title: [Pain management for patients with cancer--current problems in a pain clinic].
abstract: One hundred and twenty-three patients with early or advanced cancer who had been referred to our pain clinic were studied retrospectively to investigate current problems with pain management for cancer patients. Pain due to advanced cancer and prolonged post-thoracotomy pain were two major reasons for referral. It was found that 51.7% of the patients with advanced cancer had not been treated appropriately with the WHO protocol for cancer pain relief before referral; however, increased administration of morphine did not necessarily relieve cancer pain, and in fact decreased the QOL of some patients; and 47.7% of patients with cancer pain were effectively treated with nerve block therapy. The present investigation also indicates that many patients who had undergone thoracotomy suffered prolonged post thoracotomy pain. Although post-thoracotomy pain was refractory to NSAIDs, trigger point injections with or without intercostal nerve block were effective in 65.4% of such patients. We conclude that further propagation of the WHO protocol for cancer pain relief, appropriate use of nerve block and establishment of practical guidelines for multidisciplinary management of pain are mandatory for improving the QOL of patients with cancer.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hiroshima University Faculty of Medicine.
authors.forename: K
authors.initials: K
authors.lastname: Moriwaki
authors.forename: F
authors.initials: F
authors.lastname: Uesugi
authors.forename: S
authors.initials: S
authors.lastname: Kusunoki
authors.forename: Y
authors.initials: Y
authors.lastname: Maehara
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Kawamoto
authors.forename: O
authors.initials: O
authors.lastname: Yuge
authors.forename: S
authors.initials: S
authors.lastname: Yamawaki
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D018710:Pain Clinics; D010148:Intractable Pain / Q000628:therapy*; D010166:Palliative Care; D011788:Quality of Life; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine