Case studies in breakthrough pain.
OBJECTIVE
To illustrate the variable presentations of and treatments for breakthrough pain (BTP).


METHODS
Five cases of BTP were selected by the author, and treatment options were then considered.


RESULTS
Breakthrough pain presents in many different ways in clinical practice. Clinicians must first evaluate patients to identify the subtype, etiology, severity, and pattern of BTP, and then use that information to suggest appropriate interventions. Whenever possible, correctable causes of BTP should first be addressed. A variety of treatment tools are available, including opioid analgesics, nonopioid analgesics, adjuvant agents, nonpharmacologic strategies, and procedural and surgical interventions. In many cases, more than one treatment option will be appropriate, but in all cases, regular communication between patient and clinician will be needed to achieve optimal control of BTP.


CONCLUSIONS
Treatment of BTP should be individualized by using a multidisciplinary approach to address each patient's pain profile.
Driver
Larry C
LC
Department of Anesthesiology and Pain Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. ldriver@mdanderson.org
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010146:Pain / Q000145:classification; D059408:Pain Management; D016896:Treatment Outcome
D000700:Analgesics