Burton Beth, Zeppetella Giovambattista
Br J Nurs. 2011;20(10):S14, S16-9. doi: 10.12968/bjon.2011.20.10.S14.
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 is a common and distinct component of cancer pain and is typically of rapid onset, severe in intensity, and generally self-limiting with an average duration of 30-60minutes. Despite the self-limiting nature of breakthrough pain, it can place significant physical, psychological, and economic burdens on both patients and their carers. Patients with breakthrough pain are often less satisfied with their analgesic therapy, they have decreased functioning because of their pain, and may also experience social and psychosocial consequences, such as increased levels of anxiety and depression. Successful management of breakthrough pain is best achieved by a thorough assessment which includes determining the severity, pathophysiology, and aetiology of the pain and takes into account both background and breakthrough pains while considering whether the underlying disease, co-morbidities or precipitating events are amenable to interventions. The features of breakthrough pain and the challenges it presents to patients, their carers, and health professionals are illustrated with a case study.
爆发性疼痛是疼痛的一种短暂加剧，它可自发出现，或在背景疼痛相对稳定且得到充分控制的情况下，与特定的可预测或不可预测的触发因素相关。爆发性疼痛是癌痛常见且独特的组成部分，通常起病迅速，强度剧烈，一般为自限性，平均持续时间为30 - 60分钟。尽管爆发性疼痛具有自限性，但它会给患者及其护理人员带来巨大的身体、心理和经济负担。患有爆发性疼痛的患者通常对其镇痛治疗的满意度较低，他们因疼痛而功能下降，还可能经历社会和心理社会方面的后果，如焦虑和抑郁水平升高。成功管理爆发性疼痛最好通过全面评估来实现，评估包括确定疼痛的严重程度、病理生理学和病因，并在考虑潜在疾病、合并症或诱发事件是否适合干预的同时，兼顾背景疼痛和爆发性疼痛。通过一个案例研究来说明爆发性疼痛的特征及其给患者、其护理人员和医疗专业人员带来的挑战。
