Dosing rapid onset opioidsfor breakthrough pain

摘要

Breakthrough cancer pain (BTcP) has been defined as a transitory increase in pain intensity on a baseline pain of moderate intensity in patients on analgesic treatment regularly administered (Portenoy, 1990). Patients are often receiving basal medication for then." pain which is otherwise considered acceptable. In different surveys 50% to 90% of cancer patients with pain have been reported to experience intermittent flares of their pain, although using different definitions and methodology ( Davies, 2011). Although highly variable, BTcP is typically rapid in onset, moderate to severe in intensity, and relatively short in duration (Poitenoy, 1999). Previous surveys have found that this phenomenon, is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor quality of life (Poitenoy, 1999).Pharmacological treatment regimes are based on implementation of primary therapies, optimization of scheduled analgesia (Mercadante, 2004), and specific treatment of BTcP (Mercadante, 2002). The aim of this review is to provide update information about the use of opioids for the treatment of BTcP, with special emphasis on the use of new rapid onset opioids (ROOs).