title: [Case report: obstacles in pain therapy--is pain relief always achievable?].
abstract: No patient needs to have pain? Providing the best possible pain relief is as challenging for the anaesthesiologist as it is necessary for the patient's quality of life. The WHO algorithm allows sufficient and satisfactory treatment of 90 % of all cancer patients. This case report describes alternatives to the WHO algorithm for the remaining 10 % of cases. The alternatives concern opioid rotation, intravenous administration, and neuroaxial application. Indications for these alternative strategies are either opiod-insensitive incidental pain or neuropathic pain. Procedure and complications are discussed with the reader.
authors.affiliation: Interdsziplinären Schmerzzentrum Benjamin Franklin der Klinik für Anästhesiologie und operative Intensivmedizin, Charité, Berlin, Germany. barbara.schlisio@charite.de
authors.forename: Barbara
authors.initials: B
authors.lastname: Schlisio
authors.forename: Andreas
authors.initials: A
authors.lastname: Kopf
mesh_terms: D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D010166:Palliative Care / Q000379:methods*; D013727:Terminal Care / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome