Management of pain in the terminally ill

Abstract: Pain is common in terminal illness. It is a multidimensional experience and requires an integrated approach for its management to be successful.Pharmacological treatment follows the World Health Organization pain ladder, with early use of strong opioid analgesia in moderate-to-severe cancer pain. A variety of opioids are now available and choice will be tailored to the individual needs of the patient. Complex pain states, such as neuropathic and cancer-induced bone pain, often require multi-modal treatment with adjuvant analgesia and interventional techniques. In the final days of life, drugs will be administered by continuous parenteral infusion, and titrated until symptom control is achieved.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Authors: Tags: Pain Source Type: research

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Publication date: Available online 6 September 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Shun Yamanaka, Lucy MillerAbstractOne in five Europeans suffers from persistent pain which, for the majority, is non-oncological in origin. Patients with persistent non-cancer pain (PNCP) are a heterogeneous group in whom there is significant biological, psychological and societal comorbidity. Recently, there has been a large increase in opioid prescribing for PNCP, despite its limited evidence base and adverse side effect profile, including opioid dependence. This review examines the effectiveness and safety of lo...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
In conclusion, the management of acute postoperative pain in patients with cancer can be challenging.
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Abstract Cancer patients quite commonly will report different types of pain associated with the disease substrate. Systemic analgesia and radiotherapy provide only partial pain relief in the majority of these patients. Interventional Oncology techniques for pain management and mobility improvement in cancer patients include percutaneous techniques such as neurolysis, ablation and augmentation (both in the spine and peripheral skeleton) as well as trans-arterial embolization. Percutaneous neurolysis acts indirectly providing regional anesthesia whilst the rest of the aforementioned techniques act directly upon the ...
Source: Presse Medicale - Category: General Medicine Authors: Tags: Presse Med Source Type: research
Ashok Jadon, Shalabh Rastogi, Neelam Sinha, Mohammad AmirIndian Journal of Anaesthesia 2019 63(8):675-677
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
In conclusion, the management of acute postoperative pain in patients with cancer can be challenging.
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Publication date: Available online 26 July 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Mark R. Jones, Matthew B. Novitch, O. Morgan Hall, Andrew P. Bourgeois, George M. Jeha, Rachel J. Kaye, Vwaire Orhurhu, Mariam Salisu Orhurhu, Matthew Eng, Elyse M. Cornett, Alan David KayeAbstractThe facsia iliaca block (FIB) is a relatively new regional technique where local anesthetic is delivered within the fascia iliaca region. Indications for a FIB include surgical anesthesia to the lower extremity after knee, femoral shaft, hip surgery, management of cancer pain or pain secondary to inflammatory cond...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Abstract Ketamine's clinical use began in the 1970s. Physicians benefited from its safety and ability to induce short-term anesthesia and analgesia. The psychodysleptic effects caused by the drug called its further clinical use into question. Despite these unpleasant effects, ketamine is still applied in veterinary medicine, field medicine, and specialist anesthesia. Recent intensive research brought into light new possible applications of this drug. It began to be used in acute, chronic and cancer pain management. Most interesting reports come from research on the antidepressive and antisuicidal properties of ket...
Source: European Journal of Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Eur J Pharmacol Source Type: research
For more than a century, clinicians have noticed a paradoxical phenomenon: certain patients who are taking opioids (which are supposed to numb pain) become more sensitive to pain than those who are not taking opioids. The earliest observation of this phenomenon can be traced back to the British physician Sir Clifford Allbutt, who, in 1870, described it: “at such times I have certainly felt it a great responsibility to say that pain, which I know is an evil, is less injurious than morphia, which may be an evil. Does morphia tend to encourage the very pain it pretends to relieve?” Research studies and clinical ob...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Pain Management Source Type: blogs
This article will aim to provide an overview of the pain pathway in relation to the therapeutic targets for providing analgesia, commonly used NAOs and their brief introduction.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
l;koğlu UH Abstract STUDY OBJECTIVE: Erector spinae plane (ESP) block is a novel regional anesthesia technique and gaining importance for postoperative pain management. Since it was first described, the clinicians wonder if this new simple technique can replace paravertebral block (PVB). We aimed to compare the postoperative analgesic effect of ESP block and PVB with a control group in breast surgeries. DESIGN: Randomized controlled trial. SETTING: Operating room. PATIENTS: Seventy-five ASA I-II patients aged 25-65, who were scheduled to go under elective unilateral breast surgery for breast cancer...
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Tags: J Clin Anesth Source Type: research
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