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Revista Mexicana de Anestesiología

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ISSN 0484-7903 (Print)
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2019, Number 1

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Rev Mex Anest 2019; 42 (1)

Evidence-based recommendations for the management of cancer pain (review of the literature)

León MX, Santa-Cruz JG, Martínez-Rojas S, Ibatá-Bernal L
Full text How to cite this article

Language: Spanish
References: 12
Page: 45-55
PDF size: 246.62 Kb.


Key words:

Cancer pain, pain management, therapeutics, practice guidelines as topic.

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

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  2. Swarm RA, Abernethy AP, Anghelescu DL, Benedetti C, Buga S, Cleeland C, et al. Adult cancer pain. J Natl Compr Canc Netw. 2013;11:992-1022.

  3. Scottish Intercollegiate Guidelines Network. SIGN 106 Control of pain in adults with cancer [Internet]. [Citado 28 de agosto de 2017]. Disponible en: http://www.sign.ac.uk/sign-106-control-of-pain-in-adults-with-cancer.html

  4. 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

  5. Ripamonti C, Santini D, Maranzano E, Berti M, Roila F, ESMO Guidelines Working Group. Management of cancer pain: ESMO clinical practice guidelines. Ann Oncol. 2012;23:vii139-vii154.

  6. Yamaguchi T, Shima Y, Morita T, Hosoya M, Matoba M. Clinical guideline for pharmacological management of cancer pain: the Japanese Society of Palliative Medicine recommendations. Jpn J Clin Oncol. 2013;43:896-909.

  7. German Guideline Program in Oncology. Guideline_Palliative_Care_Short_Version.pdf [Internet]. 2015 [citado 1 de octubre de 2017]. Disponible en: http://leitlinienprogramm-onkologie.de/uploads/tx_sbdownloader/Guideline_Palliative_Care_Short_Version.pdf

  8. Cancer Care Ontario. Cancer-related pain management: a report of evidence-based recommendations to guide practice [Internet]. Cancer Care Ontario. 2011 [citado 1 de octubre de 2017]. Disponible en: https://www.cancercareontario.ca/guidelines-advice/types-of-cancer/2271

  9. Butler SF, Fernandez K, Benoit C, Budman SH, Jamison RN. Validation of the revised screener and opioid assessment for patients with pain (SOAPP-R). J Pain. 2008;9:360-372.

  10. Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the opioid risk tool. Pain Med. 2005;6:432-442.

  11. The National Institute for Health and Care Excellence. Palliative care for adults: strong opioids for pain relief | Guidance and guidelines | NICE [Internet]. 2012 [citado 27 de agosto de 2017]. Disponible en: https://www.nice.org.uk/guidance/cg140

  12. 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




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Rev Mex Anest. 2019;42