PDF(Pubmed)
Abstract：
BACKGROUND: Non-image guided injection treatments (\"nerve blocks\") are commonly provided in community pain clinics in Ontario for chronic non-cancer pain (CNCP) but remain controversial.
OBJECTIVE: We explored patients\' perspectives of nerve blocks for CNCP.
METHODS: We administered a 33-item cross-sectional survey to patients living with CNCP pain attending four community-based pain clinics in Ontario, Canada. The survey captured demographic information and asked about patient experiences with nerve blocks.
RESULTS: Among 616 patients that were approached, 562 (91%) provided a completed survey. The mean age of respondents was 53 (SD 12), 71% were female, and the majority (57%) reported living with CNCP for more than a decade. Fifty-eight percent had been receiving nerve blocks for their pain for >3 years, 51% on a weekly frequency. Since receiving nerve blocks, patients self-reported a median improvement in pain intensity of 2.5 points (95% CI -2.5 to -3.0) on an 11-point numeric rating scale and 66% reported stopping or reducing prescription medications, including opioids. The majority who were not retired (62%) were receiving disability benefits and were unable to work in any capacity. When asked what impact cessation of nerve blocks would have, most employed patients (52%) reported they would be unable to work, and the majority indicated their ability to function across multiple domains would decrease.
CONCLUSIONS: Our respondents who received nerve blocks for CNCP attribute important pain relief and functional improvement to this intervention. Randomized trials and clinical practice guidelines are urgently needed to optimize the evidence-based use of nerve blocks for CNCP.
OBJECTIVE: We explored patients\' perspectives of nerve blocks for CNCP.
METHODS: We administered a 33-item cross-sectional survey to patients living with CNCP pain attending four community-based pain clinics in Ontario, Canada. The survey captured demographic information and asked about patient experiences with nerve blocks.
RESULTS: Among 616 patients that were approached, 562 (91%) provided a completed survey. The mean age of respondents was 53 (SD 12), 71% were female, and the majority (57%) reported living with CNCP for more than a decade. Fifty-eight percent had been receiving nerve blocks for their pain for >3 years, 51% on a weekly frequency. Since receiving nerve blocks, patients self-reported a median improvement in pain intensity of 2.5 points (95% CI -2.5 to -3.0) on an 11-point numeric rating scale and 66% reported stopping or reducing prescription medications, including opioids. The majority who were not retired (62%) were receiving disability benefits and were unable to work in any capacity. When asked what impact cessation of nerve blocks would have, most employed patients (52%) reported they would be unable to work, and the majority indicated their ability to function across multiple domains would decrease.
CONCLUSIONS: Our respondents who received nerve blocks for CNCP attribute important pain relief and functional improvement to this intervention. Randomized trials and clinical practice guidelines are urgently needed to optimize the evidence-based use of nerve blocks for CNCP.
摘要：
背景：非图像引导注射治疗（“神经阻滞”）通常在安大略省的社区疼痛诊所中针对慢性非癌性疼痛（CNCP）提供，但仍存在争议。
目的：我们探讨了患者对CNCP神经阻滞的看法。
方法：我们对安大略省四个社区疼痛诊所的CNCP疼痛患者进行了一项33项横断面调查，加拿大。该调查捕获了人口统计信息，并询问了患者神经阻滞的经历。
结果：在接受治疗的616名患者中，562（91％）提供了完整的调查。受访者的平均年龄为53岁(标准差为12岁)，71%是女性，大多数（57％）报告说与CNCP一起生活了十多年。58%的人已经接受神经阻滞治疗超过3年，51%的每周频率。自从接受神经阻滞后，在11分数字评定量表上，患者自我报告疼痛强度的中位数改善为2.5分（95％CI-2.5至-3.0），66％报告停止或减少处方药，包括阿片类药物。大多数未退休的人(62%)正在领取残疾福利，无法以任何身份工作。当被问及停止神经阻滞会有什么影响时，大多数就业患者（52％）报告说他们将无法工作，大多数表明它们在多个域中发挥作用的能力会下降。
结论：接受CNCP神经阻滞的受访者认为这种干预有重要的疼痛缓解和功能改善。迫切需要随机试验和临床实践指南来优化CNCP神经阻滞的循证应用。
目的：我们探讨了患者对CNCP神经阻滞的看法。
方法：我们对安大略省四个社区疼痛诊所的CNCP疼痛患者进行了一项33项横断面调查，加拿大。该调查捕获了人口统计信息，并询问了患者神经阻滞的经历。
结果：在接受治疗的616名患者中，562（91％）提供了完整的调查。受访者的平均年龄为53岁(标准差为12岁)，71%是女性，大多数（57％）报告说与CNCP一起生活了十多年。58%的人已经接受神经阻滞治疗超过3年，51%的每周频率。自从接受神经阻滞后，在11分数字评定量表上，患者自我报告疼痛强度的中位数改善为2.5分（95％CI-2.5至-3.0），66％报告停止或减少处方药，包括阿片类药物。大多数未退休的人(62%)正在领取残疾福利，无法以任何身份工作。当被问及停止神经阻滞会有什么影响时，大多数就业患者（52％）报告说他们将无法工作，大多数表明它们在多个域中发挥作用的能力会下降。
结论：接受CNCP神经阻滞的受访者认为这种干预有重要的疼痛缓解和功能改善。迫切需要随机试验和临床实践指南来优化CNCP神经阻滞的循证应用。
