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PROJECT “The Department of Chronic Pain of the State Institution “Institute of neurosurgery named after academician A. P. Romodanov of NAMS of Ukraine”

The project justification

What does the problem of chronic pain mean for an individual and society?

The state of affairs in Ukraine.

     According to epidemiological studies from 6 to 8 percent of the population suffer from chronic pain in Europe. In terms of Ukraine's population this amounts to hundreds of thousands of patients, many of whom are forced to apply for a disability group, go to easier work and often be on a sick leave. The society and the patients` families have to carry a heavy burden of costs associated with the treatment of chronic pain.

     Pain medicine (medicine of pain or pain management) is a new field in medicine which has been developing rapidly in the advanced economies in the past few decades and is characterized by unification of approaches and efforts of various medical specialties with the aim of easing the suffering and improving the quality of life of the patients who live with pain.

       Methods of pain medicine have proved their effectiveness in various forms of headache and facial pain, pain after spine injuries and operations on it, post-traumatic pain of upper and lower extremities and other types of neuropathic pain (radiculitis without nerve root compression, diabetic neuropathy, postherpetic neuralgia), pain after amputation of limbs, pain in cancer, chronic pelvic pain. The problem of chronic pain has gained a particular importance in our country since the beginning of hostilities as a result of the Russian Federation aggression in the East of Ukraine. A large number of wounded and victims among the military and among the civilian population require the establishment of a comprehensive system of rehabilitation of these patients, a significant component of which is treatment of chronic posttraumatic pain.

Implementation of pain medicine techniques in practice allows to expand the range of treatment procedures, including those in neurosurgery, to assist patients having annoying pain, but for which conventional treatment is not recommended for forbidden. The techniques used in pain medicine are minimally invasive (non-traumatic), the vast majority of them are performed on an outpatient basis ("one day surgery") and have a lower cost compared to the "big" surgery with proven clinical efficacy.

Currently not a single department of chronic pain has been established in the public health system of Ukraine, in contrast to the vast majority of post-socialist and post-Soviet countries. There have been attempts to solve the problem by some professionals and enthusiasts in several private clinics.

            Establishment of the Department of Chronic Pain of the State Institution “Institute of neurosurgery named after academician A. P. Romodanov”. What are the possible implications for patients and society?

        The purpose of establishment of the Department of chronic pain is the development and implementation into Ukrainian medical practice and ensuring the availability of the latest guidelines on pain medicine, means and methods of anesthesia.

         Implementation in practice of pain medicine techniques allows to expand the range of treatment procedures including those in neurosurgery, assist patients (increase the number of treated patients) for whom traditional neurosurgical treatment is not indicated or is contraindicated. As shown by the data below, the development of pain medicine at the Institute of neurosurgery will be beneficiary for: 1) the patient who gets rid of suffering; 2) the institution, which expands the range of its assistance, which will cover the types of pathology that have not been the subject of attention of the traditional neurosurgical treatment; 3) the society that will benefit from the return of patients to active life and labour.

         Below we have selected a few types of pain that are most often found in clinical practice (headache, trigeminal neuralgia, spinal pain, cancer, spasticity, chronic pelvic pain) and in the table we show the benefits given by pain medicine introduction (table 1).

           What is necessary to establish the department of chronic pain?

Currently establishment of chronic pain treatment departments in medical institutions of the state form of ownership has been constrained by the need to purchase and install expensive equipment for pain medicine procedures in one surgery unit.

As shown in table 2, the cost of the necessary equipment is about 300 thousand Euros.

Cooperation with charitable organizations and foundations can be the solution to the problem. Given the lack of public funding for purchase of medical equipment, joint efforts of the medical community, concerned public and socially-oriented business can guarantee that the citizens of Ukraine will receive modern medical care in accordance with best international standards.

5,000,000

Lives in need of humanitarian assistance

3,200,000

Lives identified to be extremely vulnerable

1,700,000

Children caught in conflict torn areas