Vizüel Analog Skala ile Kanser Hastalarında Palyatif Ağrı Tedavisinin Etkinliğinin Değerlendirilmesi

OZET Giris: Palyatif bakim hastalarinda en sik gorulen ve belki de en onemli semptom, “olumun kendisinden daha korkunc” olarak tanimlanan siddetli agridir. Calismamizda agri sikayeti olan kanser hastalarinda palyatif agri tedavisinin etkinliginin belirlenmesi amaclandi. Yontem: Izmir Katip Celebi Universitesi Ataturk Egitim ve Arastirma Hastanesi Kanser Hastalarinda Palyatif Bakim ve Destek Servisinde 29 Temmuz 2013 – 1 Şubat 2016 tarihleri arasinda yatan tum hastalarin dosyalari retrospektif olarak tarandi. 704 hastadan yatisi ve taburculugu esnasinda Vizuel Analog Skala (VAS)’ya gore agri skoru kaydedilmis olan hastalar (n=112) calismaya dahil edildi. Calismaya dahil edilen hastalarin yas, cinsiyet, tanilari, yatis ve taburculuk esnasindaki VAS skorlari, kullanilan analjezik ilaclar ve hastanin yatarak tedavi gordugu gun sayisi geriye donuk olarak incelendi. Bulgular: Hastalarin 64’u (%57,1) erkek olup, tum olgularin yas ortalamalari 59,8 ± 14,5 yil idi. Kolorektal kanser %15,2 ile en cok gorulen tani olup, bunu %14,3 ile meme, %13.4 ile akciger ve %11,6 ile mide kanserinin izledigi saptandi. Hastalarin ortalama 13,0 ± 11,5 gun yatarak tedavi gordukleri tespit edilmistir. Olgularin servise yatis sirasinda kaydedilen VAS agri skorlarinin ortalama degeri 5,2 ± 2,6 olup, taburculuk sirasindaki bu deger ortalamasinin 2,2 ± 1,8’a geriledigi saptandi. Hastalarin agri tedavisinde; 82’sinde tramadol, 36’sinda fentanil, 28’inde asetaminofen ve 18’inde morfin kullanildigi tespit edildi. Sonuc: Calismamizda etkin analjezik tedaviyle hastalarin agri skorlarinda onemli derecede azalmalar tespit edilmistir. Agri tedavisinin onundeki engeller; agri tedavisi konusunda bilgi eksikligi olan doktorlar, narkotik bagimliligiyla ilgili cekinceler, semptomlarini gizleyen hastalar ve semptom kontrolune yeterince onem verilmemesi olarak siralanabilir. Palyatif bakim birimlerinde semptom yonetimine gereken onemin verilmesi ve yasam kalitesinin en yuksek duzeyde tutulmasi temel hedefler olmalidir. Anahtar kelimeler: Agri, agri yonetimi, gorsel analog skala, palyatif bakim ABSTRACT Introduction: The most common and most important symptom in the palliative care patients is severe pain as defined "more terrible than death". In our study, we aimed to determine the effectiveness of palliative pain treatment in cancer patients with pain. Methods: Files of all patients hospitalized in Palliative Care and Support Services for Cancer Patients at Izmir Katip Celebi University Ataturk Research and Training Hospital between 29.07.2013 – 01.02.2016 has been investigated retrospectively. Patients (n=112) with recorded pain scores according to the Visual Analogue Scale (VAS) from 704 patients has been included in the study.  Age, gender, diagnosis, VAS scores during hospitalization and discharge of patients included in the study, used analgesic drugs and number of days in treatment have been investigated retrospectively. Results: 57.1% (n=64) of the patients were male and the mean age was 59.8 ± 14.5 years. Considering diagnoses; colorectal cancer in 15.2%, breast cancer in 14.3%, lung cancer in 13.4% and stomach cancer in 11.6% was observed. The patients were inpatient treatment the mean 13.0 ± 11.5 days. The mean VAS pain scores of the patients recorded during hospitalization was 5.2 ± 2.6 and the mean of these values at discharge was 2.2 ± 1.8. In the pain treatment of the patients; using tramadole in 82, fentanyl in 36, acetaminophen in 28 and morphine in 18 was observed. Conclusion: A significant reduction in pain scores of the patients in our study were identified with an effective analgesic treatment. Obstacles to the treatment of pain; the doctors who are lack of information about pain treatment, fears about drug addiction, the patients who hide their symptoms and ignoring to symptom control as can be listed. Symptom management is important in palliative care units and quality of life should be kept at a high level. Keywords : Pain, pain management, palliative care, visual analog scale