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Villegas Estévez FJ, López Alarcón MD, Beato C, Sanz-Yagüe A, Porta-Sales J, Morera López RM. Procedural pain in patients with cancer: a Delphi expert management consensus. BMJ Support Palliat Care 2023; 13:e428-e436. [PMID: 34210716 DOI: 10.1136/bmjspcare-2020-002668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 06/14/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Diagnosis, treatment and care of cancer often involve procedures that may be distressing and potentially painful for patients. The PROCEDIO Study aimed to generate expert-based recommendations on the management of moderate to severe procedural pain in inpatients and outpatients with cancer. METHODS Using a two-round Delphi method, experts from pain and palliative care units, medical and radiation oncology and haematology departments expressed their agreement on 24 statements using a 9-point Likert scale, which were classified as appropriate (median 7-9), uncertain (4-6) or inappropriate (1-3). Consensus was achieved if at least two-thirds of the panel scored within the range containing the median. RESULTS With an overall agreement on the current definition of procedural pain, participants suggested a wider description based on evidence and their clinical experience. A strong consensus was achieved regarding the need for a comprehensive pre-procedural pain assessment and experts emphasised that healthcare professionals involved in procedural pain management should be adequately trained. Most panellists (98.2%) agreed that pharmacological treatment should be chosen considering the duration of the procedure. Transmucosal fentanyl (96.5%) and morphine (71.7%) were recommended as the most appropriate drugs. Oral and nasal transmucosal fentanyl were agreed as the most suitable for both outpatients and inpatients, while consensus was reached for intravenous and subcutaneous morphine for inpatients. CONCLUSIONS These results provide updated expert-based recommendations on the definition, prevention and treatment of moderate to severe procedural pain, which could inform specialists involved in pain management of patients with cancer.
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Affiliation(s)
| | | | - Carmen Beato
- Departamento de Oncología Médica, Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera, Spain
| | | | - Josep Porta-Sales
- Unidad de Cuidados Paliativos, Institut Catalá d'Oncologia, Girona, Spain
| | - Rosa M Morera López
- Servicio de Oncología Radioterápica, Hospital Universitario La Paz, Madrid, Spain
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2
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Chai Q, Yang Z, Liu X, An D, Du J, Ma X, Rand K, Wu B, Luo N. Valuation of EQ-5D-5L health states from cancer patients' perspective: a feasibility study. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023:10.1007/s10198-023-01635-1. [PMID: 37837519 DOI: 10.1007/s10198-023-01635-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/20/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES To assess the feasibility of estimating an EQ-5D-5L value set using a small study design in cancer patients and to compare the EQ-5D-5L values based on the preferences of cancer patients with those of the general public. METHODS Patients with clinically diagnosed cancers were recruited from two hospitals in Shanghai, China. In face-to-face interviews using the EQ-PVT survey, health states were valued by cancer patients using both cTTO and DCE methods. cTTO data was modelled alone or jointly with DCE data. Forty-eight models using different model specifications (cross-attribute level effect [CALE] and additive models), random/fixed effects model assumptions, data heteroscedasticity and censoring were estimated. The best performed model was identified in terms of monotonicity of estimated model coefficients and out-of-sample prediction accuracy. RESULTS Data collected from 221 cancer patients who participated in the study were included. The hybrid CALE model using both TTO and DCE data performed best in terms of prediction accuracy (Lin's concordance coefficient = 0.989; root mean squared error = 0.058) and suggested that pain/discomfort and anxiety/depression were the most undesirable health problems. Compared to values based on general Chinese public's health preferences, the values based on cancer patients' preferences were much higher and lower for health states characterized by extreme mobility problems and severe/extreme pain or discomfort, respectively. CONCLUSION This study demonstrated the feasibility of using a small design to develop EQ-5D-5L value sets based on cancer patients' health preferences. Since there were signs of differences between preferences of patients and general population, it may be valuable to develop patient-specific value sets and use them in clinical decision making and economic evaluations.
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Affiliation(s)
- Qingqing Chai
- Department of Pharmacy, Huangpu Branch, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Gui'an, China
| | - Xiaoyan Liu
- Department of Pharmacy, Huangpu Branch, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Di An
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiangyang Du
- Department of Pharmacy, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiumei Ma
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kim Rand
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Bin Wu
- Department of Pharmacy, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
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Hasanah I, Nursalam N, Haikal Z, Azizah AM, Rohita T. Impact of IV-line Insertion on Salivary Cortisol Levels as a Stress Biomarker in Children. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.10268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND: Children with leukemia will be treated for a quite long period of time that they will be subjected to multiple invasive procedures, one of which is IV-line insertion. This procedure can cause stress, which increases cortisol levels in the body.
AIM: This study aimed to investigate how IV-line insertion affected cortisol levels as a stress biomarker in children.
METHODS: This is a single-group pre-test and post-test design pre-experimental study. The study enrolled 30 children undergoing IV line insertion, aged from 6 to 18 years, who had not been eating or drinking for 30 min before the saliva sampling was scheduled to get IV-line insertion. The ELISA test was used to measure the salivary cortisol. If the difference in the cortisol levels is > 0.05 ng/ml, it is clinically significant. Furthermore, the Wilcoxon test was used to analyze the data. Cortisol changes were considered statistically significant if the p-value was <0.05.
RESULTS: The cortisol levels were 3.43 (0.19–16.67) ng/ml and 4.14 (0.19–16.67) ng/ml before and after IV-Line insertion, respectively. The difference in the median was 0.71 ng/ml. The > 0.05 ng/ml difference indicates that IV-line insertion affects cortisol elevation. The Wilcoxon test showed a value of p = 0.34 (p > 0.05) indicating that IV-line insertion had no statistically significant effect on cortisol.
CONCLUSION: Although an IV-line insertion does not have a statistically significant effect on cortisol, it clinically influences the increase of cortisol in children with leukemia.
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Jiang L, Hao J, Yang XL, Zhu JX, Wang Y, Huang YL, Sun YE, Mao YT, Ni K, Gu XP, Ma ZL. Basolateral Amygdala Reactive Microglia May Contribute to Synaptic Impairment and Depressive-Like Behavior in Mice with Bone Cancer Pain. Neurochem Res 2022; 47:3454-3463. [PMID: 36002639 DOI: 10.1007/s11064-022-03731-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/07/2022] [Accepted: 08/18/2022] [Indexed: 12/24/2022]
Abstract
Anxiety and depression induced by cancer-related pain disturb quality of life and willingness to survive. As a component of the limbic system, the basolateral amygdala (BLA) is critical for processing negative emotions. The reactive microglial engulfment of synapses may promote depression during adolescence. However, whether microglia phagocytose synapses to mediate cancer pain-induced depression remains unclear. The present study established a bone cancer-pain model to investigate the association between dendritic spine synapses and depressive-like behavior and explore the phagocytic function of microglia in the BLA. We found that tumor-bearing mice experienced postoperative pain-related depression, and their BLAs exhibited reactive microglia, as well as phagocytic synapses. The microglial inhibitor minocycline effectively mitigated depressive behavior, synaptic damage, and the phagocytic function of microglia. Our study implicates microglia-mediated synaptic loss in the BLA may act as the pathological basis of depressive-like behavior in bone cancer pain model.
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Affiliation(s)
- Li Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Jing Hao
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Xu-Li Yang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Ji-Xiang Zhu
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Yu Wang
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Yu-Lin Huang
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Yu-E Sun
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Yan-Ting Mao
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Kun Ni
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China.
| | - Xiao-Ping Gu
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China.
| | - Zheng-Liang Ma
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, China. .,Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China.
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Bossi P, Escobar Y, Pea F. Rapid-Onset Opioids for Management of Breakthrough Cancer Pain: Considerations for Daily Practice. FRONTIERS IN PAIN RESEARCH 2022; 3:893530. [PMID: 35721659 PMCID: PMC9204512 DOI: 10.3389/fpain.2022.893530] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/18/2022] [Indexed: 11/26/2022] Open
Abstract
Background and Objective Rapid-onset opioids (ROOs) are effective treatments for breakthrough cancer pain (BTcP) given their rapid onset of action and relatively short duration of analgesia. The aim of this article is to describe specific considerations for the use of ROOs in daily practice, focusing on dose titration and treatment of specific populations. Type of Review We conducted a narrative review on the use of ROOs for BTcP. We selected papers according to the following search terms: “breakthrough cancer pain” and “rapid onset opioids”. Results ROOs may be considered as the most suitable drugs to treat BTcP and can be used “on-demand”. Several fentanyl formulations are available and have been associated with control of BTcP and with improvement in quality of life. Various titration schemes have been used to optimize ROO dosing; however, a dose-proportional scheme could be considered safe and effective in most patients. Specific formulations may be more suitable for specific patient subgroups; for example, patients with oral mucositis may prefer intranasal to oral formulations. Moreover, elderly patients or those without caregivers should be clearly educated on the use of these formulations. A key element in achieving successful treatment of BTcP is awareness of the barriers to pain management, including poor overall assessment, patient reluctance to take opioids or report pain, and physician reluctance to prescribe opioids. Conclusion A personalized approach is fundamental when prescribing a medication for BTcP, and careful attention should be given to drug choice and route of administration, and to the need for alternative therapeutic options.
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Affiliation(s)
- Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health - Medical Oncology, ASST-Spedali Civili, University of Brescia, Brescia, Italy
- *Correspondence: Paolo Bossi
| | - Yolanda Escobar
- Medical Oncology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Federico Pea
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero Universitaria Sant'Orsola, Bologna, Italy
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Aguirre Siancas EE, Lam Figueroa NM, Delgado Rios JC, Ruiz Ramirez E, Portilla Flores OS, Crispín Huamaní LJ, Alarcón Velásquez L. Determination of the temperature causing a nociceptive response in the tail of albino BALB/c mice. NEUROLOGÍA (ENGLISH EDITION) 2021; 36:584-588. [PMID: 34654532 DOI: 10.1016/j.nrleng.2020.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 03/01/2018] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Designs for determining nociceptive response in rodents are of great use in neurology and experimental neuroscience. Immersing mice's tails in warm water is one of the most widely used procedures to evaluate this response; however, a wide range of temperatures are used in different studies. Knowing the temperature that produces a powerful nociceptive response in the tail of BALB/c mice is extremely useful. METHODS Eight 2-month-old male BALB/c mice were used. A 14-cm high beaker was filled with water up to 13cm. The animals' tails were immersed in the container with a starting temperature of 36°C. The water temperature was raised in 1°C increments until we identified the temperatures that produced nociceptive responses. That response was determined by counting the time taken before the mouse shook its tail to remove it from the water. RESULTS Six of the 8 mice began shaking their tails at the temperature of 51°C. All animals removed their tails from the water at the temperatures of 54°C, 55°C, and 56°C, taking a mean time of 8.54, 7.99, and 5.33seconds, respectively. ANOVA applied to the response times for each of the 3 temperatures indicated revealed a value of F=2.8 (P=.123). CONCLUSIONS The response time was statistically similar for the temperatures of 54°C, 55°C, and 56°C; however, the data were less dispersed for the latter temperature.
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Affiliation(s)
- E E Aguirre Siancas
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Peru; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru; Universidad Científica del Sur, Lima, Peru.
| | - N M Lam Figueroa
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Peru; Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - J C Delgado Rios
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Peru; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - O S Portilla Flores
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Peru; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - L J Crispín Huamaní
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Peru; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - L Alarcón Velásquez
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru; Grupo de Investigación ORALRES, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Patel P. Cancer Treatment Related Pain. Cancer Treat Res 2021; 182:27-37. [PMID: 34542874 DOI: 10.1007/978-3-030-81526-4_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
When discussing cancer treatment, it is important to be aware of the potential toxicities and side effects associated with these treatments.
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Affiliation(s)
- Purvi Patel
- Kaiser Permanente, 11284 Slover Ave, Suite 106, Fontana, CA, 92337, USA.
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8
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Singh S, Kumar A, Mittal G. Ketamine-polymer based drug delivery system for prolonged analgesia: recent advances, challenges and future prospects. Expert Opin Drug Deliv 2021; 18:1117-1130. [PMID: 33599572 DOI: 10.1080/17425247.2021.1887134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Introduction: With a sharp increase in NSAIDs and opioid use for chronic pain conditions associated with traumatic injuries and diseases, there has been an escalated risk of life-threatening side effects (cardiac and respiratory malfunction), inadvertent overdose, and even death. Their short duration of action and toxicity induces the need to develop extended-release analgesic drug formulations based on safe drugs like ketamine.Areas covered: This review presents progressive breakthroughs in pain control strategies for augmenting patient's comfort and minimizing unnecessary adverse effects associated with NSAIDs and opioids. Advantages of using ketamine, a dissociative anesthetic and potent analgesic over opioids have been elaborated here for the development of advanced sustained-release analgesic drug formulations based on ketamine and polymers (hydrogels, microparticles, and nanoparticles) as mainstream systems. These systems can be very promising in the resource-constrained healthcare set-up where frequent drug dosing at short time intervals is extremely challenging. PubMed, Embase, Google Scholar electronic databases, and clinical websites were used for conducting extensive research.Expert opinion: Controlled drug release analgesic systems can significantly reduce the burden of repeated drug dosing and opioid drug dependency, maximizing the function of analgesic drugs for clinical translation, and improving the quality of life of those living with pain.
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Affiliation(s)
- Surabhi Singh
- Department of Combat Sciences, Institute of Nuclear Medicine and Allied Sciences, Defence Research & Development Organisation, New Delhi India
| | - Amit Kumar
- Department of Combat Sciences, Institute of Nuclear Medicine and Allied Sciences, Defence Research & Development Organisation, New Delhi India
| | - Gaurav Mittal
- Department of Combat Sciences, Institute of Nuclear Medicine and Allied Sciences, Defence Research & Development Organisation, New Delhi India
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Glasser M, Chen J, Alzarah M, Wallace M. Non-opioid Analgesics and Emerging Therapies. Cancer Treat Res 2021; 182:125-142. [PMID: 34542880 DOI: 10.1007/978-3-030-81526-4_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Pain is a common and debilitating symptom of cancer. Cancer-related pain can occur at any point along the continuum from diagnosis to treatment to survivorship1. A systematic review published in 2016 estimated the prevalence of cancer pain to be 55% in those undergoing antineoplastic treatment, 66.4% in advanced cancer, and 39.3% in the post-treatment population. Thirty-eight percent of cancer patients in this pooled analysis experienced moderate to severe pain2.
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Affiliation(s)
- Marga Glasser
- Department of Anesthesiology, Center for Pain Medicine, UC San Diego Health System, 9300 Campus Point Dr, MC 7651, San Diego, USA
| | - Jeffrey Chen
- Department of Anesthesiology, Center for Pain Medicine, UC San Diego Health System, 9300 Campus Point Dr, MC 7651, San Diego, USA.
| | - Mohammed Alzarah
- Department of Anesthesiology, Center for Pain Medicine, UC San Diego Health System, 9300 Campus Point Dr, MC 7651, San Diego, USA
| | - Mark Wallace
- Department of Anesthesiology, Center for Pain Medicine, UC San Diego Health System, 9300 Campus Point Dr, MC 7651, San Diego, USA
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10
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Gutierrez C, Nelson MB. Physical Medicine and Rehabilitation. Cancer Treat Res 2021; 182:255-271. [PMID: 34542887 DOI: 10.1007/978-3-030-81526-4_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cancer patients have unique symptoms from tumor burden and cancer treatments, which affect functional status and quality of life. Reports have shown approximately 65% of cancer patients have at least one functional/rehabilitation need, yet fewer than 10% of these needs get addressed during their cancer journey.
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Affiliation(s)
- Carolina Gutierrez
- McGovern Medical School, Department of Physical Medicine, UTHealth Science Center at Houston, 1133 John Freeman Blvd. JJL 285A, Houston, TX, 77003, USA.
| | - Megan B Nelson
- Department of Neurosurgery, Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, KY, USA
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Abstract
INTRODUCTION Adult cancer pain is a disease state battled on a global scale. Proper pain management is essential to prevent health complications and promote patient well-being. Due to the opioid misuse crisis in the United States, providers are looking for alternatives to traditional opioids used for adult cancer pain. Buprenorphine has a unique pharmacologic profile, allowing it to be delivered in noninvasive ways; thus, it offers an alternative to traditional options. Randomized controlled trials have shown improved pain scores with transdermal buprenorphine, and they showed reductions in pain scores and increased improvement in quality of life scores versus other opioids. Sublingual buprenorphine has more limited, but promising data for reducing cancer pain. AREAS COVERED We provide a narrative review of pathophysiological pathways of pain in cancer, how they are treated, and the unique properties of buprenorphine. Guidelines addressing pain management during cancer treatment are assessed to identify buprenorphine's place in therapy. Recent literature reporting efficacy and safety of buprenorphine use in pain management during cancer treatment will be presented. EXPERT OPINION Current literature shows strong data for transdermal buprenorphine and promising data for sublingual buprenorphine. With this evidence, buprenorphine could have a more expanded role in managing adult cancer pain.
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Affiliation(s)
- Matthew Degnan
- The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences , Rensselaer, NY, USA
| | - Shaker A Mousa
- The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences , Rensselaer, NY, USA
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Yang Y, Li Y, Wu Y, Qiu S, Liu C, Wang Q, Hong Y, Lyu J, Zhang Y, Du D. Retrospective analysis of CT-guided percutaneous cryoablation for treatment of painful osteolytic bone metastasis. Cryobiology 2020; 92:203-207. [PMID: 31958427 DOI: 10.1016/j.cryobiol.2020.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 01/10/2023]
Abstract
This study aimed to evaluate the safety and effectiveness of CT-guided percutaneous cryoablation for treatment of painful osteolytic bone metastases. A total of 26 patients (36 bone metastases) treated with CT-guided percutaneous cryoablation between May 2012 and June 2016 were enrolled in this retrospective study. All procedures were performed under local anesthesia. A visual analog scale (VAS) was used to evaluate pain before the procedure and at 1 day, 1 month, 3 months, and 6 months after the procedure. Complications during and after the procedure were recorded and graded by the Clavien-Dindo classification. The mean VAS pain score was 7.1 ± 1.1 (range, 4-10) before cryoablation. It was significantly lower at all timepoints after treatment: 2.1 ± 1.7 (P < 0.0001) at 1 day after treatment, 1.3 ± 1.8 (P < 0.0001) at 1 month, 1.6 ± 1.7 (P < 0.0001) at 3 months, and 1.8 ± 1.3 (P < 0.0001) at 6 months. The response rates were 91.7%, 94.4%, 91.7%, and 94.4%, respectively, at 1 day, 1 month, 3 months, and 6 months after cryoablation; the complete response rates were 22.2%, 41.7%, 36.1%, and 22.2%, respectively. Adverse events (skin frostbite, nerve injury, pathologic fracture) occurred in 3 patients. CT-guided percutaneous cryoablation under local anesthesia appears to be a safe and effective treatment for painful osteolytic bone metastases. Prospective clinical trials on large samples needed to confirm this conclusion.
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Affiliation(s)
- Yumei Yang
- Department of Ultrasound, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, China
| | - Yong Li
- Department of Interventional Radiology, Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, Shenzhen, 518020, China
| | - Yumin Wu
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Shuibo Qiu
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Chunlin Liu
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Qiuyu Wang
- Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Yuefei Hong
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Jialing Lyu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Yanfang Zhang
- Department of Interventional Radiology, Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, Shenzhen, 518020, China.
| | - Duanming Du
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China.
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Effect of Inhalation Aromatherapy on Procedural Pain and Anxiety After Needle Insertion Into an Implantable Central Venous Port Catheter: A Quasi-Randomized Controlled Pilot Study. Cancer Nurs 2020; 42:35-41. [PMID: 29199999 DOI: 10.1097/ncc.0000000000000551] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Needle insertion into an implantable central venous port catheter may lead to procedural pain and anxiety in cancer patients. OBJECTIVE The aim of this study was to determine the effects of inhalation aromatherapy on procedural pain and anxiety after needle insertion into an implantable central venous port catheter. METHODS This study included 123 cancer patients who were scheduled to undergo chemotherapy. Patients were randomly assigned to either the lavender group (n = 41), the eucalyptus group (n = 41), or a control group (n = 41). Participants in the intervention groups inhaled 3 drops of essential oil for 3 minutes before needle insertion into an implantable venous port catheter. Patients in the control group received no intervention before needle insertion. Data were collected using the visual analog scale (VAS) and State Anxiety Inventory. RESULTS The average VAS scores of the lavender group were significantly lower than those of the control group (P < .05). There were no significant differences in the average VAS scores between the eucalyptus group and the control group (P > .05). In addition, the average State Anxiety Inventory scores of the lavender group, the eucalyptus group, and the control group were not significantly different (P > .05). CONCLUSION Inhalation aromatherapy with lavender may be an effective technique to relieve pain related to needle insertion into an implantable central venous port catheter. IMPLICATIONS FOR PRACTICE Inhalation aromatherapy with lavender oil may be useful in the management of procedural pain levels during needle procedure. However, further randomized controlled trials are needed to validate this study.
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Feller L, Khammissa RAG, Bouckaert M, Ballyram R, Jadwat Y, Lemmer J. Pain: Persistent postsurgery and bone cancer-related pain. J Int Med Res 2019; 47:528-543. [PMID: 30632434 PMCID: PMC6381470 DOI: 10.1177/0300060518818296] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The generation of neuropathic pain is a complex dynamic process. Factors involved include one or more dysregulated sensory neural pathways; dysregulated activity of specific neurotransmitters, synapses, receptors and cognitive and emotional neural circuits; and the balance between degenerative and regenerative neural events. Risk factors include age, sex, cognition, emotions, genetic polymorphism, previous or ongoing chronic pain conditions and the use of certain drugs. Intense pain experienced before, during and after surgery is a risk factor for the development of central sensitization with consequent persistent postsurgery neuropathic pain. Blockade of N-methyl-D-aspartate receptors with appropriate drugs during and immediately after surgery may prevent persistent postsurgical pain. Most cancers, but particularly malignant metastases in bone, can induce persistent pain. Local factors including direct damage to sensory nerve fibres, infiltration of nerve roots by cancer cells and algogenic biological agents within the microenvironment of the tumour bring about central sensitization of dorsal horn neurons, characterized by neurochemical reorganization with persistent cancer pain. In this article, the clinical features, pathogenesis and principles of management of persistent postsurgery pain and cancer pain are briefly discussed.
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Affiliation(s)
- Liviu Feller
- 1 Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Razia Abdool Gafaar Khammissa
- 1 Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Michael Bouckaert
- 2 Department of Maxillofacial Oral Surgery, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Raoul Ballyram
- 1 Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Yusuf Jadwat
- 1 Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Johan Lemmer
- 1 Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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15
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Mattarozzi K, Fino E, Panni V, Agostini A, Morganti AG, Russo PM. The Role Of Effective Radiation Therapist-Patient Communication In Alleviating Treatment-Related Pain And Procedural Discomfort During Radiotherapy. Patient Prefer Adherence 2019; 13:1861-1865. [PMID: 31802855 PMCID: PMC6826181 DOI: 10.2147/ppa.s214375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/14/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Managing radiotherapy (RT)-induced pain is essential for reducing the likelihood of treatment interruption and improving the chance of tumor control. The current study aimed to examine the role of radiation therapist (RTTs) interaction and effective information communication in modulating patients' experiences of pain and discomfort during RT. METHODS Participants were 91 cancer patients undergoing RT for the first time referred to the Radiotherapy Unit of Sant'Orsola-Malpighi Hospital in Bologna, Italy. Patient-reported outcome measures included patient satisfaction with the quality of the relationship and the information received by the RTTs, assessed by the Communication with RTTs - Shortened, scale, and pain and discomfort experienced during RT, assessed through two VAS scales. Attitudes toward RT were also assessed. All measures were collected as patients were approximately halfway through the overall RT duration (on average at the end of the 12th session). RESULTS Patient satisfaction with RTT relationships and treatment-information communication was significantly related to RT-induced pain intensity and patient attitudes toward RT. The more satisfied patients were with RTT interactions and communication, the more positive their attitudes were toward RT and the lower the pain intensity experienced during treatment. CONCLUSION Clinical implications can be drawn in terms of highlighting the need for RTTs to be mindful of their technical and supportive role in delivery of patient care and in structuring treatment information content in a way that contrasts potential nocebo effects related to patients' negative expectations about RT. The findings support the idea that RTTs may benefit from training interventions and structured education sessions with a focus on interpersonal skills and patient-centered communication.
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Affiliation(s)
- Katia Mattarozzi
- Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Edita Fino
- Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Valeria Panni
- Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Alessandro Agostini
- Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
- Correspondence: Alessandro Agostini Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, 5 Viale Berti Pichat, Bologna40127, ItalyTel +39 051 209 1341Fax +39051243086 Email
| | - Alessio G Morganti
- Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Paolo Maria Russo
- Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
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16
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Aguirre Siancas EE, Lam Figueroa NM, Delgado Rios JC, Ruiz Ramirez E, Portilla Flores OS, Crispín Huamaní LJ, Alarcón Velásquez L. Determination of the temperature causing a nociceptive response in the tail of albino BALB/c mice. Neurologia 2018; 36:S0213-4853(18)30147-6. [PMID: 29891340 DOI: 10.1016/j.nrl.2018.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 03/01/2018] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Designs for determining nociceptive response in rodents are of great use in neurology and experimental neuroscience. Immersing mice's tails in warm water is one of the most widely used procedures to evaluate this response; however, a wide range of temperatures are used in different studies. Knowing the temperature that produces a powerful nociceptive response in the tail of BALB/c mice is extremely useful. METHODS Eight 2-month-old male BALB/c mice were used. A 14-cm high beaker was filled with water up to 13 cm. The animals' tails were immersed in the container with a starting temperature of 36°C. The water temperature was raised in 1°C increments until we identified the temperatures that produced nociceptive responses. That response was determined by counting the time taken before the mouse shook its tail to remove it from the water. RESULTS Six of the 8 mice began shaking their tails at the temperature of 51°C. All animals removed their tails from the water at the temperatures of 54°C, 55°C, and 56°C, taking a mean time of 8.54, 7.99, and 5.33seconds, respectively. ANOVA applied to the response times for each of the 3 temperatures indicated revealed a value of F=2.8 (P=.123). CONCLUSIONS The response time was statistically similar for the temperatures of 54°C, 55°C, and 56°C; however, the data were less dispersed for the latter temperature.
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Affiliation(s)
- E E Aguirre Siancas
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Perú; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú; Universidad Científica del Sur, Lima, Perú.
| | - N M Lam Figueroa
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Perú; Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - J C Delgado Rios
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Perú; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | | | - O S Portilla Flores
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Perú; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - L J Crispín Huamaní
- Grupo de Investigación NEURON, Universidad Nacional Mayor de San Marcos, Lima, Perú; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - L Alarcón Velásquez
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú; Grupo de Investigación ORALRES, Universidad Nacional Mayor de San Marcos, Lima, Perú
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Jordan K, Aapro M, Kaasa S, Ripamonti C, Scotté F, Strasser F, Young A, Bruera E, Herrstedt J, Keefe D, Laird B, Walsh D, Douillard J, Cervantes A. European Society for Medical Oncology (ESMO) position paper on supportive and palliative care. Ann Oncol 2018; 29:36-43. [DOI: 10.1093/annonc/mdx757] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Segarra I, Modamio P, Fernández C, Mariño EL. Sex-Divergent Clinical Outcomes and Precision Medicine: An Important New Role for Institutional Review Boards and Research Ethics Committees. Front Pharmacol 2017; 8:488. [PMID: 28785221 PMCID: PMC5519571 DOI: 10.3389/fphar.2017.00488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 07/10/2017] [Indexed: 12/22/2022] Open
Abstract
The efforts toward individualized medicine have constantly increased in an attempt to improve treatment options. These efforts have led to the development of small molecules which target specific molecular pathways involved in cancer progression. We have reviewed preclinical studies of sunitinib that incorporate sex as a covariate to explore possible sex-based differences in pharmacokinetics and drug–drug interactions (DDI) to attempt a relationship with published clinical outputs. We observed that covariate sex is lacking in most clinical outcome reports and suggest a series of ethic-based proposals to improve research activities and identify relevant different sex outcomes. We propose a deeper integration of preclinical, clinical, and translational research addressing statistical and clinical significance jointly; to embed specific sex-divergent endpoints to evaluate possible gender differences objectively during all stages of research; to pay greater attention to sex-divergent outcomes in polypharmacy scenarios, DDI and bioequivalence studies; the clear reporting of preclinical and clinical findings regarding sex-divergent outcomes; as well as to encourage the active role of scientists and the pharmaceutical industry to foster a new scientific culture through their research programs, practice, and participation in editorial boards and Institutional Ethics Review Boards (IRBs) and Research Ethics Committees (RECs). We establish the IRB/REC as the centerpiece for the implementation of these proposals. We suggest the expansion of its competence to follow up clinical trials to ensure that sex differences are addressed and recognized; to engage in data monitoring committees to improve clinical research cooperation and ethically address those potential clinical outcome differences between male and female patients to analyze their social and clinical implications in research and healthcare policies.
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Affiliation(s)
- Ignacio Segarra
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of BarcelonaBarcelona, Spain
| | - Pilar Modamio
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of BarcelonaBarcelona, Spain
| | - Cecilia Fernández
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of BarcelonaBarcelona, Spain
| | - Eduardo L Mariño
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of BarcelonaBarcelona, Spain
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19
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Hochberg U, Elgueta MF, Perez J. Interventional Analgesic Management of Lung Cancer Pain. Front Oncol 2017; 7:17. [PMID: 28261561 PMCID: PMC5306685 DOI: 10.3389/fonc.2017.00017] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/25/2017] [Indexed: 12/31/2022] Open
Abstract
Lung cancer is one of the four most prevalent cancers worldwide. Comprehensive patient care includes not only adherence to clinical guidelines to control and when possible cure the disease but also appropriate symptom control. Pain is one of the most prevalent symptoms in patients diagnosed with lung cancer; it can arise from local invasion of chest structures or metastatic disease invading bones, nerves, or other anatomical structures potentially painful. Pain can also be a consequence of therapeutic approaches like surgery, chemotherapy, or radiotherapy. Conventional medical management of cancer pain includes prescription of opioids and coadjuvants at doses sufficient to control the symptoms without causing severe drug effects. When an adequate pharmacological medical management fails to provide satisfactory analgesia or when it causes limiting side effects, interventional cancer pain techniques may be considered. Interventional pain management is devoted to the use of invasive techniques such as joint injections, nerve blocks and/or neurolysis, neuromodulation, and cement augmentation techniques to provide diagnosis and treatment of pain syndromes resistant to conventional medical management. Advantages of interventional approaches include better analgesic outcomes without experiencing drug-related side effects and potential for opioid reduction thus avoiding central side effects. This review will describe various pain syndromes frequently described in lung cancer patients and those interventional techniques potentially indicated for those cases.
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Affiliation(s)
- Uri Hochberg
- Cancer Pain Program, McGill University Health Centre , Montreal, QC , Canada
| | | | - Jordi Perez
- Cancer Pain Program, McGill University Health Centre, Montreal, QC, Canada; Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, QC, Canada
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20
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Reardon DP, Anger KE, Szumita PM. Pathophysiology, assessment, and management of pain in critically ill adults. Am J Health Syst Pharm 2016; 72:1531-43. [PMID: 26346209 DOI: 10.2146/ajhp140541] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE The pathophysiology of pain in critically ill patients, the role of pain assessment in optimal pain management, and pharmacologic and nonpharmacologic strategies for pain prevention and treatment are reviewed. SUMMARY There are many short- and long-term consequences of inadequately treated pain, including hyperglycemia, insulin resistance, an increased risk of infection, decreased patient comfort and satisfaction, and the development of chronic pain. Clinicians should have an understanding of the basic physiology of pain and the patient populations that are affected. Pain should be assessed using validated pain scales that are appropriate for the patient's communication status. Opioids are the cornerstone of pain treatment. The use of opioids, administered via bolus dosing or continuous infusion, should be guided by patient-specific goals of care in order to avoid adverse events. A multimodal approach to pain management, including the use of regional analgesia, may improve patient outcomes and decrease opioid-related adverse events, though there are limited relevant data in adult critically ill patient populations. Nonpharmacologic strategies have been shown to be effective adjuncts to pharmacologic regimens that can improve patient-reported pain intensity and reduce analgesic requirements. Analgesic regimens need to take into account patient-specific factors and be closely monitored for safety and efficacy. CONCLUSION Acute pain management in the critically ill is a largely underassessed and undertreated area of critical care. Opioids are the cornerstone of treatment, though a multimodal approach may improve patient outcomes and decrease opioid-related adverse events.
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Affiliation(s)
- David P Reardon
- David P. Reardon, Pharm.D., BCPS, is Multispecialty Care Clinical Pharmacist, Department of Pharmacy, Yale-New Haven Hospital, New Haven, CT. Kevin E. Anger, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Critical Care; and Paul M. Szumita, Pharm.D., BCPS, is Clinical Pharmacy Practice Manager, Department of Pharmacy, Brigham and Women's Hospital, Boston, MA.
| | - Kevin E Anger
- David P. Reardon, Pharm.D., BCPS, is Multispecialty Care Clinical Pharmacist, Department of Pharmacy, Yale-New Haven Hospital, New Haven, CT. Kevin E. Anger, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Critical Care; and Paul M. Szumita, Pharm.D., BCPS, is Clinical Pharmacy Practice Manager, Department of Pharmacy, Brigham and Women's Hospital, Boston, MA
| | - Paul M Szumita
- David P. Reardon, Pharm.D., BCPS, is Multispecialty Care Clinical Pharmacist, Department of Pharmacy, Yale-New Haven Hospital, New Haven, CT. Kevin E. Anger, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Critical Care; and Paul M. Szumita, Pharm.D., BCPS, is Clinical Pharmacy Practice Manager, Department of Pharmacy, Brigham and Women's Hospital, Boston, MA
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21
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Reticena KDO, Beuter M, Sales CA. [Life experiences of elderly with cancer pain: the existential comprehensive approach]. Rev Esc Enferm USP 2015; 49:419-25. [PMID: 26107702 DOI: 10.1590/s0080-623420150000300009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 01/01/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Understanding the experiences of elderly with cancer pain. METHOD Qualitative research based on Heidegger's phenomenology. 12 elderly cancer patients from a city in northwest Paraná were interviewed from November 2013 to February 2014. RESULTS Analysis performed by vague, median and interpretive understanding which resulted in two ontological themes: Cancer pain: unveiling the imprisonment and impositions experienced by the elderly, and Unveiling the anguish of living with cancer pain; it revealed not only how the elderly experience pain in their daily lives, but also how hard it is to live with its particularities. CONCLUSION Cancer pain has biopsychosocial repercussions for the elderly, generating changes in their existence in the world, requiring holistic and authentic care.
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Affiliation(s)
| | - Margrid Beuter
- Nursing Departament, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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22
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Lau CLL, Chan ST, Selvaratanam M, Khoo HW, Lim AYL, Modamio P, Mariño EL, Segarra I. Sunitinib-ibuprofen drug interaction affects the pharmacokinetics and tissue distribution of sunitinib to brain, liver, and kidney in male and female mice differently. Fundam Clin Pharmacol 2015; 29:404-16. [DOI: 10.1111/fcp.12126] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 06/02/2015] [Accepted: 05/18/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Christine Li Ling Lau
- Department of Pharmaceutical Technology; School of Pharmacy and Health Sciences; International Medical University; Jalan 19/155B, Bukit Jalil Kuala Lumpur Malaysia
| | - Sook Tyng Chan
- Department of Pharmaceutical Technology; School of Pharmacy and Health Sciences; International Medical University; Jalan 19/155B, Bukit Jalil Kuala Lumpur Malaysia
| | - Manimegahlai Selvaratanam
- Department of Pharmaceutical Technology; School of Pharmacy and Health Sciences; International Medical University; Jalan 19/155B, Bukit Jalil Kuala Lumpur Malaysia
| | - Hui Wen Khoo
- Department of Pharmaceutical Technology; School of Pharmacy and Health Sciences; International Medical University; Jalan 19/155B, Bukit Jalil Kuala Lumpur Malaysia
| | - Adeline Yi Ling Lim
- Department of Human Biology; School of Medicine; International Medical University; Jalan 19/155B, Bukit Jalil Kuala Lumpur Malaysia
| | - Pilar Modamio
- Clinical Pharmacy and Pharmacotherapy Unit; Department of Pharmacy and Pharmaceutical Technology; Faculty of Pharmacy; University of Barcelona; Av. Joan XXIII s/n Barcelona 08028 Spain
| | - Eduardo L. Mariño
- Clinical Pharmacy and Pharmacotherapy Unit; Department of Pharmacy and Pharmaceutical Technology; Faculty of Pharmacy; University of Barcelona; Av. Joan XXIII s/n Barcelona 08028 Spain
| | - Ignacio Segarra
- Department of Pharmaceutical Technology; School of Pharmacy and Health Sciences; International Medical University; Jalan 19/155B, Bukit Jalil Kuala Lumpur Malaysia
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Cabezón-Gutiérrez L, Gómez-Pavón J, Pérez-Cajaraville J, Viloria-Jiménez MA, Álamo-González C, Gil-Gregorio P. [Update on oncological pain in the elderly]. Rev Esp Geriatr Gerontol 2015; 50:289-97. [PMID: 25777946 DOI: 10.1016/j.regg.2015.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 01/05/2023]
Abstract
Pain is a prevalent symptom in cancer geriatric patients, appearing in up to 90% of patients with terminal cancer. This requires a multidimensional approach, as there is a high percentage of inappropriate assessments and treatments. Unrecognized or poorly treated pain in the geriatric population, especially in cancer patients, leads to the development of disabling symptoms such as depression, anxiety, isolation, sleep disturbances, and appetite, and very especially, loss of functional capacity and quality of life. In this review an analysis is made on the most relevant studies on the diagnosis and management of cancer pain in the geriatric population.
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Affiliation(s)
- Luis Cabezón-Gutiérrez
- Servicio de Oncología Médica, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España.
| | | | | | | | | | - Pedro Gil-Gregorio
- Servicio de Geriatría, Unidad de Cuidados Paliativos, Hospital Clínico Universitario San Carlos, Madrid, España; Coordinador del Comité de Expertos del Dolor de la Sociedad Española de Geriatría y Gerontología, España
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