Effects of Covid-19 pandemic on algology practice: single-center clinical study results

Burcu Özalp Horsanalı; Hüsnü Yılmaz; Kazım Koray Özgül; Meltem Uyar; Can Eyigör

doi:10.19161/etd.1262466

EN TR

Effects of Covid-19 pandemic on algology practice: single-center clinical study results

Abstract

Aim: During the Covid-19 pandemic, the number of patients examined in the outpatient clinic of many health institutions was limited and some changes were made in the treatment protocols. Regional Anesthesia and Pain Associations also recommended steroid administration and opioid use restriction, especially in chronic pain. In our study, we aimed to evaluate the clinical diagnosis of the patients who applied to our clinic with complaints of pain, the treatments they received, and whether our approach to chronic pain was by the guidelines during the Covid-19 pandemic period. Material and Methods: Demographic data, clinical diagnoses, interventional procedures, and medical treatments given to the patients who applied to the Ege University Faculty of Medicine, Algology Department outpatient clinic between March 2020 and May 2021 were evaluated statistically by retrospective analysis. Results: The mean age of 444 patients included in the study was 56.8±15.9 years. It was found that 29 (6.5%) of the patients applied for acute pain and 415 patients (93.5%) for chronic pain. While the number of patients who received only pharmacological treatment was 230 (51.8%), it was determined that 199 (44.8%) patients received both pharmacological treatment and interventional procedure, and 15 (3.3%) patients received only interventional procedure. When the patients were investigated in terms of pharmacological treatment, we observed that 229 (57.1%) patients received only paracetamol treatment, 99 (24.6%) patients received only non-steroidal anti-inflammatory (NSAI) drug therapy, and 73 (18.2%) patients received both paracetamol and NSAI therapy. It was determined that 243 (96.8%) of the patients who received medical treatment received weak opioids, 3 (1.3%) patients received strong opioids, and 5 (1.9%) patients received both weak and strong combined opioid treatment.Steroid injection was observed in only 16.3% of 214 patients who underwent interventional procedures. Conclusion: It was observed that chronic pain patients were in the majority during the pandemic period and the use of strong opioids and steroid injections were minimized in these patients. Since it may cause changes in immune responses, applications that will pose the least risk in pain patients should be chosen during the pandemic period.

Keywords

Covid-19 Pandemisinin algoloji pratiğine etkileri: Tek merkezli klinik çalışma sonuçları

Öz

Amaç: Covid-19 pandemisi sırasında birçok sağlık kuruluşunda poliklinikte bakılan hasta sayıları kısıtlanmış ve tedavi protokollerinde bazı değişiklikler yapılmıştır. Rejyonel Anestezi ve Ağrı dernekleri de özellikle kronik ağrıda steroid uygulamasının ve opioid kullanımının kısıtlanmasını önermişlerdir. Çalışmamızda, Covid-19 döneminde, kliniğimize ağrı şikâyeti ile başvuran hastaların klinik tanılarını, aldıkları tedavileri ve kronik ağrıdaki yaklaşımımızın rehberlere uygun olup olmadığını değerlendirmeyi amaçladık. Gereç ve Yöntem: Mart 2020- Mayıs 2021 tarihleri arasında Ege Üniversitesi Tıp Fakültesi, AlgolojiBilim Dalı polikliniğine ağrı şikâyeti ile başvuran hastaların demografik verileri, klinik tanıları, uygulanangirişimsel işlemler ve verilen medikal tedaviler retrospektif incelenerek istatistiksel olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 444 hastanın yaş ortalaması 56,8±15,9 olarak belirlendi. Hastaların 29'unun (%6,5%) akut ağrı, 415’nin ise (%93,5) kronik ağrı nedeniyle başvurduğu saptandı. Sadece farmakolojik tedavi alan hasta sayısı 230 (%51,8) iken, 199 (%44,8) hastaya hem farmakolojik tedavi hem de girişimsel işlem uygulandığı, 15 (%3,3) hastaya ise sadece girişimsel işlem uygulandığı belirlendi. Farmakolojik tedavi alan hastaların 229 (%57,1)’unun sadece parasetamol tedavisi; 99 (%24,6)’unun sadece non-steroid antiinflamatuar (NSAI) ilaç tedavisi, 73 (%18,2)’ünün ise hem parasetamol hem de NSAI tedavisi aldığı saptandı. Medikal tedavi uygulanan hastaların 243 (%96,8)’ünün zayıf opioid, 3 (%1,3)’ünün güçlü opioid, 5 (%1,9)’inin ise hem zayıf hem de güçlü kombine opioid tedavi aldığı belirlendi. Girişimsel işlem uygulanan toplam 214 hastanın ise %16,3’üne steroid enjeksiyonu uygulandığı görüldü. Sonuç: Pandemi döneminde kronik ağrı hastalarının çoğunlukta olduğu ve bu hastalarda güçlü opioidlerin kullanımının ve steroid enjeksiyonlarının en aza indirildiği görüldü. İmmün yanıtlarda değişikliklere yol açabileceğinden pandemi döneminde ağrı hastalarında en az risk oluşturacak uygulamaların seçilmesi gerekir

Anahtar Kelimeler

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Burcu Özalp Horsanalı ^*
Türkiye

Hüsnü Yılmaz
Türkiye

Kazım Koray Özgül
Türkiye

Meltem Uyar
Türkiye

Can Eyigör
Türkiye

Publication Date

March 15, 2023

Submission Date

March 25, 2022

Acceptance Date

August 9, 2022

Published in Issue

Year 2023 Volume: 62 Number: 1

DOI

https://doi.org/10.19161/etd.1262466

IZ

https://izlik.org/JA54YR55WM

Cite

RIS / Bibtex

Vancouver

1.Burcu Özalp Horsanalı, Hüsnü Yılmaz, Kazım Koray Özgül, Meltem Uyar, Can Eyigör. Effects of Covid-19 pandemic on algology practice: single-center clinical study results. EJM. 2023 Mar. 1;62(1):68-73. doi:10.19161/etd.1262466