Rudowska Joanna
Przychodnia Przykliniczna, Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curie w Krakowie.
Contemp Oncol (Pozn). 2012;16(6):498-501. doi: 10.5114/wo.2012.32481. Epub 2013 Jan 4.
Breakthrough pain is defined as the transient exacerbation of pain occurring in a patient with otherwise stable, persistent pain. It is estimated to affect over 50% of patients, particularly those with moderate to severe background pain. Breakthrough pain is one of the most difficult pain syndromes to treat. There are several types of breakthrough cancer pain: incidental type involves flares of pain associated with movement or activity; idiopathic type is transitory pain unrelated to a specific activity; and in end-of-dose failure pain occurs when blood levels of medications fall below an analgesic threshold at the end of a dosing interval. Persistent and breakthrough pain are distinct components of cancer pain and require separate management. Successful management of breakthrough pain may require a combination of pharmacological and non-pharmacological treatment strategies. Supplemental analgesia, known as rescue medication, is a common pharmacological treatment option. Breakthrough pain is treated with supplemental short-acting opioid use, as needed, e.g. short-acting morphine, intranasal fentanyl and buccal tablets of fentanyl.
爆发性疼痛被定义为在原本疼痛稳定且持续的患者中发生的疼痛短暂加剧。据估计，超过50%的患者会受到影响，尤其是那些有中度至重度基础疼痛的患者。爆发性疼痛是最难治疗的疼痛综合征之一。爆发性癌痛有几种类型：偶发型是指与运动或活动相关的疼痛发作；特发型是与特定活动无关的短暂性疼痛；而剂量末期失败性疼痛发生在给药间隔结束时药物血药浓度降至镇痛阈值以下的时候。持续性疼痛和爆发性疼痛是癌痛的不同组成部分，需要分别进行管理。成功管理爆发性疼痛可能需要药物和非药物治疗策略相结合。补充镇痛，即所谓的解救药物，是一种常见的药物治疗选择。爆发性疼痛通过按需使用补充短效阿片类药物进行治疗，例如短效吗啡、鼻内芬太尼和芬太尼颊片。
