dwyer; Alison Elliot; Louise Fuller; Kathleen Hall; Matthew Hutchins; Melinda Kerr; Annemarie L Lee; Christina Mans; Lauren O'Connor; Ranjana Steward; Angela Potter; Tshepo Rasekaba; Rebecca Scoones; Ben Tarrant; Nathan Ward; Samantha West; Dianne White; Lisa Wilson; Jamie Wood; Anne E Holland Journal: Respirology Date: 2016-04-18 Impact factor: 6.424
Authors: Harold Tabori; Christin Arnold; Anke Jaudszus; Hans-Joachim Mentzel; Diane M Renz; Steffen Reinsch; Michael Lorenz; Ruth Michl; Andrea Gerber; Thomas Lehmann; Jochen G Mainz Journal: PLoS One Date: 2017-05-04 Impact factor: 3.240