2019, Number 1
Evidence-based recommendations for the management of cancer pain (review of the literature)
Language: Spanish
References: 12
Page: 45-55
PDF size: 246.62 Kb.
ABSTRACT
Objective: To describe the evidence-based recommendations for the integral management of oncological pain. Methodology: Literature review based on a search of clinical practice guidelines for the comprehensive management of oncological pain, from 2012 to 2017. From the included references, it was obtained information related the evaluation, classification, indications of treatment, principles of pharmacological management and not pharmacological. Results: We included 12 studies related for the management of oncological pain, after the elimination of duplicates. The synthesis and analysis of relevant aspects focused on 1) pain assessment; 2) classification of oncological pain; 3) principles and goals of pain management, as well as pharmacological and non-pharmacological management; and 4) follow-up. It is recommended that patients with mild pain (score of 1 to 3) who have not been previously treated with opioids, should be treated with acetaminophen or NSAIDs. For patients with mild pain who do not respond to non-opioids and for patients with pain intensity greater than or equal to four, short-acting opioids are recommended. Conclusion: Oncological pain inadequately treated constitutes a public health problem, which is why adequate evaluation is essential to ensure proper management from the moment of diagnosis, with follow-up at regular intervals and when a new treatment is initiated, in order to find best balance between efficacy and safety of the interventions, and maximizing functionality and improving the patient’s quality of life. The management of oncological pain therefore requires a multidisciplinary approach.REFERENCES
Merskey HBN. Classification of Chronic Pain. Descriptions of chronic pain syndromes and definitions of pain terms [Internet]. 2nd ed. Seattle, WA: IASP Press; 1994 [citado 1 de octubre de 2017]. Disponible en: https://www.iasp-pain.org/files/Content/ContentFolders/Publications2/FreeBooks/Classification-of-Chronic-Pain.pdf
Family Practice Oncology Network Guidelines and Protocols Advisory Committee (BC). Palliative Care for the Patient with Incurable Cancer or Advanced Disease Part 2: Pain and Symptom Management [Internet]. 2017 [citado 28 de agosto de 2017]. Disponible en: http://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/palliative2.pdf
Health Service Executive (HSE)/Royal College of Physicians (RCPI) National, Clinical Programme for Palliative Care, Clinical Programme for Palliative Care. Pharma-Mgmt-Cancer-Pain.pdf [Internet]. 2015 [citado 28 de agosto de 2017]. Disponible en: http://health.gov.ie/wp-content/uploads/2016/01/Pharma-Mgmt-Cancer-Pain.pdf