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Pain Therapy

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apl. Prof. Dr. med.
Winfried Meissner
Medical Director of the Department of Pain Therapy

fon: +49 3641 9323350
fax: +49 3641 9323152

mail: Winfried.Meissner



The team from the Outpatient Pain Center of the Department of Anesthesiology and Intensive Care Medicine treats patients with acute and chronic pain in various areas:

Chronic Pain Therapy - Consultation Service

Patients with chronic pain who are treated in the clinic may consult with the Pain Center team. In general, this is for cases of tumor pain resulting from advanced malignancy, severe circulatory problems or accident victims. Together with the primary physicians an attempt will be made to reduce the pain to an acceptable level. The care of cancer patients has a high priority. By first exhausting even unconventional methods, the need for instrument-based and invasive procedures such as catheters and pumps has declined. We try to see the patient as a whole and not only from the perspective of pain. Our Pain Center in Jena is a pioneer of Palliative Medicine for patients with incurable tumor diseases.

Outpatient Consultation

On referral from general practitioners, patients with chronic pain can have a consultation.

Even the regularly organized multidisciplinary pain conferences aid in patient care. Here both outpatient and inpatient "problem patients" can be seen by a team of specialists composed of inpatient and general practice experts, who will make concrete recommendations for further diagnosis and treatment. Here, a close cooperation has developed between the Clinics of Neurology, Psychiatry, Internal Medicine, the Institute of Physiotherapy, the Center for Naturopathic Medicine, and other partners.

In 2011, ten such pain conferences were held. The inpatient, multimodal treatment of chronic pain has been further expanded. The requirements were set by the introduction of the OPS procedure 8-918. Upon admission, a comprehensive assessment is made by each of the disciplines involved (the Pain Center of the Department of Anesthesiology, the Department for Neurology, Institute of Physiotherapy, and Institute of Psychology). Then, in joint meetings, an interdisciplinary treatment plan is established and implemented. Repeated team meetings accompany the treatment process, and, finally, the patient is discharged with a recommendation for further treatment.

Acute Pain Therapy

Many patients are more afraid of pain after surgery than of the surgery itself. The organization of the postoperative pain therapy is, therefore, a major concern for the pain clinic. Together with a few surgical departments and nursing services, a multidisciplinary team has been established, which is making intensive efforts to improve postoperative pain management. In addition to the establishment of treatment procedures, training courses on this topic are conducted regularly. A so-called "Pain Nurse" focuses exclusively on issues of postoperative pain management and carries out continuous quality controls. All patients who underwent regional anesthesia (e.g. epidural) for postoperative pain are seen daily by pain clinic specialists. Moreover, "problem cases", in which no adequate pain relief after surgery can be achieved using conventional methods, are treated by the pain clinic team.

Some years ago, a system for continuous quality management of acute pain therapy was implemented. From that concept emerged a nationwide project funded by the Federal Ministry of Health (BMG) now known as "QUIPS" (Quality management in postoperative pain therapy).
For this purpose, postoperative indicator data about the quality of the process and the quality of the outcome of the postoperative pain therapy are collected. Indicator data is collected at regular intervals at a central location on a so-called Benchmark Server . It is then analyzed and visualized, and, together with the data from other participants and data about the development over time, the results and comments are then reported back to all partners. These results are available on a protected website.

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Abb 1: Online-Feedback
A partner's own data is identifiable (red columns), other data is displayed anonymously.
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Abb 2: Online-Feedback
time elapsed

One particular success story of the project is the fact that the Society of Anesthesia Specialists (DGAI) continues to promote this initiative even after support from the BMG ended. Now more than 30 clinics nationwide take part in this initiative, and more than 18,000 records have been collected. Negotiations for the participation of the German Society of Surgery are also taking place.
Additional Information: www.quips-projekt.de

Palliative Medicine

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The palliative care of cancer patients has moved more and more towards the forefront of chronic pain therapy. This is not only because the minimally invasive treatment of malignant tumor pain and symptom control are a primary focus of our clinical and scientific work, but also reflects the enormous demand and completely inadequate supply of palliative care in Thuringia (ranked last place in a nationwide comparison!) . The Pain Center is a founding member of the Palliative Care Section of the Academy for Medical Training of the Thuringian Medical Association (LÄK). The palliative care team, which consists of representatives from the clinics for radiology, oncology, surgery and anesthesiology, conducted training and courses in palliative care in 2011.

In March 2007, at the urging of the pain center, an outpatient palliative team was formed that would allow patients with incurable diseases and limited life expectancy to have a caregiver in their home environment.
Additional Information: Abteilung für Palliativmedizin

Teaching, Training, and Further Education

The organizational freedoms in student teaching made possible by the new licensing regulations have been used extensively. Under the direction of the pain clinic, an interdisciplinary "Pain Week" was held again as a required course for all students. Our faculty is among the few universities that have integrated this field, which has long been neglected by the licensing regulations, into its curriculum as an interdisciplinary course. The elective course "Anatomy and regional anesthesia" for preclinical students continues to enjoy great popularity. After theoretical introduction to anatomy and pharmacology, the students could observe regional anesthesia procedures in practice in the operating room, and afterwards deepen their knowledge In the dissection hall. This course highlighted the importance of preclinical studies for future practice and had the additional effect of introducing some students to the field of anesthesiology for the first time. Both projects are unique examples of the preclinical and clinical interdisciplinary courses that are offered.

Other teaching activities included an elective seminar on "Pain Therapy", as well as collaboration on an interdisciplinary seminar on "Palliative Care", as well as a cross-section of disciplines including nursing. The "Regional Anesthesia Summer School" was offered again together with the Institute of Anatomy of the FSU and the Department of Anesthesia Eisenberg . It was attended by doctors from all over Germany.

The pain center has full authorization to acquire the additional designation of "Special Pain Therapy". The training is made particularly attractive by the fact that both acute and chronic pain therapy methods can be learned, as well as the fact that there is the possibility for scientific work and the opportunity for shadowing in related fields.

The Role of Nursing in the Pain Center

The successes of the pain center are due to a considerable extent to the commitment of the nurses working there. Besides the usual administrative and clinical tasks, the concept of a nurse qualified in pain therapy, or "Pain Nurse", based on the the Scandinavian model was introduced here early on. This job is characterized by multidisciplinary, highly independent work. The "pain nurse" makes rounds on his/her own and also carries out patient care methods specific to pain therapy and is significantly involved in the concept of post-operative quality management. In addition, the nurses take on training tasks and are involved in research. This is demonstrated not only by their own scholarly contributions to scientific conferences, but also by the numerous invitations to lecture on benchmarking, post-operative pain and palliative medicine and the internships of foreign nurses in Jena.

Performance Figures

In 2011, the employees of the pain clinic increased yet again the scope of inpatient and outpatient services that they provide, which was mainly due to an increase in post-operative care services. A total of nearly 2,400 patients were treated, while there were more than 11,000 patient contacts.

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Fig. 3: Development of
Patient Contacts from 2002 to 2011

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Fig. 4: Breakdown in various
forms of postoperative
consulting and care


Further information can be found in the current Annual Report .