Abstract
Introduction; The rate of people suffering from pain in Vietnam is very high (86.53% population), of which 63.43% are chronic pain and affect their professional activities 67.71%. People with severe and very severe pain 37.84%. In average age of 54.1 years of lìe, the patients suffered 1.86 years of pain. Pain management is very expensive (46.55% of people pay for pain treatment ≥ 150 USD in the last 6 months). The results of pain treatment are still limited; even 61.98% of the patients were satisfied with the treatment results, 19.5% were not satisfied. Hanoi Pain Society has established a own system of Pain Units and they have been working for 7 years. Objectives: 1. Determine the cause of the limitation of pain treatment results; 2. Finding solutions to improve pain treatment results in clinical practice; 3. Introduce 5 severe and difficult patients who have been successfully treated and give lessons for each case. Subjects and methods: Analysis of the results of examination and treatment of 6 Pain Units of the Hanoi Pain Society, discussion on treatment experience among pain units. Results: identified causes hindering the results of pain treatment as follows: Objectively; Patient delay in going to the doctor; There is no paraclinical diagnosis of pain; Pain has not been given enough attention; Lack of legal framework for motivation and work conditions; Subjective: Health workers are not trained in pain- lack of basic pain management skills; Many types of pain, many therapies, too many recommendations: causing bewilderment, difficult to choose the right therapy; dogma use, dependence on recommendations. The solutions to the above problems are: Active pain training and self-training; Approaching pain patients definitely (knowing regional anatomy, mastering the skills of clinical neurology, musculoskeletal specialty ..., clinical understanding of all types of pain); Meticulous (Exploiting detailed history, manipulating the patient’s diagnosis and treatment). meticulous, precise); Science (Analyzing to find the structure causing pain from the outside to the inside, accurately identifying the structure that is causing pain); Creativity (Must have “clinical bravery” in pain diagnosis and treatment, Creative use of medications and recommendations, mechanically). Skilled in performing clinical procedures (blockade) nerve, tendon-muscle-joint injection, etc.). Through 5 patients with difficult, severe pain, who are successfully treated by clinical procedures, the following lessons need to be clarified: Nerve blockade skills and musculoskeletal-ligament injection are the key to successful pain management; Clinical expertise is required to diagnose and creatively apply pain therapies. Confident and decisive in action.
