title: [Efficient treatment of breakthrough pain in adults: the importance of timing and medication choice].
abstract: Diagnostic or therapeutic procedures can lead to breakthrough pain. Thanks to a wise choice of analgesic medication started in due time, this type of pain can be avoided or decreased. The therapeutic options of this preventive approach are presented according to the expected breakthrough pain type and intensity. Specific situations are presented through case discussions. The main pharmacokinetic information needed to prescribe the right analgesic at the right time is summarized in a convenient table. When associated to non-pharmacological measures such as empathy, patient positioning and high quality procedures, preventive analgesia provides patients the best possible relief from breakthrough pain.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. cberna-renella@partners.org
authors.forename: Chantal
authors.initials: C
authors.lastname: Berna
authors.forename: Christophe
authors.initials: C
authors.lastname: Luthy
authors.forename: Caroline F
authors.initials: CF
authors.lastname: Samer
authors.forename: Hervé
authors.initials: H
authors.lastname: Spechbach
authors.forename: Sophie
authors.initials: S
authors.lastname: Pautex
authors.forename: Valérie
authors.initials: V
authors.lastname: Piguet
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001859:Bone Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D059390:Breakthrough Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D002277:Carcinoma / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D004359:Drug Therapy, Combination; D004645:Empathy; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008012:Lidocaine / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D010996:Pleural Effusion / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D011318:Prilocaine / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D011318:Prilocaine; D008012:Lidocaine