Search results for "Breakthrough pain"
showing 10 items of 40 documents
Effects of age and gender in patients receiving doses of opioids for breakthrough pain proportional to background opioid doses.
2019
Aim: To identify the role of age and gender in analgesic and adverse effects after administering fentanyl products for breakthrough pain (BT), given in doses proportional to opioid doses given for background pain. Methods: Data from nine studies, in which patients with BP were given fentanyl products in doses proportional to their basal opioid regimen, were analyzed. Results: A total 462 patients presenting 1905 episodes of BP were included in this analysis. In older patients, the decrease in pain intensity was more pronounced 15 min after administration of a BP medication. No gender differences were found. No significant differences in frequency and intensity of adverse effects for age and…
Fentanyl Pectin Nasal Spray Versus Oral Morphine in Doses Proportional to the Basal Opioid Regimen for the Management of Breakthrough Cancer Pain: A …
2016
Context Fentanyl products have shown superiority over oral opioids for the management of breakthrough cancer pain (BTcP). However, these studies did not use an appropriate patient selection, and drugs have been compared using a different rationale. Objectives The aim of this randomized, crossover, controlled study was to compare the efficacy and safety of fentanyl pectin nasal spray (FPNS) and oral morphine (OM), given in doses proportional to opioid daily doses. Methods Cancer patients with pain receiving â¥60 mg of OM equivalents/day and presenting with â¤3 episodes of BTcP/day were included. Patients received, in a randomized, crossover manner, FPNS or OM at doses proportional to the d…
World Health Organization guidelines for cancer pain: a reappraisal
2005
Pain is a prevalent symptom experienced by at least 30% ofpatients undergoing an oncological treatment for metastaticdisease and by more than 70% of advanced cancer patients[1]. In 1986 the World Health Organization [2] published a setof guidelines for cancer pain management based on the three-step analgesic ladder [2]. The main aim of WHO guidelienswas to legitimize the prescribing of strong opioids, arisingfrom evidence of poor management of cancer pain, due toreluctance of health care professionals, institutions, and gov-ernment to use opioids because of fears of addition, toleranceand illegal abuse.Its application is reported to achieve satisfactory pain reliefin up to 90% of patients w…
Breakthrough pain in oncology: A longitudinal study
2010
Abstract Context Existing studies on breakthrough pain (BP) have reported different prevalence rates because of different settings, populations, and assessment methods. These studies have used cross-sectional designs, and the relationship of BP with analgesic treatment has not been evaluated. Objectives The aim of this study was to longitudinally assess BP in cancer patients admitted to oncology units. Methods A consecutive sample of patients admitted to oncology centers was selected. At admission (T0), three months after admission (T3), and six months after admission (T6), data on background pain and BP were recorded. BP was assessed in terms of its intensity, duration, number of episodes,…
Relationship between background cancer pain, breakthrough pain, and analgesic treatment: a preliminary study for a better interpretation of epidemiol…
2020
Abstract Abstract Background: The different operational definitions of breakthrough cancer pain (BTcP) has generated unclear epidemiological data. Methods: A consecutive sample of patients was categorized on the basis of their background pain intensity, background analgesic treatment, and the presence of BTcP. Results: A total of 265 patients were surveyed; 117 patients had background pain and 91 patients presented peaks of pain intensity distinguishable from background pain. Of 117 patients with background pain, 49 patients were re-assessed after optimization of background analgesia (T1) within a mean of 8.2 days. Pain intensity significantly decreased in comparison with values recorded at…
Rapid onset opioids for breakthrough pain: Titrating or not titrating, this is the question!
2011
Abstract Breakthrough cancer pain (BTcP) has been defined as a transitory increase in pain intensity that occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain. Traditional dosing recommendations for BTcP have suggested that the effective dose of oral opioids should be a percentage of a patient’s total daily opioid dose. In the last years a number of new formulations that deliver fentanyl directly through mucous membranes have been developed in an effort to provide a more rapid onset of effect (rapid onset opioids, ROOs). Recent recommendations suggest that the dose of ROOs for BTcP…
The use of opioids for breakthrough pain in acute palliative care unit by using doses proportional to opioid basal regimen.
2010
OBJECTIVES: To determine the efficacy and safety of different opioids used in doses proportional to the basal opioid regimen for the management of breakthrough pain (BP). METHODS: In 66 patients consecutive patients admitted to a pain relief and palliative care unit, the efficacy and safety of different opioids used in doses proportional to the basal opioid regimen for the management of breakthrough pain (BP) were assessed. The choice of the opioid to be administered as rescue medication was based on the characteristics of patients, clinical stability, compliance, preference, and so on. For each episode, nurses were instructed to routinely collect changes in pain intensity and emerging prob…
Meaningful cut-off pain intensity for breakthrough pain changes in advanced cancer patients
2013
Abstract OBJECTIVES: To assess the level of pain intensity at which patients feel the impetus to ask for a breakthrough cancer pain (BTcP) medication, and level of pain intensity at which patients consider they have achieved acceptable pain control after receiving a BTcP medication. METHODS: A consecutive sample of patients who were receiving oral morphine equivalents equal to or more than 60 mg daily, and were prescribed rapid onset opioids for the management of episodes of BTcP, were included in the study. Focused educational activities regarding BTcP and numerical scales were established during hospital admission. At discharge patients were interviewed to find out what was the pain inten…
Dissatisfaction with post-operative pain management—A prospective analysis of 1071 patients
2005
Summary A total number of 1071 patients was investigated using a modified questionnaire of the American Pain Society to evaluate the pain profile and satisfaction/dissatisfaction on the second post-operative day after different types of surgery (abdominal, traumatic, orthopaedic, urologic, gynaecologic, ENT). Patients were either treated with non-standardized pain management (no measurement of pain intensities, no regular administration of analgesics) (non-APS; n = 575) under responsibility of surgical specialties or with standardized pain management (regular assessment of pain and dose adaptation with i.v. PCA or epidurals) (APS; n = 496) by an anaesthesiology-based acute pain service. Pat…
Breakthrough Pain in Advanced Cancer Patients Followed at Home: A Longitudinal Study
2009
The aim of this study was to longitudinally assess breakthrough pain (BP) in advanced cancer patients who were admitted to home palliative care. One hundred and one consecutive patients who were admitted to one of the two home care programs and were representative of the cancer population followed at home in Italy were included. Patients were excluded only if at admission they were cognitively impaired or too unwell to provide reliable answers to questions regarding data collection. At admission (T(0)), and one month later (T(1)), data were recorded about the pharmacological treatment of background pain and its effectiveness; the presence of BP and its intensity, duration, and number of epi…