Dor no paciente com lesão medular: uma revisão

Marcia de Miguel; Durval Campos Kraychete

doi:10.1590/S0034-70942009000300011

Review Article

Dor no paciente com lesão medular: uma revisão

Pain in patients with spinal cord injury: a review

Marcia de Miguel; Durval Campos Kraychete

http://dx.doi.org/10.1590/S0034-70942009000300011 Braz J Anesthesiol, vol.59, n3, p.350-357, 2009

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Resumo

JUSTIFICATIVA E OBJETIVOS: A dor crônica após a lesão medular é uma condição clínica de alta prevalência e de difícil tratamento. Desse modo, é importante que se conheça suas características clínicas e fatores causais para melhor abordagem diagnóstica e terapêutica. O objetivo desse trabalho foi revisar a literatura sobre a dor no paciente com lesão medular e sua possível associação com fatores físicos (nível da lesão, grau da lesão, tempo de início de dor) e fatores psicológicos (humor e qualidade de vida). CONTEÚDO: Foram pesquisados trabalhos na base de dados Medline, publicados nos últimos seis anos e os critérios de inclusão foram os estudos originais em maiores de 18 anos. Foram discutidas as características clínicas da dor no paciente com lesão medular, comparando casuística de diversos autores. CONCLUSÕES: Apesar das diferenças conceituais e metodológicas entre os estudos, as prevalências de dor encontradas em pacientes com lesão medular foram altas, variando entre 64% e 82%. A dor neuropática ao nível da lesão tem início precoce (dias ou semanas) e aquela abaixo do nível da lesão aparece mais tardiamente (meses ou anos). Não há associação entre dor e integridade da lesão e a porcentagem de pacientes que referem dor intensa varia entre 21 e 39%. Não foi possível concluir qual a relação entre a dor e o nível da lesão medular. A dor, no entanto, pode interferir de forma negativa no humor, na capacidade de realizar atividades cognitivas, sociais, recreacionais e laborativas.

Palavras-chave

DOR, Crônica, qualidade de vida

Abstract

BACKGROUND AND METHODS: Chronic pain after spinal cord injury is a highly prevalent clinical condition, which is difficult to treat. Therefore, it is important to know its clinical characteristics and causes for a better diagnostic and therapeutic approach. The objective of this study was to review the literature on pain in patients with spinal cord injury and the possible association with physical (level of the injury, completeness of lesion, pain duration) and psychological (mood and quality of life) factors. CONTENTS: Original studies in the Medline database with patients older than 18 years and published over the last six years were reviewed. The clinical characteristics of pain in patients with spinal cord injury are discussed, and the works of several authors are compared. CONCLUSIONS: Despite conceptual and methodological differences among the studies, the prevalence of pain in patients with spinal cord injury was high, varying from 64% to 82%. Neuropathic pain at the level of the injury has an early onset (days or weeks), while that below the level of the injury has a late onset (months or years). An association between pain and integrity of the lesion is not observed, and the percentage of patients who complain of severe pain varies from 21% to 39%. It was not possible to conclude which is the relationship between pain and level of spinal cord injury. However, pain can have a negative influence on mood and in the capacity to perform cognitive, social, recreational, and work-related activities.

Keywords

PAIN, Chronic, quality of life

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Dor no paciente com lesão medular: uma revisão

Pain in patients with spinal cord injury: a review

Marcia de Miguel; Durval Campos Kraychete

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Abstract

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