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Assessment and treatment of neuropathic cancer pain following WHO guidelines. Pain 1999 Jan;79(1):15-20

Date

02/03/1999

Pubmed ID

9928771

DOI

10.1016/S0304-3959(98)00138-9

Scopus ID

2-s2.0-0032956752 (requires institutional sign-in at Scopus site)   220 Citations

Abstract

Neuropathic pain syndromes are one of the major problems of cancer pain treatment. The present study surveys 593 cancer patients treated by a pain service following the WHO guidelines for relief of cancer pain. Of these, 380 presented with nociceptive, 32 with neuropathic and 181 with mixed (nociceptive and neuropathic) pain. In patients with nociceptive, mixed and neuropathic pain, the average duration of evaluated pain treatment was 51, 53 and 38 days, respectively. Non-opioid or opioid analgesics were given to 99%, 96% and 79%, antidepressants to 8%, 25% and 19%, anticonvulsants to 2%, 22% and 38% and corticosteroids to 26%, 35% and 22% of patients, respectively. Systemic analgesia was supported by palliative antineoplastic treatment (48%, 56% and 38% of patients), nerve blocks (3%, 6% and 6%), psychotherapy (3%, 7% and 3%), physiotherapy (6%, 12% and 13%) and transcutaneous electric nerve stimulation (1%, 6% and 6%). Analgesic treatment resulted in a significant pain relief in all groups of patients, as the mean pain intensity (NRS) decreased from 66 (nociceptive), 65 (mixed) and 70 (neuropathic) on admission to 26, 30 and 28 after 3 days and 18, 17 and 21 at the end of survey. The total outcome of pain treatment was not predicted by the designation to nociceptive, mixed or neuropathic pain. In conclusion, neuropathic cancer pain is not intractable and can be relieved in the majority of patients by treatment following the WHO guidelines.

Author List

Grond S, Radbruch L, Meuser T, Sabatowski R, Loick G, Lehmann KA

Author

Thomas Meuser MD Professor in the Anesthesiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Analgesics
Combined Modality Therapy
Evaluation Studies as Topic
Female
Humans
Male
Middle Aged
Multivariate Analysis
Neoplasms
Neuralgia
Pain
Prospective Studies
World Health Organization