Opioids for the management of breakthrough (episodic) pain in cancer patients.

摘要: Background Breakthrough pain is a transient increase in intensity over background pain. It common and distinct component of cancer that can have negative impact for both the patient carers' quality life. usually related to typically rapid onset, severe intensity, generally self-limiting with an average duration 30 minutes. At present current approach managing breakthrough using supplemental analgesia (also known as rescue medication) at dose proportional total around-the-clock (ATC) opioid dose. Objectives This review explores assesses evidence use opioids management patients cancer. Search strategy MEDLINE (1966 2005), EMBASE (1980 CancerLit (1993 CINAHL (1982 2005) Cochrane databases were searched. Handsearching medical journals reference from key textbooks was undertaken drug companies contacted unpublished data. There no language restriction. Date most recent search: January 2005. Selection criteria Randomized controlled trials used medication against active or placebo comparator included. Outcome measures sought reduction measured by appropriate scale, adverse effects, attrition, satisfaction restrictions. Data collection analysis Eligible studies selected examined independently two reviewers. Full text retrieved if any uncertainty about eligibility remained. Non-English texts screened. Quality assessment data extraction conducted standardised forms. Drug dose, titration, route formulation compared detail all outcome (if available) recorded. Main results Four (393 participants) met inclusion criteria, concerned oral transmucosal fentanyl citrate (OTFC) Two titration OTFC, one study OTFC normal release morphine placebo.OTFC shown be effective treatment When morphine, participants gave lower scores higher relief time points. Global also favoured OTFC. Authors' conclusions The randomised trial literature small found other opioids. Given importance this subject, more need undertaken.