Chronic pain management in Hospital Sultanah Nur Zahirah, Kuala Terengganu: an overview

Pain is an unpleasant, subjective, sensory and emotional experience associated with actual or potential tissue damage or describes in the terms of such damage. Implementation of multimodal analgesic in the treatment of chronic pain involved the use of different classes of analgesics and different sites of analgesic administration to provide superior dynamic pain relief with reduced analgesic-related side effects. A retrospective observational study had been conducted from November 2016 to February 2017. Generally, we like to investigate the treatments available for treating chronic pain in Hospital Sultanah Nur Zahirah. Specifically, to observe the prescribing pattern of medications for chronic pain and to investigate the practice of multimodal analgesic approach among prescriber. A total of 100 patients had been selected from Pain Clinic and their required information was collected from Hospital Information System (HIS). Various classes of drugs were available to treat chronic pain which involved Paracetamol, Non-Steroidal Anti Inflammatory drugs (NSAIDs), selective COX-2 inhibitor, opioid, antidepressant and anticonvulsant. From this research, Tramadol (weak opiod) was mostly used to treat chronic pain while Diclofenac Sodium (NSAIDS) and Carbamazepine (anticonvulsant) were the lowest drugs of choice in treating chronic pain. About 72% (n=72) of the total patients were prescribed with combination of different classes of drugs which reflected the practice of multimodal analgesic approach in pain clinic among prescriber. Moreover, Chi-Square Test for Goodness of Fit was conducted to identify the association between primary team and multimodal analgesic. From the result, we can conclude that there is an association between these two variables (p<0.05) whereas null hypothesis was rejected.