ORGANISATION OF SERVICE FOR THE TREATMENT OF CHRONIC PAIN IN THE REPUBLIC OF CROATIA

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ORGANISATION OF SERVICE FOR THE TREATMENT OF
CHRONIC PAIN IN THE REPUBLIC OF CROATIA
Vesna Golubovic, MD PhD Department of
Anaesthesiology, Reanimathology and Intensive
Therapy Medical Faculty Rijeka University of
Rijeka
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• The anaesthesiologists started with the pain
  management at the
• Department of Neurosurgery in Clinical Hospital
  Centre Zagreb in 1978.
• The Clinic for Pain Management in General
  Hospital in Karlovac in 1979.,
• The Clinic for Pain Management The Clinical
  Hospital Centre in Rijeka in 1986.
• The Clinic for Pain Management The General
  Hospital in Osijek in 1989.

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• In 1994 the Croatian Society for
  Anaesthesiology, Reanimation and Intensive Care
  (HDAIL) within the Croatian Medical Association
  (CMA) starts with the organisation of the centres
  for the treatment of pain, but the activity ends
  with the change of presidency.

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• In 1994. the Croatian Society for
  Hospicium/Palliative Care (HDH/PS) was founded at
  CMA (at that time the President was Prof. dr. sc.
  Anica Jušic). Anaesthesiologists were included in
  the activity of this society from the very first
  day (Dr. Marijana Persoli-Gudelj was the
  vice-president of the Society).

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• On 31st March 2000 the Croatian Society for the
  Treatment of Pain (HDAIL) within the Croatian
  Medical Association - CMA was founded in Zagreb.
  The founders and actuators of the Society were
  the Clinic for the pain management from General
  Hospital Karlovac, the Croatian Society for
  Hospitium/Palliative care (HDH/PS) at CMA and the
  Department for Anaesthesiology of Medical Faculty
  Zagreb. The first President of the Society was
  Prim. Dr. Marijana Persoli-Gudelj.

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OSNIVACKA SKUPŠTINA HRVATSKOG DRUŠTVA ZA
LIJECENJE BOLIPetak, 31.ožujka 2000.
HLZ-Šubiceva 9, Zagreb

• Radno predsjedništvo
• Prim dr Marijana Persoli- Gudelj
• Prof dr Višnja Majeric- Kogler
• Prof dr Anica Jušic

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INICIJATIVNI ODBOR ZA OSNIVANJE DRUŠTVA ZA
LIJECENJE BOLI-HLZ
Prim dr Marijana Persoli- Gudelj Prim dr Egidio
Cepulic Prof dr Božidar Vrhovac Prof dr Nikša
Zurag Doc dr Vesna Golubovic dr sci Josip
Žunic Doc dr Mladen Havelka Prof dr Višnja
Majeric Kogler Doc dr Antun Bacic Prof dr Anica
Jušic dr Maja Grba-Bujevic Prim dr Biserka
Valjak dr Ines Adanic Mikloška dr Mira
Fingler dr mr sci Tonko Vlak dr mr sci Biserka
Štambuk dr mr sci Zlatko Houra
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• It was proclaimed in 1989. in the USA that the
  pain treatment is the fourth field of the
  anaesthesiologists practice, besides anaesthesia,
  intensive therapy and reanimatology.
• The treatment of pain (algology) is today growing
  into a new clinical discipline in most developing
  countries of the world and our association is
  promoting the guidelines according to EFIC.

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• The Croatian Society for Pain Management become
  the member of the European Federation of IASP
  Chapters (EFIC), and International Association
  for the Study of Pain (IASP) in 2002.

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• Since 2002. the Croatian Society for the Pain
  Management (HDAIL) has been included in the
  global project Europe against Pain (EAP) in which
  take part World Health Organisation (WHO),
  European Federation of IASP Chapters (EFIC), and
  International Association for the Study of Pain
  (IASP).

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• Each year during 1 week in October in many
  Croatian cities medical educational personal and
  volunteers organize lectures about pain and
  treatement inducing media attention (TV, radio,
  newspapers, etc.) and animating community to be
  aware that pain is a desease that can be treated.

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• In our country each year since 1997. in Karlovac
  has been organized one day symposium dedicated to
  the treatment of pain and has been held in
  co-operation with many world known experts in
  this field .
• The topics of the symposium included the
  following issues
• Treatment of malignant pain - modern approach
• Three step analgesic scale - WHO
• Analgesics-opiates/neo-opiates
• Ethics
• Palliative medicine
• Pain in elderly people
• Pain in children
• Pain in women
• Neuropathic pain.

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• Since 27th November 2003. by the decision of the
  Croatian Insurance Health Organisation (HZZO) the
  Clinics for the pain treatment have become
  specially registered (coded) sub-services within
  the frame of anaesthesiology.

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• Pain treatment as entirely new medical branch
  lay on particular education.
• Curriculum for subspecialisation in pain
  medicine in Croatia was made 4 years ago, and
  still it has not been approved by Ministry of
  Health and Social Welfer.

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• Pain medicine as a speciality, a sub-speciality
  or supraspeciality, has been realised in some
  countries as Turkey, Finland and Sweden. This is
  a very important political topic that EFIC need
  to have focus on, and helping other national
  societies in their efforts to establish pain
  medicine as a recognised sub-speciality (Harald
  Brevik, President of EFIC, President's Message in
  EFIC Newsletter, January 16th, 2003.).

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• Since 2000. postgraduate courses of first
  category have been held and organized by the
  Department of Anaesthesiology of Medical Faculty
  University of Zagreb and Osijek.
• Until nowadays the topics were
• Chronic pain diagnosis and treatment general
  part
• Chronic pain diagnosis and treatment special
  part
• Pain in children diagnosis and treatment
• Pain treatment in cancer patients
• Acute pain - diagnosis and treatment
• Neuropatic pain- diagnosis and treatment.

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• The 1st Congress of the Croatian Society for
  Pain Management with international participation
  was held at the Lakes of Plitvice from 12 14th
  October 2006.
• The goal of that Congress was to promote
  multidisciplinary approach for the treatment of
  acute and chronic pain and to inform and discuss
  with the audience on the contemporary model for
  the treatment of pain in Croatia.

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• Members of the Croatian Society for Pain
  Management regularly participate in numerous
  other symposiums and congresses (oncology,
  physiatrics, neurology, surgery, or maxillofacial
  surgery, plastic and reconstructive surgery,
  primary care medicine etc.) promoting
  multidisciplinary approach in pain treatement.

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• The Society has been very active in education of
  population (gerontology public lectures,
  symposium for 100 war invalids, symposium for
  paraplegic patients, education for employees in
  the old people homes, public lectures etc.).

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• The members of the Croatian Society for Pain
  Management have issued many papers books,
  scripts, supplements, brochures, declarations,
  translations of IASP and EFIC materials etc.

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• The Society for Pain Management advocated and
  supported registration of many drugs in our
  country (Kapanol, Durogestic , MST Continus,
  Sevredol, Transtec , Fentanyl M, Oxycontin,
  Zaldiar, Palladon,Versatis,etc).

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• The data of the Croatian Insurance Health
  Organisation (HZZO) for 2008. are following
• Centre for Pain Management - Clinical Hospital
  Zagreb,
• Department for Pain Management and Palliative
  Medicine - General Hospital Karlovac,
• Department for Pain Management and Hyperbaric
  Medicine - Clinical Hospital Osijek,
• 25 Pain Management Clinics as a part of
  Departments of anaesthesiology

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• The EFIC - Grunenthal scholarship (EEG
  scholarship) for 2008. won the member of the
  Society Dr.sc. Marijana Braš from Clinical
  Hospital Centre in Zagreb on topic Connection of
  COMT polymorphism with chronic lumbar pain
  syndrome of PTSP linked with war.

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• The members of the Society took active part as
  invited lecturers, oral or poster presenters and
  participants in numerous domestic and
  international congresses and seminars .

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• COMPARATION OF POSTOPERATIVE PAIN MANAGEMENT
  TECHIQUES OF EXPRESSION OF CYTOLITIC MOLECULE
  PERFORIN
• V. Golubovic, S. Golubovic, V. Sotosek
  Tokmadzic, M. Petkovic , I. Mrakovcic-Sutic,
• EPIDURAL ANALGESIA-INDUCED IMMUNOMODULATION OF
  CELL-MADIATED CITOTOXICITY IN PATIENTS WITH
  COLORECTAL CARCINOMA
• S. Golubovic, V. Golubovic, V. Sotosek
  Tokmadzic, M. Petkovic, I. Mrakovcic-Sutic

Department of Anesthesiology, Reanimatology and
Intensive Care, Medical Faculty, University of
Rijeka, Croatia, Department of Physiology and
Immunology, Medical Faculty, University of
Rijeka, Croatia
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• THE INFLUENCE OF EARLY CONTINOUS EPIDURAL
  ANALGESIA ON HEMODYINAMIC CHANGES IN ELDERLY
  TRAUMA PATIENTS WITH SEVERAL PELVIC FRACTURES
• D. Bartolek, K. Sakic-Zdravcevic, A. Jokic
• Anaesthesiology nad ICU, University Clinic of
  Traumatology, Zagreb, Croatia, Anesthesiology,
  Clinic Hospital Center Zagreb, Zagreb, Croatia,
  Anesthesiology, General Hospital Sveti Duh,
  Zagreb, Croatia
• CONTINIOUS WOUND INFUSION OF LEVOBUPIVACINE
  PROVIDES EFFECTIVE ANALGESIA AFTER COLORECTAL
  SURGERY
• S. Maric, L. Stefancic, D. Krleža Šupic, D.
  Vrdoljak, K. Zdravcevic Sakic
• Anesthesiology and Intensive Care, University
  Hospital for Tumors, Zagreb Croatia,
  Anesthesiology and Intensive Care, University
  Hospital Center Zagreb, Zagreb, Croatia

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• A TREATMENT AND OUTCOMES ANALYSIS
• OF PATIENTS WITH COCCYDYNIA
• N. Elezovic, S. Ljubicic, M. Carev, B. Duplancic
• Anestheziology and Intensive Care, Clinical
  Hospital Split, Croatia
• POSTTRAUMATIC STRESS DISORDER AND CHRONIC PAIN
• M. Braš, Z. Loncar, M. Boban
• Clinic for Psichological Medicine, University
  Hospital Centre Zagreb, Zagreb Croatia, Pain
  Clinic, University Hospital of Traumatology,
  Zagreb, Croatia, Psychiatric Clinic, Clinical
  Hospital Sestre Milosrdnice Zagreb, Croatia
• EFFICACY OF PAIN COPING STRATEGIES IN ACUTE AND
  CHRONIC PAIN PATIENTS
• M. Havelka, A. Havelka Meštrovic, M. Bilic
• Department of Helath Psychology, Universitiy of
  Applied Health Studies, Zagreb, Croatia,
  Psychiatry Clinic, Dubrava Clinical Hospital,
  Zagreb

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• Our Society for Pain Management has been working
  intensively on educational programs for health
  care professions, patients, and common people and
  on recognition of the society in Croatia, Europe
  and world wide.

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The 2nd Congress of the Croatian Society for Pain

• 7. - 9. october 2010.
• HOTEL OSIJEK
• OSIJEK
• Predsident HDLB 2009
• Prim.dr. Mira Fingler

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Thanks for your attention