Comprehensive care of oncological patients with pain
Abstract
Introduction: Pain control is an essential component of palliative care.
Objective: Describe the management of oncological pain as a frequent symptom reported by patients.
Methods: An observational prospective longitudinal study was conducted with implementation of a medical record model for pain evaluation. The study included 116 patients admitted to the Pain Clinic at the National Institute of Oncology and Radiobiology from 1 July to 31 December 2019. The data were summarized with the use of frequencies for qualitative variables, means for quantitative variables and chi-square for the association between variables.
Results: Mean age was 62 years, with a prevalence of the female sex. 74.2% were in advanced stages. Of the patients studied, 93.1% reported chronic, mixed, moderately intense to severe pain. The most common pain site was the lumbosacral spine. Severe pain was associated to anxiety, depression and insomnia (p ≤ 0.008). Treatment with mild opioids and adjuvants was indicated in all cases, with potent opioid escalation in 59 patients. Partial or total pain control was achieved in 104 patients. The most common adverse reactions were constipation, nausea and somnolence.
Conclusions: Pain control was achieved in most patients with the implementation of a medical record, evaluation and treatment, which permitted the application of an effective individualized treatment.
Key words: pain, cancer, palliative care.Downloads
References
1) Gómez SM. Historia Clínica del dolor, clasificación, evaluación, prevalencia. Cuidados Paliativos: Las Palmas de Gran Canaria GAFOS 2003; T II Cap 46, 223-255.
2) Bruera E, Kim H. Cancer pain. JAMA 2003; 290: 2476-2480.
3) Reyes C, Grau J, Chacón M. Cuidados paliativos en pacientes con cáncer avanzado: 120 preguntas y respuestas. Editorial Ciencias Médicas.2009; II, 21-64.
4) Williams AC, Craig KD. Updating the definition of pain. Pain. 2016; 157:2420-3.
5) Van den Beuken-van Everdingen MHJ, de Rijke JM, Kessels AG, Schouten HC, Van Kleef M, Patijn J. Prevalence of pain in patients with cancer: A systematic review of the past 40 years. Ann Oncol. 2007;18:1437–49
6) Alonso BA.La importancia de evaluar adecuadamente el dolor. Aten Primaria. 2011; Nov; 43(11): 575–576.DOI:10.1016/j.aprim.2011.07.003
7) Arrate PD. Manual para el tratamiento de las urgencias oncológicas. Disponible en: https://www.osakidetza.euskadi.eus/contenidos/informacion/hd_publicaciones/es_hdon/adjuntos/ProtocoloUrgoncologicasC.pdf
8) Bayés R. Psicología y Cuidados Paliativos (editorial). Medicina Paliativa 2005; 12(3): 137-8.
9) González-Escalada JR, Camba A, Casas A, Gascón P, Herruzo I, Núñez-Olarte JM, Ramos-Aguerri A, Trelis J, Torres LM. Código de buena práctica para el control del dolor oncológico. Rev Soc Esp Dolor 2011; 2: 98-117.
10) Hanks GW, Conno F, Cherny N, Hanna M, Kalso E, McQuay HJ, et al. Morphine and alternative opioids in cancer pain: the EAPC recommendations. Br J Cancer 2001; 84:587-93.
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