Episodic (breakthrough) pain: consensus conference of an expert working group of the European Association for Palliative Care.
BACKGROUND
Breakthrough pain is transitory exacerbation of pain that occurs in addition to otherwise stable persistent pain. The wide differences in estimation of incidence reported in literature are probably because of different settings and meanings attributed to the definition of breakthrough pain.


METHODS
A panel of experts met to establish the actual knowledge on breakthrough pain, according to the evidence in literature and experience. They agreed that episodic or transient pain could be a more simple and adequate term in most languages, including English, French, Italian, and Spanish.


RESULTS
A specific assessment and precise pain characterization are essential to plan the most appropriate treatments. Despite the relevance of this temporal pain pattern for the influence on the outcome and quality of life, few controlled studies have been performed to give evidence of a specific approach. Several experiences have reported the possible efficacy of different drugs, route of administration, and modalities of administration in different circumstances.


CONCLUSIONS
Prospective studies with previous treatments using similar terminologies are necessary to find the most convenient therapeutic intervention, according to the temporal pattern characteristics and the pain mechanism involved.
Mercadante
Sebastiano
S
Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy. mercadsa@tin.it
Radbruch
Lukas
L
Caraceni
Augusto
A
Cherny
Nathan
N
Kaasa
Stein
S
Nauck
Friedemann
F
Ripamonti
Carla
C
De Conno
Franco
F
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005060:Europe; D006801:Humans; D007391:International Cooperation; D009294:Narcotics / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications; D010146:Pain / Q000188:drug therapy* / Q000473:pathology; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009294:Narcotics