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Chronic Pain Treatment for Patients with Vascular Ulcers of the Lower Limbs

Received: 21 February 2022    Accepted: 18 March 2022    Published: 16 June 2022
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Abstract

Pain is found in 46-84.5% of patients with vascular ulcers of the lower limbs, varying according to the records considered and the etiology of the ulcer. Vascular ulcers associated with arterial insufficiency are generally more painful than vascular ulcers associated with venous insufficiency. An algorithm for the management of chronic cancer pain in patients is provided by the WHO analgesic ladder, which is commonly used by physicians. In clinical practice, the ladder is also applied to chronic non-cancer pain, even though this kind of application is limited by the absence of an evaluation of the pathogenetic mechanisms of pain. The WHO analgesic ladder drives therapy solely depending on the severity and persistence of pain, recommending progressive “step by step” pharmacologic therapy, starting with non-opioid medications (NSAIDs and Paracetamol) for mild pain, followed by mild (e.g. tramadol) and strong opioids (e.g. morphine) for moderate to severe pain. It must be noted that addiction to long-term therapy may occur even with non-opioid drugs. Short-term therapy with opioids has been associated with adverse reactions (nausea, constipation, sleepiness, dizziness and itching) in nearly 50% of the patients. Our revision of the literature on this subject analyzes the issues of analgesic chronic therapy with opioids, providing directions on how to optimize it for patients with chronic pain associated with the presence of vascular ulcers of the legs.

Published in Journal of Family Medicine and Health Care (Volume 8, Issue 2)
DOI 10.11648/j.jfmhc.20220802.12
Page(s) 37-41
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Opioids, Chronic Non-cancer Pain, Vascular Skin Ulcers, Wound Care

References
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Cite This Article
  • APA Style

    Rolando Tasinato, Mario Biral, Corrado Da Lio, Max Dei Negri, Gaia Degli Angeli, et al. (2022). Chronic Pain Treatment for Patients with Vascular Ulcers of the Lower Limbs. Journal of Family Medicine and Health Care, 8(2), 37-41. https://doi.org/10.11648/j.jfmhc.20220802.12

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    ACS Style

    Rolando Tasinato; Mario Biral; Corrado Da Lio; Max Dei Negri; Gaia Degli Angeli, et al. Chronic Pain Treatment for Patients with Vascular Ulcers of the Lower Limbs. J. Fam. Med. Health Care 2022, 8(2), 37-41. doi: 10.11648/j.jfmhc.20220802.12

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    AMA Style

    Rolando Tasinato, Mario Biral, Corrado Da Lio, Max Dei Negri, Gaia Degli Angeli, et al. Chronic Pain Treatment for Patients with Vascular Ulcers of the Lower Limbs. J Fam Med Health Care. 2022;8(2):37-41. doi: 10.11648/j.jfmhc.20220802.12

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  • @article{10.11648/j.jfmhc.20220802.12,
      author = {Rolando Tasinato and Mario Biral and Corrado Da Lio and Max Dei Negri and Gaia Degli Angeli and Greta Loss},
      title = {Chronic Pain Treatment for Patients with Vascular Ulcers of the Lower Limbs},
      journal = {Journal of Family Medicine and Health Care},
      volume = {8},
      number = {2},
      pages = {37-41},
      doi = {10.11648/j.jfmhc.20220802.12},
      url = {https://doi.org/10.11648/j.jfmhc.20220802.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jfmhc.20220802.12},
      abstract = {Pain is found in 46-84.5% of patients with vascular ulcers of the lower limbs, varying according to the records considered and the etiology of the ulcer. Vascular ulcers associated with arterial insufficiency are generally more painful than vascular ulcers associated with venous insufficiency. An algorithm for the management of chronic cancer pain in patients is provided by the WHO analgesic ladder, which is commonly used by physicians. In clinical practice, the ladder is also applied to chronic non-cancer pain, even though this kind of application is limited by the absence of an evaluation of the pathogenetic mechanisms of pain. The WHO analgesic ladder drives therapy solely depending on the severity and persistence of pain, recommending progressive “step by step” pharmacologic therapy, starting with non-opioid medications (NSAIDs and Paracetamol) for mild pain, followed by mild (e.g. tramadol) and strong opioids (e.g. morphine) for moderate to severe pain. It must be noted that addiction to long-term therapy may occur even with non-opioid drugs. Short-term therapy with opioids has been associated with adverse reactions (nausea, constipation, sleepiness, dizziness and itching) in nearly 50% of the patients. Our revision of the literature on this subject analyzes the issues of analgesic chronic therapy with opioids, providing directions on how to optimize it for patients with chronic pain associated with the presence of vascular ulcers of the legs.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Chronic Pain Treatment for Patients with Vascular Ulcers of the Lower Limbs
    AU  - Rolando Tasinato
    AU  - Mario Biral
    AU  - Corrado Da Lio
    AU  - Max Dei Negri
    AU  - Gaia Degli Angeli
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    Y1  - 2022/06/16
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    DO  - 10.11648/j.jfmhc.20220802.12
    T2  - Journal of Family Medicine and Health Care
    JF  - Journal of Family Medicine and Health Care
    JO  - Journal of Family Medicine and Health Care
    SP  - 37
    EP  - 41
    PB  - Science Publishing Group
    SN  - 2469-8342
    UR  - https://doi.org/10.11648/j.jfmhc.20220802.12
    AB  - Pain is found in 46-84.5% of patients with vascular ulcers of the lower limbs, varying according to the records considered and the etiology of the ulcer. Vascular ulcers associated with arterial insufficiency are generally more painful than vascular ulcers associated with venous insufficiency. An algorithm for the management of chronic cancer pain in patients is provided by the WHO analgesic ladder, which is commonly used by physicians. In clinical practice, the ladder is also applied to chronic non-cancer pain, even though this kind of application is limited by the absence of an evaluation of the pathogenetic mechanisms of pain. The WHO analgesic ladder drives therapy solely depending on the severity and persistence of pain, recommending progressive “step by step” pharmacologic therapy, starting with non-opioid medications (NSAIDs and Paracetamol) for mild pain, followed by mild (e.g. tramadol) and strong opioids (e.g. morphine) for moderate to severe pain. It must be noted that addiction to long-term therapy may occur even with non-opioid drugs. Short-term therapy with opioids has been associated with adverse reactions (nausea, constipation, sleepiness, dizziness and itching) in nearly 50% of the patients. Our revision of the literature on this subject analyzes the issues of analgesic chronic therapy with opioids, providing directions on how to optimize it for patients with chronic pain associated with the presence of vascular ulcers of the legs.
    VL  - 8
    IS  - 2
    ER  - 

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Author Information
  • General and Vascular Surgery Department, Mirano General Hospital, Venezia, Italy

  • General and Vascular Surgery Department, Mirano General Hospital, Venezia, Italy

  • General and Vascular Surgery Department, Mirano General Hospital, Venezia, Italy

  • General and Vascular Surgery Department, Mirano General Hospital, Venezia, Italy

  • General and Vascular Surgery Department, Mirano General Hospital, Venezia, Italy

  • General and Vascular Surgery Department, Mirano General Hospital, Venezia, Italy

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