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Pain Management in Chronic Limb Threatening Ischaemia: A Multi-centre Cross-Sectional Study - PubMed

6 days ago
  • #Pain Management
  • #Chronic Limb-Threatening Ischaemia
  • #Analgesics
  • Chronic Limb-Threatening Ischaemia (CLTI) involves persistent ischaemic rest pain lasting two weeks or more.
  • Pain management in CLTI patients remains challenging, with the WHO analgesic ladder potentially leading to suboptimal relief and side effects.
  • A cross-sectional study across two hospitals evaluated pain management using the Brief Pain Inventory (BPI) score.
  • 104 patients (median age 69; 64.4% male) reported median current pain of 5/10 and worst pain of 8/10 in the last 24 hours.
  • 80.7% of patients reported moderate to severe pain (≥5/10), with inadequate pain relief in 39.6% despite widespread use of paracetamol and strong opioids.
  • Pain interfered with general activity (76.7%), mood (67.0%), mobility (83.5%), and sleep (73.6%) in most patients.
  • 14.2% of patients with severe pain (≥7/10) had no strong opioid documented, and 6.3% received no paracetamol.
  • The study concludes that pain management for CLTI inpatients is inadequate, negatively affecting nearly all aspects of life.
  • Lack of research and understanding of ischaemic pain mechanisms likely contributes to poor pain management.
  • Urgent further research is needed to establish evidence-based analgesic strategies specific to ischaemic pain.