Código de buena práctica para el control del dolor oncológico / Good clinical practice guide for control of oncological pain

En muchas ocasiones, los pacientes con cáncer no expresan su dolor por miedo a que el médico desvíe su atención hacia este síntoma, en lugar de centrarse en el tratamiento de su enfermedad principal. No obstante, el paciente debe saber que el tratamiento de su dolor no sólo no interfiere con la terapia curativa, sino que colabora con ella. Entre los pacientes, es habitual el temor a que el avance de la enfermedad les lleve a situaciones de sufrimiento insostenible que supere todas las posibilidades médicas, pero es nuestro deber ayudarles a ser conscientes de que la medicina ofrece un abanico de tratamientos capaces de aliviar su dolor y evitar su sufrimiento. Este conocimiento es esencial para aumentar su confianza en el tratamiento y mejorar la relación médico-paciente. Frente a este desafío, la Sociedad Española de Cuidados Paliativos, la Sociedad Española del Dolor, la Sociedad Española de Oncología Médica y la Sociedad Española de Oncología (..) (AU)

Patients with cancer often do not mention their pain as they are afraid that the doctor will be distracted towards this symptom instead of focusing on the treatment of their primary disease. However, should know that the treatment of their pain not only does it not interfere with their remedial therapy, but also contributes to it. It is usual, among patients, to be afraid that the advance of the disease may lead to situations of unsustainable suffering which may exceed all the medical possibilities, but it is our duty to help them to be aware that medicine offers a wide range of treatments to relieve their pain and prevent them suffering. This knowledge is essential to increase their (..)(AU)

High dose transdermal buprenorphine for moderate to severe pain in spanish pain centres--a retrospective multicenter safety and efficacy study.

OBJECTIVES: To assess the effectiveness of transdermal buprenorphine in patients suffering from moderate to severe pain. Secondary objectives included gathering information about the causes of pain, management of episodic pain, and the safety profile. METHODS: Retrospective data were collected from 1,465 patients with moderate to severe pain, ie, > or =50 mm on a 0 to 100 mm visual analog scale (VAS), that were switched to transdermal buprenorphine, and received a dose > or =52.5 microg/hour for at least 14 days during the previous 12 months. Pain could have any etiology. Most patients (72.1%) were on tramadol and/or paracetamol (40.7%) before switching to buprenorphine. Using case report forms, efficacy was determined from changes in VAS score compared with 24 hours prior to the first patch application. Safety was evaluated by retrieving information about the nature and incidence of adverse events (AE), whether they were related to the study compound, and the percentage considered being serious. RESULTS: An absolute reduction of 25.1 points in VAS score was seen over a median period of 3.7 months treatment. In addition, the VAS score was reduced by at least 10% in 88.4% of patients and the incidence of episodic pain fell significantly. Treatment was rated as "Good" or "Very Good" by 82.5% of patients. Out of 1,465 patients, 50.2% experienced an AE; this was related to the drug in 48.8%, and considered serious in 4.0%. CONCLUSIONS: Transdermal buprenorphine was an effective and considerably safe drug for relieving chronic moderate to severe pain.