S130 European Journal of Pain 2006, Vol 10 (suppl S1) Abstracts, 5th EFIC Congress, Free Presentations
previous pain exposure). Findings were compared with age and gendermatched controls without previous hospital experiences.Results: Former patients were significantly less sensitive to cold andwarmth perception at the heel (p< 0.05), and for warmth on the hand.Conversely, former patients were significantly more sensitive to heat andcold pain at the heel (p< 0.05); pain thresholds on the hand did not differwith controls. Preterm-born neonates were more hypo- and hypersensitivethan term born patients.Conclusions: Eight years following NICU admission, alterations in painprocessing at the area of previous tissue damage are still measurable. Inaccordance to experimental findings in animals, these long-term conse-quences are more prominent in preterm born neonates, confirming theexistence of a developmental window.
490TEMPOROMANDIBULAR DISORDER (TMD) PAIN DIAGNOSISIN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS
M. Sevastjanova1 °, A. Rozenblats1, N. Zlobina2. 1Riga StradinsUniversity, Department of Oral and Maxillofacial Surgery, Riga; 2StatesBlood Center, Riga, Latvia
Objectives: Evidence based diagnosis of TMD pain still remains achallenge. To distinguish a somatic, psychosomatic and pseudosomaticdiseases as reliable cornerstone of working-up diagnosis in children andadolescents with TMD and facial pain is considered. The most commondiagnosis in group of true somatic disorder is JIA (International Leagueof Associations for Rheumatology, 2001). Attempts are made to evaluateearly diagnostic features of TM joint somatic disease and it value in clinicaldecision making.Methods: Two groups (total n–65) are encountered from our 2004–2005year register of patients. Group 1 – (n–33) treated before with/without diag-nosis of JIA on the level of primary care or rheumatologist. Group 2 – (n–32) untreated before TMD pain patients. History physical examination andvisual analogue scale (VAS) for evaluation of pain and specific/nonspecificlaboratory tests were used.Results: Correlation of from physical examination and VAS revealed a“functional avoidance” phenomena in 15 patients from group 1, and 9patients from group 2. sleep disturbing pain was fined in 2 patients fromgroup 2 with positive specific/nonspecific laboratory tests.Conclusion: Involvement of TMJ in pauciarticular JIA should be sus-pected in patients with/without previous diagnosis. In cases with noresponse or incomplete response to nonsurgical treatment a medicalcounseling and health management are necessary.
C12 PAIN IN THE ELDERLY
491NURSES’ COMPLIANCE WITH PAIN REGISTRATION INDUTCH NURSING HOMES
A.A. Boerlage1 °, M. van Dijk2, D.L. Stronks1, C.C.D. van der Rijt3,D. Tibboel2, R. de Wit4,5. 1Pain Expertise Center, Erasmus MC,Rotterdam; 2Pediatric Surgical Intensive Care, Erasmus MC –SophiaChildren’s Hospital, Rotterdam; 3Medical Oncology, Erasmus MC –Daniel den Hoed Cancer Center, Rotterdam; 4Faculty of HealthSciences, University of Maastricht; 5University Hospital Maastricht, TheNetherlands
Background and Aims: High prevalence of pain has been documentedin nursing homes’ residents. Pain registration is a valuable instrument tomonitor and evaluate pain. This study aimed to assess (1) the nurses’compliance of pain registration, (2) the proportion of the residents unableto rate their pain on a numerical scale, and (3) their pain intensity.Method: Pain registration was introduced by which nurses once a dayasked residents in three nursing homes (NH) to rate their pain on a 0–10numerical scale, (0 = no pain; 10 =worst pain). Compliance was calculatedover a period of 14 days by comparing the recorded pain registrations withall possible registrations. Residents unable to rate their pain were excludedfrom the compliance analysis.
Results: 201 residents were enrolled in this study. A total of 125 nursesperformed the registration. With median compliances rates of 35.4%(NH1), 14.3% (NH2), and 82.1% (NH3), compliance differed significantlybetween the nursing homes (Kruskall–Wallis, p< 0.001). Percentages ofresidents able to assign a pain score were 42.5%; 82.9%, and 77.4%respectively. Median pain intensity was 2.0 (Interquartile Range 0 to 4.2),5.0 (IQR 2.5 to 5.7), and 1.3 (IQR 0 to 5.7) (Kruskall-Wallis, p< 0.001).Conclusions: Nurses’ compliance of pain registration was on average low,but varied significantly between nursing homes. The high proportion ofresidents (one third) unable to rate their pain, suggests the necessity ofother tools to measure pain intensity besides a numerical rating scale.Median pain intensity varied significantly between the homes (range 1.3;5.0).
492ELDERLY PATIENTS (>80) WITH CHRONIC PAIN:INTERMIXTURE OF LOSS OF AUTONOMY AND CHRONICPAIN (1000 CONSULTATIONS).
J.M. Gomas°, A. Petrognani, M. Denis, K. Knorreck, E. Sales. HopitalSainte Perine, Paris, France
Chronic pain can impact more strongly in symbolic and social respect thanthe objective injuries would suggest.Method: Retrospective study of 1000 consultations at 158 patients withchronic pain (60 to 99 years).As a subset a group of “elderly” patients is analysed with 325 consultationsat 112 patients aged above 80 years (of which 24 patients were over 90years).Results: In this subset of “elderly patients” (>80 years old) 84% arefemale, living in urban areas. Cognitive deficiency (MMS<27) is observedonly for 15%.Only 10% come in a rolling chair. 72% have more than two consults.Rhumatologic pain (58%), 28% neurologic and 12% cancer pain arepredominant.70% have intensive nociception pain that warrants oral opioids. Neuro-pathic pain is not treated in 90% of the cases. The reduction of pain isobtained in 85 % of case.Discussion: These elderly patients are very much upset by their handicapsin ambulatory life. The pain is considered as most responsible for theirstate.In fact in 63% of cases this was not true: progressive limitations ofautonomy and global ageing aspects were the responsible factors for theirloss of quality of life and not the pain. Of course, pain makes things worse,but the real problem is to accept the biologic results of the old age.
493NARCOANALGESICS IN FRAIL, AGED, CHRONIC PAINPATIENTS TREATED IN ALTERNATIVE CARE SETTINGS
L.B. Jovanovic1 °, M. Prostran2. 1Institute of Gerontology, HomeTreatment and Care, Belgrade, Serbia, 2School of Medicine, Universityof Belgrade, Department of Pharmacology, Clinical Pharmacology andToxology, Belgrade, Serbia
Background and Aims: Population of frail aged is characterized byadvanced age, polimorbidity, functional disability, mental impairmentsand disorders, high prevalence of chronic non-malignant pain, politherapy,solitary life in their homes.Tramadol is centrally acting narcoanalgesics with dual mechanism ofaction, less serious side effects, low cost and because that very popularamong prescribes for elderly patients.The aim was to underline problems in continuous, per os tramadoltherapy in the treatment of chronic pain in out-patient frail aged (i.e.discontinuation etc.).Methodology: Case report, three female pts.Results: Pts had common characteristics: advanced age (79, 91, 97 y),polimorbidity, politherapy, mental disease treated with psychoactive drugs,functional disability and dependence on others, mental declining. First case
