환자가 아파하면 근전도 검사 제대로 못한다?!

APMR에 실린 글 하나..

환자는 근전도 검사를 받을 때 실제 느끼는 통증보다 고통스러울 것이라고 생각한다.

그러면 근전도 검사하는 사람이 환자가 고통을 심하게 느끼는 것으로 과대평가하게되고... 검사를 덜 아픈 방향으로 바꾸게 된단다. (필요한 검사를 다 못하게 되는 것이겠지…)

이거 뭐.. 당연한 얘기 아닌가!!

그래서 이 글 결론은 검사시에 환자와 대화가 중요하단다. 흠…

Altering Electromyography Studies: Importance of the Electromyographer's Perception of Patient Pain Presented to the American Academy of Neuromuscular and Electrodiagnostic Medicine, October 17, 2013, San Antonio, TX. Zachary N. London, MD, Rebecca Hazan, James F. Burke, MD, Brian C. Callaghan, MD published online 26 August 2013. Abstract Full Text PDF References Abstract Objective To determine the relation between the patient's actual pain, the electromyographer's perception of patient pain, and whether an electromyogram (EMG) is altered. Design Patients undergoing electromyography reported expected pain and procedure-related overall pain on a 100-mm visual analog scale (VAS). Blinded electromyographers estimated patient pain levels and indicated if they altered the study in any way because of this perception. Multivariable logistic regression was used to determine predictors of altering the EMG. Paired t tests were used to compare overall pain with expected pain and electromyographer perception of pain. Setting Tertiary referral center. Participants Referred sample of adult subjects (N=304). Interventions Not applicable. Main Outcome Measures Patient pain, electromyographer perception of patient pain, and whether an EMG was altered because of the electromyographer's perception of patient pain. Results Mean VAS scores ± SD were 48±25mm for patient-expected pain (P<.001), 42±24mm for electromyographer perception of pain (P<.0001), and 36±25mm for actual overall pain. Electromyographers altered their study 31.7% of the time because of concerns about pain. For every 13-mm increase on the VAS (a prespecified clinically meaningful difference), the electromyographer perception of pain increased the odds of altering a study 2.36 times (95% confidence interval [CI], 1.71–3.26), whereas patient overall pain did not have a significant effect (odds ratio=1.12; 95% CI, .86–1.47). Conclusions Patients expect EMGs to be more painful than they are. Electromyographers overestimate patient pain and are more likely to alter their studies when they believe patients are experiencing more pain, independently of whether patients actually have more pain. Improving the communication between electromyographers and patients may prevent unnecessary alterations. Keywords: Electromyography, Pain, Rehabilitation List of abbreviations: VAS, visual analog scale