Impact of different types of pain on organizational decisions in palliative medicine

Abstract

In press This short scientific report reveals important aspects of palliative medicine use of narcotic and non-narcotic analgesics, antidepressants, and anticonvulsants. Specific indications and restrictions on their use, routes of drug administration (oral, intravenous, intramuscular, subcutaneous, transdermal, intrarectal) are defined. The issues of monitoring the dosage of narcotic painkillers by medical personnel and patients themselves, the administration of bolus doses, and the medical equipment necessary for this were discussed. Special attention is paid to such pharmaceuticals as morphine, oxycodone, buprenorphine, butorphanol, morphine. The study of pathogenesis, clinical manifestations, diagnostic methods and the arsenal of therapeutic agents for overcoming acute and chronic pain in palliative patients is important for the organization of hospice and palliative care (HPC). Different types of pain are described depending on the nosological forms, individual sensitivity to pain, sensitization to pain, ways of transmitting the pain signal from the peripheral to the central part of the nervous system, humoral mechanisms of increasing and decreasing the sensation of pain, pain assessment on the Visual Analogue Scale. The need for organizational solutions to improve the situation with analgesia in Ukrainian palliative and hospice institutions, in particular to increase the availability of effective analgesia for palliative patients, was identified. Improving the situation with pain relief corresponds to the national strategy of Ukraine for the development of the HPC system. The report makes a comparison with the development of such a system in Great Britain on the way to one of the best systems of medical care for palliative patients, and on the basis of the futuristic development models described in the literature, it is assumed that Ukraine is on a similar path. Keywords: nociception, somatic pain, visceral pain, neuropathic pain, narcotic analgesics, non-narcotic analgesics.