Abordagens médica e odontológica da neuralgia trigeminal

• Main Author: Tacon, Kelly Cristina Borges
• Publication Date: 2014
• Format: Doctoral thesis
• Language: por
• Source: Repositório Institucional da UFG
• Download full: http://repositorio.bc.ufg.br/tede/handle/tede/4380
• topic: Neuralgia do trigêmeo; Serviços de saúde; Fisiopatologia; Diagnóstico; Tratamento; Trigeminal neuralgia; Health services; Pathophysiology; Diagnosis; Treatment; MEDICINA::ANATOMIA PATOLOGICA E PATOLOGIA CLINICA

Introduction: Among the neuropathic pain to trigeminal neuralgia (TN) belongs to the group of chronic painful conditions of the head and neck region, characterized by paroxysmal and recurrent attacks of excruciating and sudden pain, shock-like. Various specialties may be involved in the process of differential diagnosis and treatment, and the lack of integration of this process a major cause of the complexity of diagnosis and lack of treatment effectiveness. There are few specialized services to treat this type of chronic pain and the knowledge about the existing approaches of those is of fundamental importance for stimulating the process of integrating them, the translation of accumulated knowledge to other professionals and creating new ones. Objective: To investigate the medical and dental approaches front of trigeminal neuralgia in two at a public university services. Methodology: An exploratory study, cross-sectional, qualitative. The subjects were 19 professionals working in one of the services studied. The data collection instrument was an interview guide with 13 questions divided into four axes, based on literature: a) pathophysiology and diagnosis of TN; b) knowledge and use of different treatments; c) professionals' perception of the services and d) routing flows and monitoring of patients. The taped interview, open and semi-structured guided the construction of a descriptive analysis that enabled the identification of emerging analytical categories (Bardin, 1995). Results: Of the analyzed statements seven categories. Among the main results are: lack of consensus among professionals about the pathophysiology; the diagnostic process was considered eminently clinical, while further tests are requested for differential diagnosis and exclusion of secondary causes for TN; perceived lack of training for the diagnosis, particularly for dental professionals; the choice of treatment is associated with vocational training, and the reported pharmacotherapy as the most used; integrative and complementary practices are known as part of the TN treatment, reported by some use; the limitations found in the treatment included the professional integration of disabled and knowledge to suit the individual needs of patients and also those found in the Unified Health System (UHS); as the perception of the services, despite reporting poor infrastructure, understand that there are other more significant problems such as those related to human resources; lack of specific nuclei for the treatment of pain; the teaching-learning environment as a facilitator for the care and multiprofessional and multidisciplinary approach; the lack of effectiveness of previous treatment and the limitations of the UHS regulation system as increased demand generators in the investigated services; the lack of understanding on the part of patients, that healing does not occur when pain control achieved by therapeutic dose, makes it difficult to follow. Considerations: The investigation of medical and dental approaches against TN in both investigated services identified aspects that can motivate and closer to them and the enhancement of existing resources, creating more favorable results to affected individuals, vocational training, research and the solvability of UHS actions.