Integrated Media Reporter Qin Miao
On July 24, in order to respond to the call of the "China Pain Strategy" and enhance multidisciplinary pain management exchanges, the "Painless V Come" 2021 Pain Summit Forum sponsored by Huizhi Pharmaceutical Co., Ltd. was held in Beijing.
In fact, since 2007, the Ministry of Health issued Document No. 227 requiring hospitals above the second level to open pain departments. In the past 15 years, the establishment of disciplines has been on the way, but chronic pain management in my country has always been a huge systematic project, not only relying on the construction and development of pain disciplines.
What is the significance of holding this theme meeting today? What is the crux of pain in China? How to break the deadlock?
As we all know, pain is one of the most common causes for patients to seek medical treatment, and the majority of patients in each clinical department complain about pain. The current situation of chronic pain diagnosis and treatment in China is not optimistic. Data shows that long-term and chronic pain seriously affects the good relationship between doctors and patients, and will undoubtedly affect social harmony in the long run. The treatment methods for pain are changing with each passing day, and for patients with pain, how to provide comprehensive management has become a topic of concern to this meeting. Multidisciplinary collaboration is currently the main model of pain management. Its main purpose is to transform the single-line connection between a patient and a doctor into a roundabout between a patient and multiple doctors according to the diagnosis and treatment needs of different pain patients, which is of great significance to improving the treatment of patients' pain.
Is this meeting convened by national policy trends, or is it the urgent need of clinicians, or is it the eager expectation of pain patients? Undoubtedly, this is the joint efforts of the three parties to push the "painless life" to the forefront, which is to break the island of pain treatment and turn it into a clinical connection chain.
Pain Department of Sino-Japanese Friendship Hospital Professor Fan Bifa
my country's chronic pain patients have exceeded 300 million
Data shows that my country's chronic pain patients have exceeded 300 million, and are growing rapidly at a rate of 10 million to 20 million per year, showing a trend of younger age. The current situation of chronic pain diagnosis and treatment in my country is extremely unobjective, both in terms of pain identification, diagnosis, and standardized treatment are in the early stages.
Compared with other developed countries, the development of pain disciplines in my country started late. Since the national level introduced relevant policies for the construction of pain disciplines at the construction of pain disciplines in 2007, secondary hospitals have required to set up special pain departments. Professor Fan believes that in the face of the pain problem of 300 million people, relying solely on one pain department cannot solve the problem. China's pain discipline is still a young discipline and still faces many challenges such as insufficient multidisciplinary collaboration, lack of individualized analgesia, and irregular medication use. In 2020, the China-Japan Friendship Hospital was commissioned by the National Health Commission Medical Administration and Administration Bureau to establish the National Pain Quality Control Center. It can be seen that the quality control and management of pain diagnosis and treatment are paid attention to from the national level.
Orthopedic Department of West China Hospital, Sichuan University Professor Pei Fuxing
New Thoughts on Postoperative Pain Management of Orthopedics
Accelerated Rehabilitation Surgery (ERAS) is a new requirement and thinking for modern surgery. Nowadays, many of the tension in the relationship between doctors and patients are caused by the patient's large and small complications. While these complications cause patients to suffer, they extend the hospitalization time, and the medical expenses continue to increase, which has increased the impact on work and family. Just imagine if the doctor cures the patient's disease without any complications, then the doctor-patient conflict will naturally be reduced. Only by truly achieving painless surgery can patients recover faster. Among them, COX-2 inhibitors play an important role in multimodal analgesia, which can reduce patients' stress response and promote rapid recovery.
Department of Rheumatology and Immunology, First Affiliated Hospital, Harbin Medical University Professor Zhang Zhiyi
Early recognition of osteoarthritis is particularly important
Since there are individual differences in the responses of different patients to pain and analgesic drugs, various factors should be considered comprehensively, such as the patient's pain degree, pain mechanism, different drug action mechanisms and administration methods, so as to formulate the optimal pain management plan, so as to achieve the maximum benefit of analgesic treatment.
Early diagnosis of bone and joints has always been a challenging topic.Because only by identifying patients early, strengthening management, and cooperating with drug treatment can we achieve an ideal treatment state. Studies have shown that celecoxib can directly act on inflammation of the cartilage, synovium and subchondral bone, and at the same time has a small impact on the gastrointestinal tract and can be a priority for early arthritis.
Department of Neurology, Huashan Hospital Affiliated to Fudan University Professor Wang Yi
Comprehensive treatment concept for stroke pain
In the central sensitization state, the upward pain signal is amplified, the downward regulation effect is suppressed, and the pain amplifier effect is exerted, and the patient's pain response is aggravated. Pain after stroke is caused by multiple mechanisms, and central sensitization is a very important mechanism. After the inflammation subsides, the neurotic excitement still does not subside, and the "pointing a deer to make a horse" becomes a small pain and becomes a big pain.
Department of Pain, First Affiliated Hospital, Nanchang University Professor Zhang Daying
Digital health and pain management in the post-epidemic era
In the situation where the public medical system is nearly saturated, the full and individualized management of chronic pain patients is the current problem. Digital health provides comprehensive support for pain patients and pain specialists. The mini program for assisted diagnosis of myofibropathy helps patients identify early and assists doctors in rapid diagnosis. This program ensures that timely and reasonable treatment is a reality for patients.
Starting ceremony—China Pain Diagnosis and Treatment Quality Improvement Initiative
Sub-venue: ERAS Orthopedic Acceleration Sub-venue
from Beijing Hospital Orthopedics Professor Xue Qingyun's report is "Exploration and Coping Mechanism of Orthopedics Chronic Pain Mechanism". He pointed out that preventive analgesia should run through the entire perioperative period. Multimodal analgesia advocates the combination of different analgesic drugs and analgesic methods to exert the synergistic effect of analgesics.
From Professor Ma Jun of the Orthopedic Department of West China Hospital of Sichuan University, the report is "Construction and Evaluation of ERAS Demonstration Ward". He emphasized that the pain management of orthopedic ERAS wards must achieve two-way management of "physiological analgesia" and "psychological analgesia". Physiological analgesia mainly reduces harmful stimulation and afferent, and reduces the risk of central sensitization. Psychological analgesia is to provide preoperative education, build trust and eliminate fear.
From Professor Wu Zhicheng, the Pain Department of the Anesthesiology Department of Taichung Veterans General Hospital, the report is "Practice of Perioperative NSAIDs Use Strategies Based on Evidence-Based Guidelines". He proposed that continuing to administer NSAIDs drugs represented by oral selective COX-2 after discharge can be used as part of multimodal analgesia, which can effectively reduce postoperative pain, reduce opioid use, and accelerate postoperative rehabilitation.
From the Orthopedic Department of Peking University People's Hospital Professor Sun Tiezheng 's report is "The Painless Path of Joint Surgery under the Guidance of Precision Medicine". ERAS is based on the entire system and evidence-based . Multidisciplinary collaboration helps patients reduce the occurrence of surgical risks. Selective COX-2 inhibitors are the preferred analgesics of orthopedic surgery. They have fast, long-term and strong efficacy, and are safer than non-selective NSAIDs. ERAS is based on the entire system and evidence-based medical evidence, and multidisciplinary collaboration helps patients reduce the risk of surgery.
Sub-venue: Chronic Pain Sub-venue
From Professor Dong Zhao, Department of Neurology, General Hospital of the People's Liberation Army, the report is "Identification and Specification of Central Sensitization". He pointed out that common chronic pain diseases are often accompanied by central sensitization, which is also the main mechanism of neuropathic pain and central dysfunctional pain.
From Professor Feng Zhiying from the Department of Pain, , the First Affiliated Hospital of Zhejiang University School of Medicine, said that correct evaluation of pain will help the diagnosis and treatment of diseases. Comprehensive evaluation of pain includes intensity assessment and assessment of impact on patients, screening and evaluation of current mechanisms, evaluation of accompanying symptoms (sleep, mood) and disease-specific evaluation. Dynamic assessment of pain helps to manage pain comprehensively, and appropriate treatment options should be selected based on the pain mechanism and pain accompanying symptoms.
Professor Xiong Donglin from the Department of Pain, Nanshan District People's Hospital, Shenzhen was "Early Identification and Intervention of Myofibrous Pain". He believes that pain is the main symptom of fibrous muscle pain. At the same time, it is often accompanied by fatigue and sleep disorders. Early identification of clinical symptoms can help guide diagnosis and treatment.
From Professor Ye Ling, the Department of Pain, West China Hospital, Sichuan University, in "Rational Selection and Use of Pain Drugs", she pointed out that with the in-depth research on pain diagnosis and treatment in my country, the continuous improvement of analgesic concepts, and the variety of analgesic drugs are becoming more and more abundant, individualized analgesics has received more and more attention in pain management. Choosing medicine is like "making a dish". According to the patient's different symptoms, mechanisms and comorbidities, select the content of "this dish" and match the patient with appropriate drugs.
Huizhi Greater China Chief Medical Officer and Clinical Research Head Yu Wei said: "Huizhi's mission is to help people around the world live healthier at every stage of their lives. In China, we have more than 20 high-quality drug brands and have benefited tens of millions of patients. Based on the forward-looking disease management concept, strong business capabilities and advanced digital technology, we are committed to helping doctors provide individualized diagnosis and treatment and health management services to patients. After more than 30 years of Puqiang's history in the Chinese market, we have been highly recognized by doctors and industry experts and established a deep foundation of cooperation. Especially in the field of pain treatment, we have been closely working with the government and multiple partners to actively promote interdisciplinary cooperation in chronic pain diagnosis and treatment, establish a comprehensive management and prevention system for chronic pain, and help realize the Chinese dream without pain."
