Caraceni Augusto, Shkodra Morena
Palliative Care, Pain Therapy and Rehabilitation Department, Fondazione IRCCS-Istituto Nazionale dei Tumori (INT), 20133 Milan, Italy.
Cancers (Basel). 2019 Apr 10;11(4):510. doi: 10.3390/cancers11040510.
More than half of patients affected by cancer experience pain of moderate-to-severe intensity, often in multiple sites, and of different etiologies and underlying mechanisms. The heterogeneity of pain mechanisms is expressed with the fluctuating nature of cancer pain intensity and clinical characteristics. Traditional ways of classifying pain in the cancer population include distinguishing pain etiology, clinical characteristics related to pain and the patient, pathophysiology, and the use of already validated classification systems. Concepts like breakthrough, nociceptive, neuropathic, and mixed pain are very important in the assessment of pain in this population of patients. When dealing with patients affected by cancer pain it is also very important to be familiar to the characteristics of specific pain syndromes that are usually encountered. In this article we review methods presently applied for classifying cancer pain highlighting the importance of an accurate clinical evaluation in providing adequate analgesia to patients.
超过一半的癌症患者经历中度至重度疼痛,通常疼痛部位不止一处,病因和潜在机制也各不相同。疼痛机制的异质性表现为癌症疼痛强度和临床特征的波动性质。在癌症患者中对疼痛进行分类的传统方法包括区分疼痛病因、与疼痛及患者相关的临床特征、病理生理学,以及使用已得到验证的分类系统。爆发痛、伤害性疼痛、神经病理性疼痛和混合性疼痛等概念在评估这类患者的疼痛时非常重要。在处理癌症疼痛患者时,熟悉通常遇到的特定疼痛综合征的特征也非常重要。在本文中,我们回顾了目前用于癌症疼痛分类的方法,强调了准确的临床评估在为患者提供充分镇痛方面的重要性。