Department of Supportive Care, University Health Network, Toronto, ON, Canada.
Acute Palliative Care Unit, Princess Margaret Cancer Center, Toronto, ON, Canada.
Can J Anaesth. 2020 Feb;67(2):235-246. doi: 10.1007/s12630-019-01482-w. Epub 2019 Sep 30.
Pain is a common symptom associated with advanced cancer. An estimated 66.4% of people with advanced cancer experience pain from their disease or treatment. Pain management is an essential component of palliative care. Opioids and adjuvant therapies are the mainstay of cancer pain management. Nevertheless, a proportion of patients may experience complex pain that is not responsive to conventional analgesia. Interventional analgesia procedures may be appropriate and necessary to manage complex, cancer-related pain. This narrative review uses a theoretical case to highlight core principles of palliative care and interventional anesthesia, and the importance of collaborative, interdisciplinary care. An overview and discussion of pragmatic considerations of peripheral nervous system interventional analgesic procedures and neuraxial analgesia infusions are provided.
疼痛是晚期癌症常见的症状。据估计,66.4%的晚期癌症患者会因疾病或治疗而感到疼痛。疼痛管理是姑息治疗的重要组成部分。阿片类药物和辅助治疗是癌症疼痛管理的主要方法。然而,一部分患者可能会出现对常规镇痛治疗无反应的复杂疼痛。介入性镇痛程序可能适合且有必要用于管理复杂的癌症相关疼痛。本综述性文章使用一个理论案例强调了姑息治疗和介入麻醉的核心原则,以及协作、跨学科护理的重要性。还提供了外周神经系统介入性镇痛程序和脊神经镇痛输注的实际考虑因素的概述和讨论。