A team led by Dr. Zi-Xuan Wang from the Qingdao Municipal Hospital, a hospital affiliated with the Medical College, Qingdao University, has compared the pain management of psychological intervention and medication with commonly used medication in 262 patients requiring hepatic arterial chemoembolization for hepatic malignancy. The results indicate that both methods reduce pain and the patients who received psychological intervention combined with medication during the procedure report that the pain control is better.
Psychological intervention has been shown to reduce the postembolization pain during hepatic arterial chemoembolizatiom therapy. It is highly recommended as a complementary approach to pharmacological analgesia according to researchers.
Unbearable pain is the most common complaint during and after transarterial embolization. Large doses of opioid analgesics are often required in most patients when the pain is too severe to endure. Because these medications have side effects and a few patients are not susceptive to sedative and analgesic medication, it would be useful to develop nonpharmacologic analgesia approaches to improving this painful experience.
In the study it was demonstrated that the psychological status of hepatic malignancy patient was abnormal and several symptoms were related to the pain intensity during the procedure. It was indication to psychological intervention.
When psychological intervention was performed initially, only some of patients described pain relief. Once the medication was administrated, the pain intensity decreased clearly. Therefore, psychological intervention can not be practiced as the only form of pain relief. However, because the pain management of patients who received psychological intervention & medication was obviously better than that of control group, the effect of psychological intervention can not be neglected.
"This study is a step forward in pain management of transarterial embolization therapy," says Dr. Wang, "Though it was not a large study with complex trials, it conclusively shows that psychological intervention is effective and provides clinicians a safe, inexpensive, and effective complementary approach to pharmacological analgesia.
After several years of study, it's wonderful to demonstrate that the nonpharmacologic analgesia effectively improve the patient's experience of pain during the transarterial embolization. It is good news for patients."
Reference: Wang ZX, Liu SL, Sun CH, Wang Q. Psychological intervention reduces post- embolization pain during hepatic arterial chemoembolization therapy: A complementary approach to pharmacological analgesia. World J Gastroenterol 2008; 14(6): 931-935
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