Evidence-Based Interventional Pain Medicine E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 718

Veröffentlichungsjahr: 2011

Beschreibung

Unrelieved chronic pain is a worldwide epidemic Chronic pain has been subject to multiple international initiatives through the World Health Organization. Interventional Pain Medicine, the use of minimally invasive techniques to relieve pain, is the best approach when simpler measures such as physical therapy or medications fail. However, these procedures can be associated with significant risk and expense. Establishing uniformity in diagnostic criteria and procedural performance can reduce both morbidity and unnecessary procedures, and hence healthcare expenditures. While other texts explain how to perform these procedures, little focus has been given to diagnostic considerations: if and when these procedures should be performed. Evidence-Based Interventional Pain Medicine focuses on a balance between effectiveness and safety of interventional management for specific diagnoses, across all areas of chronic pain including: * Head, neck and shoulder pain * Lower back pain * Neuropathic pain syndromes * Complex Regional Pain Syndrome * Pain in patients with cancer * Vascular and visceral pain Evidence-Based Interventional Pain Medicine provides essential knowledge for anyone who uses, or intends to use, interventional pain techniques.

Leseprobe

Table of Contents

Cover

Title page

Copyright page

Contributor List

Foreword

Introduction

Guideline development

Guideline rationale

Future guidelines

Supporting information

Search strategy and evidence rating

1 Trigeminal Neuralgia

Introduction

Symptoms

Physical examination

Additional test

Differential diagnosis

Treatment options

Recommendations

Clinical practice algorithm

Summary

2 Cluster Headache

Introduction

Diagnosis

Treatment options

Recommendations

Summary

3 Persistent Idiopathic Facial Pain

Introduction

Diagnosis

Treatment options

Recommendations

Summary

4 Cervical Radicular Pain

Introduction

Diagnosis

Treatment options

Recommendations

Summary

5 Cervical Facet Pain

Introduction

Diagnosis

Treatment options

Recommendations

Summary

6 Cervicogenic Headache

Introduction

Diagnosis

Treatment options

Recommendations

Summary

7 Whiplash-Associated Disorders

Introduction

Diagnosis

Treatment options

Recommendations

Summary

8 Occipital Neuralgia

Introduction

Diagnosis

Treatment options

Recommendations

Summary

9 Painful Shoulder Complaints

Introduction

Diagnosis

Treatment options

Recommendations

Summary

10 Thoracic Pain

Introduction

Thoracic radicular pain symptoms

Thoracic facet pain

11 Lumbosacral Radicular Pain

Introduction

Diagnosis

Treatment options

Recommendations

Summary

12 Pain Originating from the Lumbar Facet Joints

Introduction

Diagnosis

Treatment options

Recommendations

Conclusions

Summary

13 Sacroiliac Joint Pain

Introduction

Diagnosis

Treatment options

Recommendations

Summary

14 Coccygodynia

Introduction

Diagnosis

Treatment options

Recommendations

Summary

15 Discogenic Low Back Pain

Introduction

Anatomy of the discus intervertebralis

Diagnosis

Treatment options

Recommendations

Summary

16 Complex Regional Pain Syndrome

Introduction

Pathophysiology

Diagnosis

Treatment options

Recommendations

Summary

17 Herpes Zoster and Post-Herpetic Neuralgia

Introduction

Pathophysiology

Diagnosis

Treatment options

Recommendations

Summary

18 Painful Diabetic Polyneuropathy

Introduction

Diagnosis

Treatment options

Recommendations

Summary

19 Carpal Tunnel Syndrome

Introduction

Diagnosis

Treatment options

Recommendations

Summary

20 Meralgia Paresthetica

Introduction

Diagnosis

Treatment options

Recommendations

Summary

21 Phantom Pain

Introduction

Mechanism

Diagnosis

Treatment options

Recommendations

Summary

22 Traumatic Plexus Lesion

Introduction

Diagnosis

Treatment options

Recommendations

Summary

23 Pain in Patients with Cancer

Introduction

Epidural and intrathecal administration of analgesics

Unilateral pain with limited life expectancy

Upper abdominal pain due to cancer of the pancreas/stomach

Visceral pain due to pelvic tumors

Perineal pain due to pelvic tumors

Spinal pain related to vertebral compression fracture (with or without pathologic tumor invasion)

Summary

24 Chronic Refractory Angina Pectoris

Introduction

Diagnosis

Treatment options

Recommendations

Summary

25 Ischemic Pain in the Extremities and Raynaud’s Phenomenon

Introduction

Epidemiology

Etiology

Pathophysiology

Diagnosis

Treatment options

Summary

26 Pain in Chronic Pancreatitis

Introduction

Diagnosis

Treatment options

Recommendations

Other treatment options

Summary

Index

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Contributor List

Honorio T. Benzon MD, FIPP

Department of Anesthesiology

Northwestern University Feinberg School of Medicine

Chicago, IL, USA

Kees Besse MD, FIPP

Department of Anesthesiology Pain and Palliative Medicine

Radboud University

Nijmegen Medical Centre

Nijmegen, the Netherlands

Allen W. Burton MD, FIPP

Department of Pain Medicine

UT MD Anderson Cancer Center

Houston, TX, USA

Jianguo Cheng MD, PhD

Department of Pain Management

Cleveland Clinic, Cleveland

OH, USA

Steven P. Cohen MD

Department of Anesthesiology & Critical Care Medicine

John Hopkins School of Medicine, Baltimore

Walter Reed Army Medical Center

Washington, DC, USA

Paul Cornelissen MD

Department of Anesthesiology and Pain Management

Jeroen Bosch Ziekenhuis’s Hertogenbosch

the Netherlands

Miles Day MD, DABA FIPP, DABIPP

Professor

Medical Director

International Pain Centre Texas Tech University HSC

Lubbock, Texas, USA

Jan De Witte MD

Department of Anesthesiology

Intensive Care Medicine, and Pain Management

OLV-Ziekenhuis, Aalst, Belgium

Richard Derby, MD, FIPP

Medical Director

Spinal Diagnostics and Treatment Center

Daly City, CA, USA

Jacques Devulder MD, PhD

Department of Anesthesiology and Multidisciplinary Pain Centre

University Hospital Ghent

Ghent, Belgium

Sudhir Diwan, MD, DABIPP, FIPP

Executive Director

The Spine & Pain Institute of New York

Staten Island University Hospital

New York

Robert van Dongen MD, PhD, FIPP

Department of Anesthesiology, Pain and Palliative Medicine

Radboud University Nijmegen Medical Centre

Nijmegen, the Netherlands

Maarten van Eerd MD, FIPP

Department of Anesthesiology and Pain Management

Amphia Ziekenhuis, Breda

The Netherlands

Frank van Eijs MD

Department of Anesthesiology and Pain Management

St. Elisabeth Hospital

Tilburg, the Netherlands

Catharina G. Faber MD, PhD

Department of Neurology

Maastricht University Medical Centre

the Netherlands

Wilco E. van Genderen, MD

Department of Anesthesiology and Pain Management

Medical Centre Jan van Goyen

Amsterdam, the Netherlands

José W. Geurts, MSc

Department of Anesthesiology and Pain Management

Maastricht University Medical Centre

Maastricht, the Netherlands

Maurice J.M.M. Giezeman MD, PhD

Department of Anesthesiology and Pain Management

Diakonessenhuis, Utrecht

the Netherlands

Gerbrand J. Groen MD, PhD

Department of Anesthesiology & Pain Treatment,

University Medical Centre Groningen

University of Groningen, Groningen, the Netherlands

Craig T. Hartrick, MD, FIPP

Department of Anesthesiology, Biomedical Sciences, and Health Sciences

Oakland University William Beaumont School of Medicine

Rochester, MI, USA

Salim Hayek MD, PhD, FIPP

Division of Pain Medicine

University Hospitals

Cleveland, OH, USA

Marc Huntoon MD

Division of Pain Medicine

Chief

Professor of Anesthesiology Vanderbilt University, Nashville TN, USA

Frank Huygen MD, PhD, FIPP

Department of Anesthesiology and Pain Management

Erasmus University Medical Centre

Rotterdam

Markus Janssen MD, FIPP

Department of Anesthesiology and Pain Management

Maastricht University Medical Centre, Maastricht

The Netherlands

Jan Willem Kallewaard MD, FIPP

Department of Anesthesiology and Pain Management

Rijnstate Hospital

Arnhem, the Netherlands

Leonardo Kapural MD, PhD, FIPP

Department of Pain Management, Cleveland Clinic

Cleveland, OH, USA

Yolande Keulemans, MD, PhD

Department of Gastroenterology

Maastricht University Medical Centre

Maastricht, the Netherlands

Maarten van Kleef, MD, PhD, FIPP

Department of Anesthesiology and Pain Management

Maastricht University Pain Centre

Maastricht, the Netherlands

Arno Lataster MSc

Department of Anatomy and Embryology

Maastricht University

Maastricht, the Netherlands

Robert Levy MD, PhD

Professor and Chairman

Department of Neurological Surgery and Co-Director,

Shands Jacksonville Neuroscience Institute University of Florida College of Medicine

Jacksonville, Fl, USA

Timothy R. Lubenow MD, FIPP

Department of Anesthesiology

Rush University Medical Center

Chicago, IL, USA

Nagy Mekhail, MD, PhD, FIPP

Department of Pain Management

Cleveland Clinic

Cleveland, OH, USA

Samer Narouze MD, MSc, FIPP

Centre For Pain Medicine

Summa Western Reserve Hospital

Cuyahoga Falls, Oh, USA

Turo J. Nurmikko MD, PhD

Pain Research Institute and

Faculty of Health and Life Sciences

University of Liverpool

Liverpool, UK

Nileshkumar Patel MD, MBA

Clinical Professor, Anesthesiology

Advanced Pain Management

Green Bay, WI, USA

Jacob Patijn, MD, PhD

Department of Anesthesiology and Pain Management

Maastricht University Pain Centre

Maastricht, the Netherlands

Dirk Peek MD

Department of Anesthesiology and Pain Medicine

St. Jans Gasthuis, Weert

The Netherlands

Wouter Pluijms MD

Department of Anesthesiology and Pain Management

Maastricht University Medical

Centre, Maastricht

Jason E. Pope, MD

Director of the Headache Center

Napa Pain Institute

Napa, CA

Assistant Professor of Anesthesiology

Vanderbilt University Medical Center

Nashville, TN

Martine Puylaert MD, FIPP

Department of Anesthesiology and Multidisciplinary Pain Centre

Ziekenhuis Oost-Limburg

Genk, Belgium

Prithvi Raj, MD, FIPP

Department of Anesthesiology and Pain Medicine

Texas Tech University

Texas, TX, USA

Olav Rohof MD, PhD, FIPP

Orbis Medisch Centrum,

Pijnkliniek

Sittard Geleen

the Netherlands

Richard W. Rosenquist MD

Chairman of the Pain Management Department

Cleveland Clinic

Cleveland, OH, USA

Menno E. Sluijter MD, PhD, FIPP

Pain Unit, Swiss Paraplegic Centre

Nottwil, Switzerland

Peter Staats MD, FIPP

Department of Anesthesiology and Critical Care Medicine

John Hopkins University

Baltimore, MA, USA

Michael Stanton-Hicks MB; BS, Dr med, FIPP

Department of Pain Management

Cleveland Clinic, Cleveland

OH, USA

Robert Jan Stolker MD, PhD

Department of Anesthesiology and Pain Management

Erasmus University Medical Centre

Rotterdam the Netherlands

Hans van Suijlekom MD, PhD

Department of Anesthesiology and Pain Management

Catharina Ziekenhuis, Eindhoven

The Netherlands

Karolina Szadek MD

Department of Anesthesiology and Pain Management

Vrije Universiteit Amsterdam

Amsterdam, the Netherlands

Michel A. M. B. Terheggen MD

Department of Anesthesiology and Pain Management

Rijnstate Hospital

Arnhem, the Netherlands

Ricardo Vallejo MD, PhD, FIPP

Millennium Pain Center

Bloomington, IL, USA

Koen Van Boxem MD, FIPP

Department of Anesthesiology and Pain Management

Sint-Jozefkliniek, Bornem and Willebroek

Bornem, Belgium

Eric Vanduynhoven MD

Department of Anesthesiology and Pain Management

GZA, Campus Sint

Augustinus, Antwerp

Belgium

Pascal Vanelderen MD, FIPP

Department of Anesthesiology and Multidisciplinary Pain Centre

Ziekenhuis Oost-Limburg, Genk, Belgium

Jan Van Zundert, MD, PhD, FIPP

Department of Anesthesiology and Muitidisciplinary Pain Centre

Ziekenhuis Oost-Limburg, Genk, Belgium

Kris C. P. Vissers MD, PhD, FIPP

Department of Anesthesiology Pain and Palliative Medicine

Radboud University

Nijmegen Medical Centre

Nijmegen, the Netherlands

Michel Wagemans MD, PhD

Department of Anesthesiology and Pain Management

Renier de Graaf Groep

Delft, The Netherlands

Mark Wallace MD

Center for Pain Medicine

University of California

San Diego Medical Center

San Diego, CA, USA

Albert J. M. van Wijck

MD, PhD

Department of Anesthesiology and Pain Management

University Medical Centre, Utrecht

the Netherlands

Andre Wolff MD, PhD

Department of Anesthesiology Pain and Palliative Medicine

Radboud University Nijmegen Medical Centre

Nijmegen, the Netherlands

Wouter Zuurmond MD, PhD

Department of Anesthesiology, Pain Therapy and Palliative Care

VU Medical Centre, Amsterdam

The Netherlands

Foreword

by Menno E. Sluijter MD, PhD, FIPP

Seeing this book makes me proud of my university city Maastricht, where I have left so many footsteps and where I still have many friends. It is a great honor for me to have been invited to write this foreword.

Besides accurately describing the various techniques in detail, this book has an accent on evidence-based medicine. This comes naturally for the Dutch since soberness and standing firmly on the ground belong to their prominent features. It makes the book into a solid and reliable guide for many pain practitioners.

My first footsteps in the world of invasive pain treatment date back to a very different period. My mentors and teachers were Jur Bouma in the Netherlands and legendary names, such as Sampson Lipton and Mark Mehta, who played such a pivotal role in their time. Those were the days when solitary observations easily sparked attention or even a trend. Epidural phenol at T12 has been recommended for anal pain for about a decade, one author copying it from another because it was so bizarre. Ondine’s syndrome, as a complication of a cordotomy, received undue attention probably because of its romantic name. Evidence-based medicine was still a far cry.

This book therefore symbolizes for me how invasive pain treatment has become mature within a relatively short period. This process of growth has taken place despite a head wind that is specific for the subject. Many of the procedures are intricate, and success or failure may depend on seemingly trivial details, causing differences in results between researchers. Also pain is a subjective experience and this has various consequences. It makes it particularly difficult to translate results into numbers that are suitable for meaningful statistical analysis. It may even influence results. I firmly believe that a procedure that is performed by a friendly, interested doctor in a friendly environment has a greater chance of success than a procedure under less favorable circumstances. If this is placebo, so be it. It makes pain treatment different from putting a stent into a coronary artery or from removing a tumor under general anesthesia.

Maturity is a sign of growth and it has to be encouraged. Evidence-based medicine will be an indispensible and welcome element of invasive pain treatment in the time to come. It will save patients from getting useless treatments and it will convince insurers to follow up on reasonable demands. It will hopefully discourage those who seek financial gain from a vulnerable group of patients. It will also provide interventional pain treatment with the respected place in the medical community that it deserves.

But, on the other hand, maturity may also be taken as a sign of immanent old age. When reading this book the reader should also realize that all these procedures have once been done for the first time. This reflects a mixture of prudence and courage, but also alertness to observations and the urge to make it a better world for patients who could not be helped before. This process of growth and renewal must not be lost. It should be seen as a complement of evidence-based medicine rather than as a contradiction. After all, without ideas and innovation the need for evidence would soon dry up, and what good is a new procedure without evidence?

The book underscores the need for proper training. The prevalence of chronic pain is such that, despite the laudable efforts of World Institute of Pain, there is still a shortage of well trained doctors who can provide this type of treatment. This is a problem because reading even this book is not enough and practical training is costly in terms of material and manpower. It is to be hoped that the increasing number of potential trainers will gradually resolve the problem.

I recommend this book as a standard manual in the library of every interventionalist. Happy reading!

Foreword

by P. Prithvi Raj MD, FIPP

Jan Van Zundert, Jaap Patijn, Craig Hartrick, Arno Lataster, Frank Huygen, Nagy Mekhail, and Maarten van Kleef, all internationally renowned pain physicians, have embarked on writing “Evidence-Based Interventional Pain Medicine According to Clinical Diagnosis”. They have devoted most of their lives to improving the pain management of patients globally. At their request, I am honored to write a Foreword for their new book.

To emphasize the importance of this book, I need to reiterate the statistics available to us on chronic pain today. Chronic pain prevails globally, the total number of persons living with this specific disease or condition with feeling of pain, ranges from 54% in Sweden to 13% in Japan. These studies show that in the rest of the developed countries, such as United States, United Kingdom and Australia, the incidence is somewhere in between. Studies also show that pain imposes a huge economic burden on all countries; for example, in the United States it was calculated that in 1991, the USA spent eighty-six billion dollars on chronic back pain management. Today, because the elderly are living longer, the prevalence of chronic pain is rising with age. Another problem one needs to recognize is that only one billion people in the developed countries have the luxury of utilizing the most advanced pain management techniques. The other five billion people, who have medium to low standards of living, are unable to receive the benefits of these new techniques of pain management.

The World Institute of Pain (WIP) and its members have been aware of this problem and the disparities between countries in terms of standard of care and practices of pain management. Since 1994, WIP’s mission has been to train pain physicians and certify their competency in interventional pain management. By all accounts, this mission has become very successful globally.

Pain practice today is fortunate to have many physicians taking this practice as a professional part of their career. They come from all specialties and the book now has to reflect the advances in Pain Practice of all those specialties, not just those in Anesthesiology. The debate is still raging whether a single pain specialist can deliver better pain management than a group of specialists together. The cost of managing such multidisciplinary clinics has been called into question especially by the reimbursement agencies. A program developed by a multidisciplinary clinic is nowadays rejected outright by the reimbursement agencies, and even if it is approved, the efficacy of such programs is questionable. More and more the patients are referring themselves to the Pain Clinics where their pain will be relieved over the short-term rather than addressing the long-term goal of improving the patient’s function and quality of life. That is why one finds a prolific growth of Interventional Pain Management Clinics and decrease in University-based Multidisciplinary Clinics. This is certainly the case in the USA and is also becoming common in other countries.

Pain Physicians have not tackled at all the discrepancy in pain practices between developed, developing and under developed countries. There is no factual account of the epidemiology of pain the world over; one cannot say for certain how many Pain Physicians are available per capita in any community. We certainly have made advances in understanding the new theories of pain, and in some pain syndromes, the longitudinal natural course, but we are far from having a reliable algorithm for any pain disorder. It is still hit and miss.

The challenge today is to train Pain Physicians in such a way that they have a standardized curriculum during their Residency and Pain Fellowship programs, followed by skilled practical training, either in Anesthesiology, Neurosurgery, Physical Medicine and Rehabilitation or Psychiatry. Once trained, they need to be examined and tested periodically for their competency. This will raise the standard of pain practice, not only in the USA, but all over the world.

Evidence-based medicine (EBM) or evidence-based practice (EBP) aims to apply the best available evidence gained from scientific methods to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments (including lack of treatment) and diagnostic tests. Evidence quality can range from meta-analyses and systematic reviews of double-blind, placebo-controlled clinical trials at the top end, down to conventional wisdom at the bottom.

Let me explain the history of evidence-based medicine’s origin. Traces of evidence-based medicine’s origin can be found in ancient Greece. Although testing medical interventions for efficacy has existed since the time of Avicenna’s The Canon of Medicine in the 11th century, it was only in the 20th century that this effort evolved to impact almost all fields of health care and policy. Professor Archie Cochrane, a Scottish Epidemiologist, through his book Effectiveness and Efficiency: Random Reflections on Health Services (1972) and subsequent advocacy caused increasing acceptance of the concepts behind evidence-based practice. Cochrane’s work was honored through the naming of centers of evidence-based medical research—Cochrane Centers—and an international organization, the Cochrane Collaboration. The explicit methodologies used to determine “best evidence” were largely established by the McMaster University research group led by David Sackett and Gordon Guyatt. Guyatt later coined the term “evidence-based” in 1990. The term “evidence-based medicine” first appeared in the medical literature in 1992 in a paper by Guyatt et al. Relevant journals include the British Medical Journal’s Clinical Evidence, the Journal of Evidence-Based Healthcare and Evidence-Based Health Policy. All of these were co-founded by Anna Donald, an Australian pioneer in the discipline.

There has been discussion of applying what has been learned from EBM to public policy. In his 1996 inaugural speech as President of the Royal Statistical Society, Adrian Smith held out evidence-based medicine as an exemplar for all public policy. He proposed that “evidence-based policy” should be established for education, prisons and policing policy, and all areas of government

This book “Evidence-Based Interventional Pain Medicine According to Clinical Diagnoses” fits the void where literature should conform to local necessities for information to be useful in that society. The format of the book is excellent; each chapter is consistent in describing an interventional technique in simple terms from history to complications and efficacy, stressing at all times the technique.

The reader who is interested in learning, training and practicing interventional pain medicine will find this book extremely useful and informative. It illustrates not only the usual common techniques but also the emerging techniques; this makes it unique and different from the usual text books on pain. I wholeheartedly recommend the interventional pain physician to have this book in their library.

Introduction

The use of interventional pain management techniques has gradually become integrated into the treatment plan of patients suffering from chronic pain. After a long period of empirical use, it is time to move on to the professionalization and standardization of this practice. Interventional pain management techniques are target specific. There is evidence that better patient selection increases the success ratio.1 Therefore, a standard patient evaluation to “fine-tune” the clinical pain diagnosis is mandatory. A detailed description of the technical performance provides a guideline for the standardized interventional pain procedure.

The efficacy of these techniques has been described in randomized controlled trials, observational studies, retrospective studies, and case reports. Evidence-based practice guidelines provide a good review of the literature in a context that makes it accessible and useful to both the clinician and researcher.2,3

The available evidence is summarized by treatment option or technique. There are, however, several studies indicating that the chances for treatment success increase with better patient selection.1,4–7 A wellformed management strategy starts with an accurate evaluation process to identify the pain diagnosis. It is of utmost importance to first check for the so-called red flags that may be indicative of an underlying primary pathology, which needs adequate treatment prior to symptomatic pain management techniques. The treatment relies on accurate use of conservative interventions, potentially in association with interventional pain management techniques. Consequently, evidence-based practice guidelines are of greater practical value when they are specific for each different pain diagnosis.

Guideline Development

In daily practice the important goal of pain medicine is to use a specific treatment, conservative and/or interventional, for the right patient at the right moment. Therefore, treatment selection should be according to clinical diagnoses. To improve recognition and information retrieval, the articles have been organized according to a strict structure:

Introduction

Diagnosis

History

Physical examination

Additional tests

Differential diagnosis

Treatment

Conservative management

Interventional management

Complications of interventional treatment

Evidence for interventional management

Recommendations

Treatment algorithm

Techniques

Summary

Although the scientific literature is predominantly Anglo-Saxon and most doctors use the English denominations of anatomical structures, in this series, anatomical structures were indicated with the Latin denomination (Terminologia Anatomica) and the English denomination was, where appropriate, added between brackets.8 This option was specifically chosen to help people around the world to use the correct denomination when expressing themselves in a language other than English.

This series has focused on interventional pain management techniques, because they have undergone a rapid evolution in recent decades with additional well-conducted research being published regularly. The use of these techniques for the right indication may improve the quality of life of carefully selected patients. Moreover, for correct application of interventional pain management techniques, both good theoretical knowledge and practical experience are mandatory. These skills can only be acquired through training and continuing education.