This was the topic discussed recently when Dr. Adriano Laudico, consultant, Dept. of Surgery at UP-PGH and Chairman of PMIA (Pain Management Information Agency), was a guest on "Damayan" Channel 4’s longest running public service program hosted by Magsaysay awardee Ms. Rosa Rosal.
Dr. Laudico discussed the importance of pain control and management in safeguarding the patient’s health and total well being, particularly when confined in a hospital. He believes that when a patient’s complaint of pain is not promptly or properly treated, other complications could arise - like pneumonia, heart attack, delay in patient recovery, even an increase in hospital expenses. For this reason, surgeons, anesthesiologists and nurses were trained on the use and implementation of a "Pain Scale," a numeric scale from 0 to 10 indicating the level of pain experienced by the patient (with 1 as the lowest level of pain). This scale helps doctors and nurses determine the patient’s level of physical pain, thereby enabling them to choose the appropriate pain medication and dosage, and to evaluate whether the drug and the dose are causing satisfactory pain relief.
During the program, Dr. Laudico further added that in treating pain, it is vital that the proper medicines be prescribed. He said that there is a new class of pain medication in the market today called coxibs (rofecoxib) that does not cause side effects like gastric irritation and ulcers, which the more commonly used over-the-counter pain drugs called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) like Ibuprofen, diclofenac, aspirins, naproxen, etc. are known to cause. He stressed that in treating the patient’s pain, it is crucial that the pain reliever given should not add complications to the patient’s condition.
For serious and extreme levels of pain, particularly the kind that is experienced right after surgery (usually 9 or 10 on the pain scale), Dr. Laudico recommends a combination of an opiod (morphine) and rofecoxib (Vioxx) to help alleviate the patient’s discomfort. This, he said, has proven to be very effective during the critical pain state after the operation.
When asked whether rofecoxib could also be used in treating arthritis,
Dr. Laudico gave a resounding "Yes". Dr. Laudico strongly recommends rofecoxib for arthritic pain and swelling. Since there is yet no cure for arthritis, constant and regular use of pain relievers is necessary to reduce the arthritic pain and inflammation. It has been noted that, long term use of other pain medications like NSAIDs, may result in peptic ulcers, gastric bleeding or kidney damage. Ms. Rosal stated that she herself uses rofecoxib for the arthritis in her knees. "Even my daughter Toni Rose was prescribed Vioxx for acute pain," Rosal added.
Dr. Laudico urges the public to start scoring their own pain using the 0 to 10 numeric scale and reporting this to their physicians, families and friends. He advises the public to consult their doctors and seriously look into the benefits and possible side effects of pain relievers. He recommends alternatives such as coxibs for a safer and effective pain relief minus the side effects.
In its pursuit to help uplift the physical quality of life of Filipinos through information dissemination of proper pain management, the Pain Management Information Agency (PMIA) accepts inquiries from the general public. PMIA can be reached through e-mail paincare@pmia.com.ph , fax 892-3968 or send letters to P.O. Box 3485 Makati.
PMIA was established primarily to increase public awareness and understanding of pain and to recommend appropriate medical and practical ways to manage and control pain.