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New recommendations are given for the key pain assessment question, step 2 of the analgesic ladder and for ketamine and cannabinoid use. Updated guidelines for breakthrough cancer pain, bone and neuropathic pain are included.
Patients should be informed about pain and pain management and be encouraged to take an active role in their pain management [II, B]. Analgesic for chronic pain should be prescribed on a regular basis and not on an ‘as required’ schedule [V, D].
Table 1 shows the guidelines for a correct and complete assessment of the patient with pain. The proper and regular self-reporting assessment of pain with the help of validated assessment tools is the first step for an effective and individualized treatment.
Breakthrough cancer pain (BTcP), defined as ‘a transitory flare of pain that occurs on a background of relatively well-controlled baseline pain’, requires careful assessment and appropriate management.
The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional aspects of this topic, including pathophysiologic classification of cancer pain syndromes, comprehensive pain assessment, management of pain crisis, ongoing care for cancer pain, pain in cancer survivors, and specialty consultations.
1 Ιαν 2019 · The World Health Organization (WHO) has developed Guidelines for the pharmacologic and radiotherapeutic management of cancer pain in adults and adolescents to provide evidence-based guidance to initiating and managing cancer pain.
Management of Pain. For management of cancer-related pain in adults, the algorithm distinguishes 3 levels of pain intensity, based on a 0 to 10 numeric rating scale (with 10 being the worst pain): severe pain (7–10); moderate pain (4–6); and mild pain (1–3). 12, 14.
