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Revista de la Sociedad Española del Dolor

Print version ISSN 1134-8046

Abstract

MORALES, C. et al. Fibromyalgia population before surgery: A descriptive study and analysis of post-hysterectomy pain. Rev. Soc. Esp. Dolor [online]. 2010, vol.17, n.5, pp.233-238. ISSN 1134-8046.

Objective: This study attempts to determine, firstly, the prevalence, and clinical and demographic profile of the fibromyalgia population in our health area subjected to major surgery, and secondly, to analyse the characteristics of the pain of fibromyalgia patients after abdominal hysterectomy, and comparing them with a control group. Material and method: A retrospective study conducted over the period January 2006 to May 2008, selecting cases with a previously established diagnose of fibromyalgia recorded in the Anaesthesia medical records. A standardised telephone interview was then carried out, in which the demographic, clinical and medical data was collected, paying particular attention to the treatment and follow-up of their fibromyalgia, as well as noting the post-surgical pain. A comparative study on the efficacy of the treatment of post-surgical pain, using a an intravenous (iv) PCA (Patient Controlled Analgesia) system with Tramadol and Metamizole, of patients with fibromyalgia who had an abdominal hysterectomy versus a control group. Results: Out of a total of 11,814 anaesthesia medical records were reviewed, there was a prevalence of 0.86% of the disease during the study period. The average clinical profile was: middle-aged woman, overweight, musculoskeletal and accompanying psychiatric disease, generally assessed as anaesthetic risk ASA II, on follow-up due to her fibromyalgia disease by her primary care doctor, multiple medication with NSAIDs (non-steroidal anti-inflammatory drugs), tranquillisers and muscle relaxants, and poorly controlled pain. The comparative study of post-operative pain in hysterectomies showed a similar efficacy in the treatment of both groups. However the patients with fibromyalgia requested 45% more analgesia by PCA than the control group. Conclusions: Patients with fibromyalgias could need a greater amount of analgesics than the general population after an abdominal hysterectomy. The PCA system enables a more individualised treatment to be chosen, since the patients can control the amount of analgesia they need depending on their pain, without increasing secondary effects.

Keywords : Fibromyalgia; Post-operative pain; PCA.

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