title: [Issues in cancer pain management].
abstract: In this article, three aspects of recent issues in cancer pain management such as pain assessment, drowsiness with morphine, and problem in home care setting. First, the assessment of 'impact of pain' is to assess whether the treatment is sufficient for the patient. On the other hand, assessment of 'pain intensity' is the effectiveness of the treatment. Therefore, to reduce the gap in pain evaluations between cancer patients and medical stuffs by assessing the 'impact of pain' in addition to 'intensity of pain'. Second, increasing dosage of morphine often reduces pain, at the same time patients become drowsy. This is often observed soon after starting morphine administration, especially, patients who have renal dysfunction. An active morphine metabolite morphine-6-Glucuronide is excreted into urine, so that, renal dysfunction causes drowsiness. Third, at home care setting, patients tend to be into poor pain control condition. It is necessary that paying attention on patient's knowledge of medications and having support program for pain management for home care setting.
authors.affiliation: Department of Anesthesiology, School of Medicine, Kitasato University.
authors.forename: M
authors.initials: M
authors.lastname: Matoba
authors.forename: S
authors.initials: S
authors.lastname: Murakami
authors.forename: S
authors.initials: S
authors.lastname: Hoka
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D002908:Chronic Disease; D002985:Clinical Protocols; D005283:Fentanyl / Q000627:therapeutic use; D006699:Home Care Services; D006801:Humans; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D018710:Pain Clinics; D010147:Pain Measurement; D010166:Palliative Care; D012893:Sleep Wake Disorders / Q000139:chemically induced
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D005283:Fentanyl