Use of Opioid Analgesics for the Treatment of Chronic Noncancer Pain ‐ A Consensus Statement and Guidelines from the Canadian Pain Society, 2002

Jovey, Roman D; Ennis, Jeffrey; Gardner-Nix, Jacqueline; Goldman, B; Hays, Helen; Lynch, Mary; Moulin, Dwight E.

doi:10.1155/2003/436716

Cited by 124 publications

(99 citation statements)

References 22 publications

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“…5 This group is most likely to benefit from multi-disciplinary pain management, 6,7 that includes taking prescription medications for pain, and frequent follow-up. 8 In Canada, a mismatch exists between population distribution and Multidisciplinary Pain Treatment Facilities (MPTFs). Approximately 20% of the population lives in rural areas (population \10,000), but only 2% of MPTFs are located in these areas.…”

Section: Résumémentioning

confidence: 99%

Telemedicine in the management of chronic pain: a cost analysis study

Pronovost

Peng

Kern

2009

Can J Anesth/J Can Anesth

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Section: Résumémentioning

confidence: 99%

Telemedicine in the management of chronic pain: a cost analysis study

Pronovost

Peng

Kern

2009

Can J Anesth/J Can Anesth

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“…Chronic non-cancer pain can also result from conditions where there is ongoing nociception, such as arthritic inflammation. 11 Some types of CNCP have well-defined characteristics and a temporal pattern, whereas others do not. Neuropathic and myofascial CNCP may co-exist and be difficult to differentiate.…”

Section: Pain Classificationmentioning

confidence: 99%

Brief review: Perioperative management of the patient with chronic non-cancer pain

Ibrahim

Morley‐Forster

Dain

et al. 2006

Can J Anesth/J Can Anesth

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Purpose: Both opioid and non-opioid medications are being utilized increasingly in the treatment of chronic non-cancer pain, and the number of surgical patients receiving large regular doses of opioids is ever-expanding. The perioperative pain control of these patients is often challenging, and is broadening the role of the anesthesiologist as 'perioperative physician'. These patients need to be identified before surgery to plan optimal pain control postoperatively. The purpose of this review is to provide an update on the important considerations in managing the chronic non-cancer pain patient receiving high dose opioids and other adjunctive medications/analgesics. Source: English language articles published between June 1980 and May 2006 were identified by a computerized Medline search using keywords ˝chronic pain˝, ˝opioid dependent˝ and ˝perioperative˝. This same search strategy was repeated and updated using both Medline and Embase. All relevant publications were retrieved and their bibliographies were scanned for additional sources. Principal findings:Although an increasingly common problem for the acute pain service, there is very little published on this topic. Key points include the concept of opioid equivalency, tolerance, the role of adjunctive medications, and the need for good communication between the surgical team, the acute pain service and the patient who is often anxious about the upcoming procedure due to previous unpleasant experiences with poor pain control in hospital. Conclusion:Clinical care of the opioid-dependent patient in the perioperative period can be a daunting task. Education to all staff involved in this area needs to be enhanced to improve outcome and patient satisfaction. Objectif

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“…8 Certains essais contrôlés ont montré que la douleur chronique non cancéreuse est soulagée à 30-50% sans tolérance à la suite d'une administration prolongée. 4 La tolérance à certains effets secondaires comme les nausées et la sédation survient souvent, ce qui est positif.…”

Section: Ces Craintes Et Suppositions Sont-elles Fondées?unclassified

“…8 There are several controlled trials of oral opioids in chronic non-cancer pain where pain relief of 30-50% occurs with chronic dosing without tolerance. 4 Tolerance to some side effects, such as nausea and sedation, often does occur, which is beneficial.…”

mentioning

confidence: 99%

“…12 The risk of diversion of opioid medication into the community can be reduced by the prescriber being aware of the characteristic patterns of drug diversion and by the behaviours of drug-seeking patients. 4 In Canada (1994 data) it is estimated that 0.006 to 0.07% of prescriptions for opioid medications were forged and that 0.1 to 0.9% of all opioids prescribed were lost or stolen. 13 Physicians also have a wide-held misconception that sanctions by the regulatory bodies are frequent.…”

mentioning

confidence: 99%

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