Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY 10003, USA.
Lancet. 2011 Jun 25;377(9784):2236-47. doi: 10.1016/S0140-6736(11)60236-5.
In patients with active cancer, the management of chronic pain is an essential element in a comprehensive strategy for palliative care. This strategy emphasises multidimensional assessment and the coordinated use of treatments that together mitigate suffering and provide support to the patient and family. This review describes this framework, an approach to pain assessment, and widely accepted techniques to optimise the safety and effectiveness of opioid drugs and other treatments. The advances of recent decades suggest a future that includes increased evidence-based targeting of specific analgesic interventions within an individualised plan of care that is appropriate throughout the course of illness.
在患有活动性癌症的患者中,慢性疼痛的管理是姑息治疗综合策略中的一个重要组成部分。该策略强调多维评估和协调使用治疗方法,以共同减轻痛苦,并为患者及其家属提供支持。本综述描述了这一框架、疼痛评估方法以及广泛认可的技术,以优化阿片类药物和其他治疗方法的安全性和有效性。近几十年来的进展表明,未来将在个体化护理计划中针对特定的镇痛干预措施进行更多基于证据的靶向治疗,该计划适用于疾病的整个过程。