Emergency Care, Critical Care Medicine, Pain Medicine and Anesthesiology Department, Tor Vergata Polyclinic, University of Rome Tor Vergata, Rome, Italy.
Adv Ther. 2013 Mar;30(3):298-305. doi: 10.1007/s12325-013-0013-8. Epub 2013 Feb 25.
Breakthrough pain (BTP) is traditionally defined as a transitory pain flare in opioid-treated patients with chronic background pain. This definition has, however, been challenged in recent years. This study aimed to analyze BTP prevalence in different pain conditions.
This was a prospective, non-interventional, observational study conducted from June to September 2011 in two Italian pain treatment reference centres. Consecutive patients aged >18 years with oncological or non-oncological pain were eligible for this study; background pain was acute/ subacute (<3 months) or chronic (>3 months). The characteristics of pain were evaluated by means of a structured interview by physicians, and patients were asked to complete a dedicated clinical study form. The following outcomes were assessed: chronic pain duration (in patients with chronic pain), BTP prevalence, and number and severity of daily BTP episodes. All outcomes were assessed in four populations of patients with: (a) chronic oncological pain; (b) chronic non-oncological pain; (c) non-chronic oncological pain; (d) non-chronic non-oncological pain. The correlation between BTP and gender was also investigated.
Of 1,270 patients with chronic pain, 1,086 had non-oncological pain (85.5%). Most patients (68.6%) with non-oncological pain were female (P = 0.001). Pain duration was significantly longer in non-oncological pain versus oncological pain groups (P = 0.002). BTP prevalence was lower in non-oncological patients (P < 0.001). No differences were reported in terms of number and severity of daily BTP episodes. BTP was more frequent in females with non-oncological pain (P = 0.04). Females had a significantly higher pain severity (P = 0.02) than males.
BTP is frequently reported in patients who do not have BTP according to the traditional definition. BTP frequency and severity is similar in oncological and non-oncological pain.
突破性疼痛（BTP）传统上被定义为接受阿片类药物治疗的慢性背景疼痛患者中短暂的疼痛发作。然而，近年来这一定义受到了挑战。本研究旨在分析不同疼痛状况下 BTP 的患病率。
这是一项前瞻性、非干预性、观察性研究，于 2011 年 6 月至 9 月在意大利两个疼痛治疗参考中心进行。符合条件的连续患者为年龄 > 18 岁、患有癌性或非癌性疼痛的患者；背景疼痛为急性/亚急性（<3 个月）或慢性（>3 个月）。通过医生的结构化访谈评估疼痛特征，患者还需要填写专门的临床研究表格。评估以下结果：慢性疼痛持续时间（在慢性疼痛患者中）、BTP 患病率、每日 BTP 发作次数和严重程度。所有结果均在四个患者群体中进行评估：（a）慢性癌性疼痛；（b）慢性非癌性疼痛；（c）非慢性癌性疼痛；（d）非慢性非癌性疼痛。还研究了 BTP 与性别之间的相关性。
在 1270 名慢性疼痛患者中，有 1086 名患有非癌性疼痛（85.5%）。大多数非癌性疼痛患者（68.6%）为女性（P = 0.001）。非癌性疼痛患者的疼痛持续时间明显长于癌性疼痛患者（P = 0.002）。非癌性疼痛患者的 BTP 患病率较低（P < 0.001）。每日 BTP 发作次数和严重程度无差异。非癌性疼痛女性中 BTP 更常见（P = 0.04）。女性的疼痛严重程度明显高于男性（P = 0.02）。
根据传统定义，患有 BTP 的患者经常报告 BTP。癌性和非癌性疼痛的 BTP 频率和严重程度相似。
