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Yıl:2021; Cilt: 58; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2021;58(4):257-260
Nöroloji Polikliniklerinde Nöropatik Ağrı Sıklığı: Çok Merkezli Bir Çalışma
CE Bekircan, B İnan, O Bulut, İ Sengün, N Karlı, N Günes, BG Cokal, SK Güler, T K Yoldas, D G Ozcanyüz, F Koc, Z Unlütürk, C Erdogan, B Uludağ
Hacettepe Üniversitesi, Ankara
Amaç: Nöropatik ağrı sık görülmesine rağmen, hastaların takibinde yanlış tanı ve irrasyonel tedavi sıklıkla gözlenmektedir. Bu çalışmanın amacı, nöroloji polikliniklerine başvuran hastalarda nöropatik ağrı sıklığını geçerli ve güvenilir skalalarla saptayıp hastaların tedavilerini gözden geçirmektir. Yöntem: Çalışma, üç ay boyunca 11 üçüncü basamak sağlık kuruluşunda yapılmıştır. Tüm hastalar nöropatik ağrı semptomları açısından sorgulanmıştır. Nöropatik ağrı yakınması olan ve/veya nöropatik ağrı nedeniyle takipte olan hastalara painDETECT ve “Douleur neuropathic en 4 questions (DN4)” anketleri uygulanmıştır. DN4 skoru 3’ten ve/ veya painDETECT skoru 13’ten yüksek olan hastalarla, çalışma sırasında nöropatik ağrı tedavisi alan hastalar nöropatik ağrılı hasta olarak değerlendirilmiştir. Buna göre nöropatik ağrı sıklığı hesaplanmış ve nöropatik ağrılı hastaların tedavileri incelenmiştir. Bulgular: Kohortumuzda nöropatik ağrı sıklığı %2,7’ydi (%95 CI: 1,5-4,9). En sık nöropatik ağrı nedeni diabetik nöropatiydi. Hastaların ortalama ağrı şiddeti painDETECT anketine göre 5,7±2,4 olup tedavi alanlarda daha düşüktü. Hastaların %72,8’i farmakolojik tedavi altında olup, en sık tercih edilen tedavi pregabalindi. Fakat gabapentinoid tedavisi alan hastaların %70’i yetersiz doz kullanmaktaydı. Buna ek olarak, hastaların %4,6’sı nöropatik ağrı tedavi kılavuzlarında yer almayan ilaç tedavileri altındaydı. Tartışma: Çok merkezli bu çalışmada, nöropatik ağrı sıklığı literatüre göre düşük saptandı. Nöropatik ağrının orta şiddetli olduğu gözlendi. Nöropatik ağrı tedavisindeki çok sayıda kılavuza rağmen, hastaların çoğunun ya yetersiz dozlarla ya da irrasyonel ilaçlarla tedavi edilmeye çalışıldığı gözlendi.
Neuropathic Pain Frequency in Neurology Outpatients: A Multicenter Study
Introduction: Neuropathic pain is common, but the frequency of misdiagnosis and irrational treatment is high. The aim of this study is to evaluate the rate of neuropathic pain in neurology outpatient clinics by using valid and reliable scales and review the treatments of patients.

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