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Bol je neugodno osjetno i emocionalno iskustvo koje se redovito javlja u mnogim kroničnim stanjima. U ovom radu opisana je primjena epiduralne analgezije kod bolesnika s kroničnom boli, od čega je obrađena primjena kod nemaligne i maligne boli. Kronična bol kompleksan je klinički problem koji utječe na sva područja života i rada pojedinca. Pod kroničnom boli podrazumijeva se bol koja traje od 3 do 6 mjeseci i dulje i ostaje prisutna i nakon što je završen proces cijeljenja tkiva. Opisana je primjena epiduralne analgezije kod liječenja križoblje kao najčešće kronične nemaligne boli, a potom je opisana i primjena epiduralne analgezije u liječenju karcinomske boli kao maligne boli. Epiduralna analgezija je tzv. neuroaksijalna blokada kod koje se anestetik aplicira u epiduralni prostor, a njegova će definicija, kao i kontraindikacije te komplikacije spomenute analgezije biti dane u radu. Kronična nemaligna bol tretira se davanjem epiduralnih injekcija koje najčešće sadrže kortikosteroide, a ponekad i lokalne anestetike, dok se kronična maligna bol najčešće tretira plasiranjem tuneliranog epiduralnog katetera putem kojeg se daju opijati i lokalni anestetici. Prilikom primjene epiduralne analgezije u liječenju kronične nemaligne i maligne boli od neizmjerne je važnosti uloga medicinske sestre. Medicinska sestra zadužena je za provođenje kvalitetne psihološke i fizičke pripreme pacijenta, uzimanje detaljne anamneze, edukaciju pacijenta i obitelji o samom postupku, pripremu aseptičnih uvjeta i monitoring pacijenta za vrijeme i po završetku postupka. Pain is an uncomfortable sensory and emotional experience that occurs regularly in many chronic conditions. In this paper, the use of epidural analgesia in patients with chronic pain is described, of which the use in non-malignant and malignant pain is discussed. Chronic pain is a complex clinical problem that affects all areas of an individual’s life and work. Chronic pain is pain that lasts from 3 to 6 months and longer and remains present even after the tissue healing process has been completed. The use of epidural analgesia in the treatment of low back pain as the most common chronic non-malignant pain is described, and then the use of epidural analgesia in the treatment of carcinoma pain as malignant pain is described. Epidural analgesia is the neuroaxial blockade in which the anesthetic is applied to the epidural space, and its definition, as well as contraindications and complications of the mentioned analgesia, will be given in the paper. Chronic non-malignant pain is treated by giving epidural injections, which usually contain corticosteroids and sometimes local anesthetics, while chronic malignant pain is usually treated by placing a tunneled epidural catheter through which opiates and local anesthetics are given. In the application of epidural analgesia in the treatment of chronic non-malignant and malignant pain, the role of the nurse is of immense importance. The nurse is in charge of conducting quality psychological and physical preparation of the patient, taking detailed anamnesis, educating patients and families about the procedure, preparing aseptic conditions and monitoring the patient during and after the procedure. |
