Interventional pain management in patients with cancer-related pain.

Interventional pain management in patients with cancer-related pain. Postgrad Med. 2020 Aug 17;: Authors: Bhaskar A Abstract Invasive interventional procedures for managing pain in cancer patients are often under-utilised following the popularisation of the WHO analgesic ladder. The procedures that were successfully used until then were relegated away from mainstream palliative care practice, with the advent of newer opioids and adjuvants. Even though nerve blocks, intrathecal pumps and spinal cord stimulation were re-introduced as the fourth step of the WHO ladder, often referrals for these procedures are too late to produce a meaningful effect on quality of life. At this point most patients have advanced disease and are requiring end of life care. Additionally, it is becoming evident that at least 10% of patients do not achieve good quality analgesia with oral opioids and are often troubled by unacceptable side-effects. There is an increasing public awareness of the problems with long-term opioid therapy and some of these patients would certainly benefit from invasive procedures to alleviate their pain and improve their quality of life. Improving life quality and expectancy with better treatment options and increasing number of cancer survivors should be heralding a change and hence neurolytic procedures are to be used only in patients with limited life-expectancy. ITDDs, neuromodulation and ever-increasing use of procedures routin...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research