RESUMO
Cannulation of the internal jugular vein is often necessary for the management of critically ill patients. Despite being a very common procedure and performed more and more safely, several complications still occur. Horner's Syndrome (HS) is one of those complications described before the use of ultrasound as a method of guidance. HS is caused by functional interruption of sympathetic nerve supply to the eye, leading to a classic triad of ipsilateral ptosis, miosis, and anhidrosis. We present the case of a patient, in need of emergent surgery to control the hemorrhagic focus after delivery, with a transient HS secondary to internal jugular vein cannulation under real-time ultrasound guidance.
RESUMO
BACKGROUND: Multiple sclerosis is a chronic neurological disease with increasing incidence and prevalence worldwide being the main cause of non-traumatic disability in young adults. Both acute and chronic pain have been mentioned as the most common symptoms among those patients. OBJECTIVE: This study was designed to evaluate the pain experience among patients with multiple sclerosis by describing its prevalence, characteristics, analgesic treatment and its efficacy, and also the impact of pain on quality of life. METHODS: A cross-sectional observation survey was carried out on patients with multiple sclerosis followed in a tertiary hospital. Data were collected between December 2019 and March 2021 from a structured telephone inquiry, applying two questionnaires, the Brief Pain Inventory and the McGill Pain Questionnaire (MPQ), to evaluate the prevalence of pain and its impact on quality of life (QoL). Clinical records were also consulted to obtain data on disease duration, year of diagnosis, MS type, Expanded Disability Status Scale (EDSS) score. RESULTS: Our sample included 305 patients in a universe of 1500, mainly women, with mean age of 44.27 years, and most of them presented with an outbreak-remission subtype of disease. One hundred twenty-four patients experienced pain which corresponds to 41% of the patients. Considering the patients who experienced pain, 67.7% were under treatment and of these, 64.3% with only one painkiller. Pain significantly interfered with general activity, mood, and regular work. CONCLUSION: Pain was an important symptom in this group of patients with MS and significantly interfered with mood, general activity, and regular work. The maximum intensity of pain felt by patients was significant and only 67.7% of patients were under analgesic treatment with mean pain relief of 54. NSAIDs were the most used drugs followed by gabapentinoids and acetaminophen for the management of pain. Medical community must continue to study this population in order to improve the approach to pain in these patients and improve quality of life.
