Mercadante Sebastiano
Main regional center for pain relief and supportive/palliative care, La Maddalena Cancer center, via San Lorenzo 319, 290146 Palermo, Italy.
Cancers (Basel). 2019 Apr 19;11(4):565. doi: 10.3390/cancers11040565.
Most patients with cancer pain can be managed with relatively simple methods using oral analgesics at relatively low doses, even for prolonged periods of time. However, in some clinical conditions pain may be more difficult to manage. Various factors can interfere with a desirable and favorable analgesic response. Data from several studies assessing factors of negative pain prognosis have indicated that neuropathic pain, incident pain, psychological distress, opioid addiction, and baseline pain intensity were associated with more difficult pain control. In this narrative review, the main factors that make the therapeutic response to opioids difficult are examined.
大多数癌症疼痛患者可以通过相对简单的方法进行治疗，即使用相对低剂量的口服镇痛药，甚至可以长期使用。然而，在某些临床情况下，疼痛可能更难控制。各种因素可能会干扰理想的镇痛效果。几项评估疼痛预后不良因素的研究数据表明，神经性疼痛、突发疼痛、心理困扰、阿片类药物成瘾和基线疼痛强度与更难控制的疼痛有关。在这篇叙述性综述中，我们将探讨导致对阿片类药物治疗反应困难的主要因素。
