新冠肺炎疫情下的慢性疼痛處置考量
 
林旺生^1,2　蘇府蔚³　張祜銘⁴　王偉全^5,6　楊振亞^2,5,7

 
新冠肺炎疫情自2019年末以來，自中國武漢地區迅速蔓延至世界各地，對各國的公衛和醫療量能造成巨大威脅。醫療資源的整合和重新分配成為公共衛生的一大課題，所以許多慢性疾病的處置，在疫情之下有著不同的面貌。保持社交距離和減少不必要的外出，在疫情期間是許多國家廣泛採取的防疫措施，也因此，病人因非急迫性醫療至醫院就診的意願大幅下降。慢性疼痛為一普遍的健康問題，在處理上往往需要長期的使用藥物及非藥物的治療方式，且必須定期地監控各項治療所帶來的療效和潛在副作用。疫情席捲各國的當下，就面對慢性疼痛病人的第一線醫護人員而言，是一個全新的挑戰。本篇旨在藉由文獻回顧，協助醫師和健康相關從業人員能在疫情期間，讓慢性疼痛病人持續地得到適切且有效的治療和追蹤。
（台灣家醫誌2022; 32: 8-18）DOI: 10.53106/168232812022033201002
 
關鍵詞：新冠肺炎，慢性疼痛，鴉片類藥物，新型冠狀肺炎病毒
 

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¹臺北榮民總醫院員山暨蘇澳分院復健科、²國立陽明交通大學醫學系、³臺北榮民總醫院麻醉部、⁴臺北市立聯合醫院松德院區成癮防治科、⁵台北超全能診所、⁶台中長安醫院復健科、⁷台中榮民總醫院嘉義分院復健科
受理日期：110年7月26日　　修改日期：110年9月26日　　同意刊登：110年12月28日
通訊作者：楊振亞　　　　　通訊地址：嘉義市600西區世賢路二段600號　台中榮總嘉義分院復健科

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Clinical Considerations in Chronic Pain Management
during the Era of COVID-19 Pandemic
 
Wang-Sheng Lin^1,2, Fu-Wei Su³, Hu-Ming Chang⁴, Wei-Chuan Wang^5,6 and Chen-Ya Yang^2,5,7

 
Chronic pain is a major public health concern which not only results in impaired quality of life on the individual level but also poses a tremendous burden on the healthcare system and economy on a national scale. As the COVID-19 pandemic has greatly impacted the world since 2019, the operation of healthcare systems has changed to accommodate non-pharmacologic interventions against the COVID-19 outbreak. As a result, chronic conditions have been managed differently since the medical resources are less accessible. Chronic pain requires continuous and concerted medical attention to carefully assess the possible adverse events associated with pharmacologic interventions and to adjust the regimen accordingly. The indication for procedural interventions should also be evaluated since the pain is often fluctuating. In this article, we aim to review updated evidence-based practices of pharmacologic and non-pharmacologic interventions with a focus on clinical considerations for chronic pain management. A feasible framework is proposed for telemedicine and interdisciplinary teamwork to help facilitate continuous care during this trying time.
(Taiwan J Fam Med 2022; 32: 8-18) DOI: 10.53106/168232812022033201002
 
Key words: analgesics, chronic pain, COVID-19, opioid, SARS-CoV-2
 

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¹Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Yuan-Shan/Su-Ao Branch, Yilan, Taiwan. ²School of Medicine, National Yang-Ming Chiao-Tong University, Taiwan. ³Department of anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan. ⁴Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan. ⁵Department of Physical Medicine and Rehabilitation, Everan Hospital, Taichung, Taiwan. ⁶Ultra Clinic, Taipei, Taiwan. ⁷Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Chiayi Branch, Chiayi, Taiwan.
Received: July 26, 2021; Revised: September 26, 2021; Accepted: December 28, 2021.