Analgesia for patients with advanced disease: I.
This series of two articles explores the challenge of managing pain in patients with advanced malignant and non-malignant disease. Pain is a common symptom in advanced disease. Despite guidance from organisations such as the World Health Organisation, cancer pain is often inadequately managed. Managing pain in non-malignant conditions, such as end stage cardiac failure, presents an even greater challenge to healthcare professionals. This first article discusses epidemiology, definitions, pathophysiology, assessment, non-pharmacological approaches, the analgesic "ladder", and opioids. The second article will examine the use of non-opioids, anaesthetic techniques, and analgesia in dying patients as well as discussing future directions.
Hall
E J
EJ
St Christopher's Hospice, 51-59 Lawrie Park Road, Sydenham, London SE26 6DZ, UK. emmahall@doctors.org.uk
Sykes
N P
NP
D000698:Analgesia; D002908:Chronic Disease; D000529:Complementary Therapies; D006801:Humans; D007880:Legislation, Drug; D009020:Morphine / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D059408:Pain Management; D009626:Terminology as Topic; D004561:Transcutaneous Electric Nerve Stimulation
D009294:Narcotics; D009020:Morphine