Dolor crónico o persistente

Introduccion: la carencia de experiencia en el tratamiento del dolor cronico en el hospital «Dr. Luis Diaz Soto¼, determino la implementacion de la consulta de dolor cronico. Metodos: se realizo una investigacion en 2 etapas. La primera (descriptiva), disenada para aproximarnos al comportamiento del dolor cronico en el hospital sede de la investigacion (incidencia) y la segunda (cohorte), para evaluar la efectividad de 2 propuestas terapeuticas analgesicas. Resultados: se evidencio errores de diagnostico, al no dominar conceptos esenciales de la tematica en cuestion, predomino el sexo femenino (61 %), con una edad promedio de 52,6 anos; las especialidades que mas remitieron a la consulta de dolor cronico fueron: oncologia (201 casos), ginecologia (137 casos) y ortopedia (68 casos). La combinacion de tramadol-paracetamol-piroxican-amitriptilina fue mas eficaz que la de cosedal-paracetamol-piroxican-amitriptilina, con menos efectos indeseables y mayor posibilidad de ajuste de dosis. El tiempo promedio de resolucion del sintoma dolor fue de 19 ± 4 dias, las consultas promedio fueron de cuatro, y el alta promedio se logro a los 151 dias. Los sintomas reaparecieron en 16 casos y en solo 9 no fue posible controlarlos de manera optima. Conclusiones: implementar una consulta de dolor cronico permitio atender a pacientes aquejados por este tipo particular de dolor, conocer su comportamiento en la institucion, e implementar medidas que mejoraron su calidad de vida. Background: The lack of experience in the treatment of chronic pain in "Luis Diaz Soto" Central Military Hospital led to the implementation of a consultation for chronic pain. Methods: Research was done in two stages. The first, (the descriptive stage) was designed to come closer to the behaviour of chronic pain in the hospital in which the investigation was done and the second (the cohort phase) was intended to evaluate the effectiveness of two analgesic and therapeutic proposals. Results: Diagnostic mistakes were shown which also revealed that there was no control of the essential concepts of the subject matter of the investigation. The sex that predominated was the female one (61%) and the average age was 52,6 years. The specialties that referred the most patients to the chronic pain consultation were: Oncology (201 cases), Gynaecology (137 cases) and Orthopaedics (68 cases). The combination of tramadol-paracetamol-piroxicam-amitriptyline was more effective than the one of cosedal-paracetamol-piroxicam-amitriptyline, with less undesirable effects and higher probabilities of dose adjustment. The average time resolution of pain symptoms was 19 ± 4 days. The average number of consultations was four and the average patients´ discharge was achieved at the 151 days of treatment. Symptoms reappeared in 16 cases and in only 9 cases it was impossible to control them in an optimal way. Conclusions: The implementation of a consultation for chronic pain allowed us to attend patients suffering from this particular type of pain, to know their behaviour in this hospital and to implement measures that improve their quality of life.