The Right to Life without Pain

In 21st century, no patient should suffer pain. No matter how severe or advanced the disease, the patient has the right to spend days in peace, rather than in suffering. The development of the Pain Medicine, as a new branch of medicine, is therefore extremely important.

Pain is the most common symptom we encounter throughout life. As many as 50 percent of adult patients visit a doctor because they feel pain. If pain persists longer than three months, it is called chronic pain and then it is no longer considered to be just a symptom of a disease.

‘If the pain persists for a long time, it causes not only the physical but also severe mental suffering. Such a pain threatens the normal functioning of all organs and organ systems, disrupts the mental stability of a patient and changes his social behaviour. At that point, the pain is no longer just a symptom but grows into a disease per se’, explains Prof. Dr Nebojša Lađević, Anaesthesiologist and Director of the Centre for Anaesthesiology and Resuscitation of the Clinical Centre of Serbia, within which the Pain Management Office is also active.

Nobody Should Suffer Pain

Chronic pain is presently studied as an autonomic disease that manifests in a number of conditions such as rheumatic and neurological diseases, diabetes, AIDS, malignant diseases. Nowadays, chronic pain is taking on epidemic proportions, but it is still underestimated and insufficiently treated in our country.

‘Our people are ready to suffer pain for a long time. There are even doctors who explain to patients that it is normal for them to experience pain at a hospital, as it is synonymous with the institution itself. Therefore, it is necessary to intensify the education of not only all doctors, but also nurses and technicians about the necessity of proper assessment and treatment of pain. Nowadays, no patient should suffer pain. To that end, the Serbian Pain Society conducts trainings and is involved in large projects led by the European Association of Anaesthesiologists and the European Pain Federation’, says Prof. Dr Nebojša Lađević, who is at the same time the President of the Serbian Pain Society.

Global Trends Present Also in Our Country

The modern trends in the area of pain management are actively followed in Serbia. The multidisciplinary Pain Management Office within the Clinical Centre of Serbia, where patients with long-persisting severe pain find the lifesaver for their suffering, is an example to follow. In accordance with the European concept of treatment, it gathers anaesthesiologists, physiatrists, neurosurgeons and psychiatrists to work together. It is also supplied with equipment for the most complex interventional procedures that can be performed only here. Nevertheless, the need for pain management is rapidly growing across Serbia.

‘Pain management outpatient clinics and offices have been opened, and education of doctors is continuing on a daily basis. Being familiar with the pain assessment, type and intensity, as well as proper therapy is invaluable for every doctor. Elective courses in the field of Pain Medicine have been introduced in the 4th and 5th year of the Faculty of Medicine, a subspecialization in Pain Medicine has been established and the sixth generation of subspecialists is about to surface. It is necessary to further develop education, especially in the field of very complex interventional procedures, where we lack experts’, explains professor Lađević.

New, Even More Effective Therapies

Pain Medicine is being developed in the United States and Western European countries as a special branch of medicine that is considered an indispensable support to almost all other branches of medicine. In most European countries, there are stand-alone pain management clinics, as specialized institutions for the diagnosis and treatment of chronic pain. Even when there is no cure for a serious disease, there are remedies now to alleviate the suffering of such patients. This is achieved by administering opioids either via tablets or patches, or by some of the interventional procedures.

‘New generations of medicines have better efficacy in treatment and fewer side effects, which is of immense importance for our patients. Tapentadol, having a new mode of action, is one of the medicines to be launched soon, from which we have great expectations. The particular medicine acts in two ways, both as an opioid for severe pain and as a good analgesic for neuropathic pain, and it has low number of side effects in general, so its safety profile is high. We nowadays must not let patients suffer pain irrespective of the cause thereof’, states Prof. Dr Nebojša Lađević.