Neuropathic pain in cancer patients--prevalence and management in a tertiary care anesthesia-run referral clinic based in urban India.
BACKGROUND
Cancer pain is often intractable and has a considerable impact on the quality of life. Nociceptive pain is easily recognized and managed using conventional analgesics. The neuropathic component makes cancer pain difficult to manage. The epidemiology of neuropathic pain in cancer patients has not been well documented.


OBJECTIVE
This retrospective study attempted to discern the prevalence of neuropathic pain over a period of 2 years, in cancer patients at the Pain and Palliative Care Clinic of a tertiary care cancer center in India. The study also aimed to describe the approach to neuropathic cancer pain alleviation.


METHODS
A retrospective analysis of 3238 cancer patients who presented with complaints of pain during 2006-2008 was undertaken. Findings including type and intensity of pain, initial evaluation, treatment initiated, and other associated symptoms were recorded at the initial visit and 1 week, 1 month, and 6 months thereafter. Pain with a burning, radiating, or shooting component was considered to be neuropathic.


RESULTS
The prevalence of neuropathic pain in cancer pain patients was found to be 11.8%. Oral morphine emerged as the commonest cancer pain management modality (95.8% of patients). However, 29.89% of our patients with neuropathic pain required interventional blocks for adequate pain relief.


CONCLUSIONS
The present study highlights the significance of neuropathic pain as an integral component of cancer pain and further provides insight into its management.
Bhatnagar
Sushma
S
Department of Anaesthesia, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India. shumob@yahoo.com
Mishra
Seema
S
Roshni
S
S
Gogia
Vikas
V
Khanna
Sandeep
S
D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D009407:Nerve Block / Q000379:methods*; D009437:Neuralgia / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D018710:Pain Clinics; D015995:Prevalence; D012189:Retrospective Studies; D018434:Sickness Impact Profile
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid