Prevalencia del dolor irruptivo

31 de enero de 2014

Captura de pantalla 2014-01-31 a la(s) 12.08.52En esta ocasión traemos un interesante artículo muy reciente publicado en el Journal of Pain and Symptom Management. Es la primera revisión de la literatura haciendo énfasis en la prevalencia del dolor irruptivo. Realizaron búsquedas en Medline y Embase desde 1990 hasta 2012, y concluyen que la Prevalencia del dolor irruptivo en pacientes oncológicos es de uno de cada dos pacientes.

Dolor Episódico por Cáncer

22 de enero de 2014

Captura de pantalla 2014-01-22 a la(s) 09.54.34 “En esta excelente presentación sobre dolor incidental en cáncer, el autor presenta un planteamiento práctico desde el punto de vista clínico del dolor incidental en pacientes oncológicos. Resulta muy completa la parte en la que establece diagnóstico diferencial con otros dolores o aquella en la que lo acompaña de ejemplos clínicos prácticos.El abordaje que realiza sobre las posibilidades terapéuticas es muy útil, e incluye incluso una valoración económica de los distintos tratamientos.”

Bibliografía

21 de enero de 2014
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Breakthrough Pain, the Pain Emergency, and Incident Pain

6 de enero de 2014

Captura de pantalla 2014-01-06 a la(s) 10.34.04Presentamos un artículo de la revista PAIN sobre dolor irruptivo. Está redactado para los países en vías de desarrollo como guías de tratamiento y los autores son Gona Ali y Andreas Kropf. Es muy importante la tarea que realiza la IASP para dar información científica de manera gratuita a los países en vías de desarrollo. La revisión es francamente buena, basada en un caso clínico a modo de introducción.

 

A Practical Approach to Cancer Pain Management

16 de diciembre de 2013

“En esta presentación se abordan de forma muy práctica distintos aspectos en el manejo del dolor oncológico, resaltando el uso de opioides, su titulación, la rotación, el manejo de efectos secundarios. Todo ello acompañado de varios casos prácticos expuestos con claridad. Puede resultar de gran ayuda en la práctica clínica diaria en la que en ocasiones podemos sentirnos inseguros para una rotación, una titulación, etc.”
Captura de pantalla 2013-12-16 a la(s) 18.33.59

When Cancer Pain Breaks Through

16 de diciembre de 2013

PDFCaptura de pantalla 2013-12-16 a la(s) 18.08.28

En este PDF, de nuevo el Dr. Portenoy, uno de los mayores expertos mundiales en dolor, hace referencia al dolor irruptivo en el cáncer. Con un esquema sencillo y claro, explica sus característics, su incidencia y su tratamiento, pero resaltamos un apartado ineteresante sobre “Cómo los doctores deben evaluarlo”. Hemos destacado siempre la necesidad de realizar una buena anamnesis para diagnosticar este tipo de dolor, y este documento demuestra su importancia.

Opioids for the management of breakthrough pain in cancer patients

9 de diciembre de 2013
CochraneActualización de la revisión Cochrane imprescindible para conocer la evidencia sobre le dolor irruptivo y su tratamiento.

Cochrane Database Syst Rev. 2013 Oct 21;10:CD004311. doi: 10.1002/14651858.CD004311.pub3.

Opioids for the management of breakthrough pain in cancer patients.

Zeppetella G, Davies AN.

Source

St Clare Hospice, Hastingwood Road, Hastingwood, Essex, UK, CM17 9JX.

 

Captura de pantalla 2013-12-09 a la(s) 12.42.23Abstract

BACKGROUND:

This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 1, 2006). Breakthrough pain is a transient exacerbation of pain that occurs either spontaneously or in relation to a specific predictable or unpredictable trigger despite relative stable and adequately controlled background pain. Breakthrough pain usually related to background pain and is typically of rapid onset, severe in intensity and generally self limiting with a mean duration of 30 minutes. Breakthrough pain has traditionally been managed by the administration of supplemental oral analgesia (rescue medication) at a dose proportional to the total around-the-clock (ATC) opioid dose.

OBJECTIVES:

To determine the efficacy of opioid analgesics given by any route, used for the management of breakthrough pain in patients with cancer, and to identify and quantify, if data permitted, any adverse effects of this treatment.

SEARCH METHODS:

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and trial registries in January 2005 for the original review, and again on 6 February 2013 for this update.

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Breakthrough Pain in Patients with Abdominal Cancer Pain

9 de diciembre de 2013

PAINRecomiendo esta nueva publicación que me parece muy importante por varios motivos:

intenta identificar  el dolor irruptivo según el tipo de cáncer y en este caso el producido por tumores que causan dolor abdominal. Como los autores indican, es el primer artículo que se centra en este binomio entre localización cáncer abdominal –dolor irruptivo.

en la práctica clínica, el dolor irruptivo, que ya de por sí es de difícil identificación y tratamiento, puede ser todavía más complicado de controlar en los pacientes que sufren dolor localizado en abdomen. El dolor abdominal es de difícil manejo por múltiples causas: puede estar causado por un abanico tan amplio de posibilidades que van del origen benigno como el estreñimiento hasta el causado por el tumor en el extremo contrario. El dolor abdominal puede ser complicado de localizar y entran en juego componentes que originan una etiología múltiple: víscera hueca, distensión capsular, compresión nerviosa. Además, puede tener un origen incidental pero no volitivo como el que ocurre durante la digestión.

Por todo esto, recomiendo no soló la lectura del artículo sino felicito a los autores por explorar un problema clínico de máxima importancia para un amplio número de enfermos.

Dr.-MercadanteClin J Pain. 2013 Nov 25. [Epub ahead of print]

Breakthrough Pain in Patients with Abdominal Cancer Pain.

Mercadante S, Adile C, Giarratano A, Casuccio A.

Source

*Anesthesia and Intensive Care Unit and Pain Relief and Palliative Care Unit, La Maddalena Cancer Center †Chair of Anesthesiology, Palliative Medicine, University of Palermo ‡Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo.

 

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Calculadora de dosis de opioides

17 de octubre de 2013

Captura de pantalla 2013-10-17 a la(s) 17.26.21“A través de este link podemos acceder a una sencilla pero práctica calculadora de dosis de opioides, tanto en pacientes que lo requieren por vez primera como para aquellos que ya están con algún tratamiento. Es intuitivo y da información útil. Puede resultar de ayuda en nuestra consulta en caso de duda”.

http://opioidcalculator.practicalpainmanagement.com/