Non pharmacological interventions and non-fentanyl pharmacological treatments for breakthrough cancer pain: A systematic and critical review

摘要: Abstract Background: Oral opioids or other pharmacological non-pharmacological interventions are often suggested in the management of breakthrough cancer pain (BTcP). The aim this systematic and critical review was to analyse critically comment evidence any non-fentanyl therapies proposed for BTcP. Methods A literature search carried out find studies providing clinical data on treatment excluding fentanyl products. Results No exist about use oral opioids. Some information is available parenteral morphine a large sample patients episodes For treatments, including methadone, nitrous oxide, anti-inflammatory drugs, samarium, gabapentin existing data, observational obtained small number do not provide useful be generalized. Only ketamine, drug difficult many physicians, particularly determined setting, provided some according randomized controlled double-blind study. Conclusions Recommendations suggesting non-pharmacologic BTcP, based any, even minimal evidence. These treatments worthwhile further investigation, conditions that should fit pharmacokinetics