Overcoming difficulties in acute pain management in chronic pain sufferers

摘要

The management of acute pain in people with chronic pain is an area that frequently causes difficulties. Dr CHARLES PITHER, Guy's & St Thomas NHS Trust, London, gave examples of chronic pain problems that are characterised by episodes of severe pain followed by intervals with milder symptoms, such as migraine or pancreatitis. He explained that syndromes such as these present difficulties because of the psychological and behavioural influences on pain, and because inappropriate treatment with either surgery or strong opioids can leave the sufferer worse off. He recommended that over-zealous therapy should be balanced with effective care, incorporating behavioural and cognitive principals, and exercising caution in prescribing intramus-cular analgesia, which can lead to addiction.