Dalal Shalini, Bruera Eduardo
Department of Palliative Care and Rehabilitation Medicine - Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Prim Care. 2011 Jun;38(2):195-223, vii-viii. doi: 10.1016/j.pop.2011.03.004.
Regular assessment for the presence of pain and response to pain management strategies should be high priority in terminally ill patients. Pain management interventions are most effective when treatments are individualized based on the various physical and nonphysical components of pain at the end of life, and patients and family are educated and involved in the decision making. Opioids remain the cornerstone of pain management, and adjuvant analgesics and nonpharmacologic options are usually considered after relative stabilization of pain. This article describes the various issues that are pertinent to the assessment and treatment of pain in terminally ill patients.
对临终患者定期评估疼痛的存在情况以及对疼痛管理策略的反应应列为高度优先事项。当根据临终时疼痛的各种身体和非身体因素进行个体化治疗,并对患者及其家属进行教育并让他们参与决策时,疼痛管理干预措施最为有效。阿片类药物仍然是疼痛管理的基石,在疼痛相对稳定后通常会考虑使用辅助镇痛药和非药物治疗选项。本文描述了与临终患者疼痛评估和治疗相关的各种问题。