title: Breakthrough pain and its treatment: critical review and recommendations of IOPS (Italian Oncologic Pain Survey) expert group.
abstract: Controversies exist about the definition and epidemiology of breakthrough cancer pain (BTcP), the pharmacological treatment options, drug dosing, and how to select the medications for BTcP among the new fentanyl products. Existing data were critically evaluated to provide recommendations by an expert group. An algorithm to diagnose BTcP should be used followed by a careful assessment. Fentanyl products provide efficacy and rapidity of action to counteract the temporal pattern of BTcP. The doses of opioids used for background pain should guide the choice of the doses of fentanyl products. The choice of fentanyl products should be based on individual clinical conditions.
authors.affiliation: Anesthesia and Intensive Care & Pain Relief and Supportive Care, La Maddalena, Italy. terapiadeldolore@lamaddalenanet.it.|Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Via San Lorenzo 312, 90146, Palermo, Italy. terapiadeldolore@lamaddalenanet.it.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
authors.affiliation: Molecular and Clinical Medicine Medical Oncology, La sapienza University of Rome, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchetti
authors.affiliation: Abdominal Medical Oncology, National Cancer Institute Pascale, Naples, Italy.
authors.forename: Arturo
authors.initials: A
authors.lastname: Cuomo
authors.affiliation: Primary Care Unit, ASL RME, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mammucari
authors.affiliation: Palliative Care, Pain Therapy and Rehabilitation, National Cancer Institute, Milan, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Caraceni
mesh_terms: D000465:Algorithms; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D059390:Breakthrough Pain / Q000188:drug therapy*; D002755:Choice Behavior; D005006:Ethnicity; D005104:Expert Testimony; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007558:Italy; D009369:Neoplasms / Q000188:drug therapy; D010147:Pain Measurement / Q000379:methods*; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl
keywords: Breakthrough pain; Fentanyl; Morphine; Opioids