[New pharmaceutical and invasive approaches in cancer pain therapy].
Recent developments of newer opioids are now alternatives to morphine hydrochloride. Fentanyl and buprenorphine can be administered as trans dermal therapeutic systems. Hydromorphone and oxycodone can be given orally with different adverse profiles compared to morphine hydrochloride. Invasive therapeutic options should be kept in mind for patients refractory or resistant to conventional analgesic approaches. These approaches are presented and discussed, especially the neurolytic blockade of the celiac plexus which is important in the therapy of visceral pain. Epidural and intrathecal morphine administration can be used in the treatment of severe cancer pain.
Klein
M
M
Klinik für Anästhesiologie, Intensiv- und Schmerztherapie, Evangelisches Johannes-Krankenhaus, Bielefeld, Deutschland. markus-klein@johanneswerk.de
Wagner
T
T
Hankemaier
U
U
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000698:Analgesia / Q000379:methods*; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local; D002447:Celiac Plexus / Q000187:drug effects; D003692:Delayed-Action Preparations; D000431:Ethanol; D006801:Humans; D009369:Neoplasms / Q000503:physiopathology*; D009407:Nerve Block / Q000379:methods; D059408:Pain Management; D010166:Palliative Care / Q000379:methods*; D010636:Phenols
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D003692:Delayed-Action Preparations; D010636:Phenols; D000431:Ethanol