title: Pain management for the cancer patient - current practice and future developments.
abstract: Anaesthesiologists will be asked to provide pain management for cancer patients in the absence of more specialised services, when interventional techniques are indicated and in the postoperative period. In all these settings, the complexity of cancer pain and its psychosocial connotations need to be considered to provide appropriate and holistic care. Principles of systemic pain management, effective in most patients, continue to follow established guidelines; identification of neuropathic pain and its appropriate treatment is important here. Interventional pain relief is required in a minority of cancer patients, but it should be considered when appropriate and then done with best available expertise. Neurolytic procedures have lost importance here over the years. Postoperative pain management should be multimodal with consideration of regional techniques when applicable. In managing postoperative pain in cancer patients, opioid tolerance needs to be addressed to avoid withdrawal and poor analgesia. Preventive techniques aiming to reduce chronic postoperative pain should be considered.
authors.affiliation: Rural Clinical School of WA, UWA Science Building M701, 35 Stirling Tce, Albany, WA 6330, Australia. Electronic address: Kirsten.Auret@rcswa.edu.au.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Auret
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Schug
mesh_terms: D000698:Analgesia / Q000379:methods; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000776:Anesthesiology / Q000379:methods; D004361:Drug Tolerance; D006801:Humans; D009369:Neoplasms / Q000473:pathology / Q000601:surgery*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D059408:Pain Management / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy; D017410:Practice Guidelines as Topic
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid
keywords: WHO ladder; cancer pain; multimodal analgesia; neuropathic pain; opioid tolerance; postoperative pain; preventive analgesia