Pain services and palliative medicine – an integrated approach to pain management in the cancer patient

O’Brien, Tony; Kane, Christopher M

doi:10.1177/2049463714548768

Cited by 18 publications

(19 citation statements)

References 28 publications

(33 reference statements)

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“…Moreover, earlier application of these techniques is recommended before considering the use of strong opioids. 5 Before choosing and utilizing these interventional techniques, the cause of pain should be identified if possible. Additionally, multidisciplinary treatment and cooperation among clinicians from several disciplines are imperative for an integrated program.…”

Section: Discussionmentioning

confidence: 99%

Integrated approach to pain management for a patient with multiple bone metastases of uterine cervical cancer

Qin

Song

et al. 2018

J Int Med Res

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BackgroundPain management for multiple bone metastases is complex and often requires multidisciplinary treatment. We herein describe patient-centered multidisciplinary pain management for metastatic cancer.Case presentation: A 61-year-old woman with multiple bone metastases of uterine cervical cancer developed intractable low back pain. After external beam radiotherapy failed, we performed lumbar spinal intralesional curettage, pedicle screw fixation, and nerve decompression. However, the neuralgia persisted. We then percutaneously injected epirubicin into the intervertebral foramina under computed tomography guidance for L5 dorsal root ganglion destruction. Osteoplasty was performed under C-arm X-ray guidance; however, the sacrum was mistaken for the ilium, and treatment was ineffective. We administered zoledronic acid and strontium-89. The last resort was outpatient implantation of an epidural bupivacaine-morphine infusion system. A visual analog scale (VAS) was used for pain evaluation. Lumbar spinal intralesional curettage and fixation, epirubicin-induced ganglion destruction, and administration of zoledronic acid and strontium-89 decreased her VAS pain score from 7–8 to 3–4. Radiotherapy and nerve decompression and release were ineffective, as was osteoplasty because of the location error. The epidural infusion system decreased the VAS score from 7–8 to 2–3 and was highly efficient.ConclusionsMultidisciplinary integrated treatment for metastatic cancer can be effective.

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Section: Discussionmentioning

confidence: 99%

Integrated approach to pain management for a patient with multiple bone metastases of uterine cervical cancer

Qin

Song

et al. 2018

J Int Med Res

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“…[ 35 ] This is where pain specialist comes in, they can provide interventional methods when conventional analgesics fail. [ 36 ] If palliative physicians alone are able to provide adequate relief, pain specialists need to be brought in for impeccable assessment and control of pain. [ 37 ]…”

Section: Discussionmentioning

confidence: 99%

Integration of specialized pain control services in palliative care: A nationwide web-based survey

Page

2017

Indian J Palliat Care

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Introduction:Pain control is an important part of palliative care (PC), and conventional analgesics do not provide adequate pain relief to all patients. Many patients present with complex pain syndromes that require interventional pain control measures usually deployed by pain specialists. There is adequate integration of specialized pain control services with PC elsewhere, but information about the same in our country is lacking.Materials and Methods:An internet survey was conducted among palliative specialists regarding the need and availability of pain specialists for their patients suffering from complex pain syndromes. Their attitude toward integrating specialized pain control services in their practice was also explored.Results:Majority of palliative physicians came across situations where specialists in pain would control the patients’ pain better. There was a poor availability of such services, and when available, the cost was significant. It is heartening to note that though there is poor integration of specialized pain control services with palliation, palliative physicians acknowledge the need for pain specialists and their techniques for providing pain relief for their patients.Conclusions:Effective pain control is needed in palliation, barriers however exist, and there is a need to make pain specialists and interventional techniques more freely available.

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“…Patients who present with cancer pain are often complex, and as chronic cancer pain can be difficult to manage, these patients often require more than a single interaction with a physician or other health-care professional to achieve even adequate control over their pain. Participation of anesthetists who are interested in the field of interventional cancer pain management has been highlighted as a key to achieving successful control over cancer pain 3,4. A combination of conventional medical management with intraspinal drug delivery resulted in significant pain relief and reduced side effects 5.…”

Section: Introductionmentioning

confidence: 99%

<p>Nurse-led follow-up to outpatients with cancer pain treated with opioids at home—telephone calls plus WeChat versus telephone calls only: a quasi-experimental study</p>

Qiao¹,

Tang²,

Zhang³

et al. 2019

PPA

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Background: Recently, cancer pain management has come increasingly to be provided in outpatient settings, requiring health-care providers and outpatients to take on responsibilities. Pain is among the most distressing symptoms of cancer. Objectives: To compare the effectiveness of nurse-led telephone calls plus WeChat versus telephone calls only for the pain management of outpatients with cancer. Methods: 231 outpatients with cancer pain were classified into two groups (group 1, N=125; group 2, N=106). Group 1 was followed up with weekly telephone calls for eight weeks, and group 2 with weekly telephone calls combined with the booklets through WeChat for eight weeks. Differences between groups in pain level, side effects, medication adherence, and satisfaction with pain management were analyzed, and statistical differences were tested usingan independent-sample t -test and a chi-squared test. Results: Group 2 had a significantly lower rest pain ( p <0.01), and lower move pain but there was no statistical difference between the two groups. Among patients in group 2, constipation, nausea and vomiting, and dizziness were less ( p <0.01), while medication adherence ( p <0.05) and pain management satisfaction were higher ( p <0.01) than patients in group 1. Conclusion: Nurse-led follow-up telephone calls combined with WeChat significantly reduced opioid-related health problems, such as pain intensity, side effects and medication adherence.

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Pain services and palliative medicine – an integrated approach to pain management in the cancer patient

Cited by 18 publications

References 28 publications

Integrated approach to pain management for a patient with multiple bone metastases of uterine cervical cancer

Integrated approach to pain management for a patient with multiple bone metastases of uterine cervical cancer

Integration of specialized pain control services in palliative care: A nationwide web-based survey

<p>Nurse-led follow-up to outpatients with cancer pain treated with opioids at home—telephone calls plus WeChat versus telephone calls only: a quasi-experimental study</p>

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