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Author: haixin This article is published by Yimaitong authorized by the author, please do not reprint without authorization
.
Pain is one of the most common symptoms of cancer patients, which seriously affects the quality of life of cancer patients
.
The incidence of pain in newly diagnosed cancer patients is about 25%; the incidence of pain in patients with advanced cancer is about 60%-80%, of which 1/3 of patients have severe pain
.
If cancer pain is not relieved, the patient will feel extremely uncomfortable, which may cause or aggravate the patient’s symptoms such as anxiety, depression, fatigue, insomnia, and loss of appetite, which will seriously affect the patient’s daily activities, self-care ability, communication skills and overall quality of life
.
Cancer Pain Etiology Pain Assessment 01 Numerical Grading Method (NRS) Mild Pain (1-3) Moderate Pain (4-6) Severe Pain (7-10) 02 Pain Facial Score Scale 03 Complaint Pain Degree Grading Method (VRS) )(1) Mild pain: Pain but tolerable, normal life, no sleep
.
(2) Moderate pain: The pain is obvious and cannot be tolerated, requiring analgesics and disturbed sleep
.
(3) Severe pain: The pain is severe and unbearable, analgesics are needed, sleep is severely disturbed, and it may be accompanied by autonomic disorders or passive posture
.
Cancer pain analgesic drug classification principle 01 non-steroidal drugs commonly used in the treatment of cancer pain, non-steroidal anti-inflammatory agents include: ibuprofen, diclofenac, acetaminophen, indomethacin, celecoxib and the like
.
Common non-steroidal anti-inflammatory drugs adverse reactions are: peptic ulcers, gastrointestinal bleeding, platelet dysfunction, kidney damage, liver damage
.
The occurrence of its adverse reactions is related to the dosage and duration of use
.
The daily limited doses of non-steroidal anti-inflammatory drugs are: ibuprofen 2400 mg/d, acetaminophen 2000 mg/d, and celecoxib 400 mg/d
.
When using non-steroidal anti-inflammatory drugs, when the dosage reaches a certain level, increasing the dosage will not enhance its analgesic effect, but the toxicity of the drug will increase significantly ("ceiling effect")
.
Therefore, if long-term use of non-steroidal anti-inflammatory drugs is required, or when the daily dose has reached the limit, you should consider switching to opioid analgesics; if it is a combination drug, only increase the dose of opioid analgesics
.
02 Opioids The short-acting opioids commonly used clinically for the treatment of cancer pain are immediate-release morphine tablets, and long-acting opioids are morphine sustained-release tablets, oxycodone sustained-release tablets, fentanyl transdermal patches, etc.
.
For the treatment of chronic cancer pain, opioid receptor agonists are recommended
.
When opioid analgesics are used for long-term maintenance, oral administration is the first choice.
Subcutaneous injection, intravenous injection, transdermal administration can be used when clear indications are available, and self-controlled analgesics can be administered if necessary
.
Opioid Dose Conversion Table 03 Adjuvant medications in the treatment of cancer pain 04 Side effects of opioids and their treatment of constipation, nausea, vomiting and respiratory depression References (1) NCCN Guidelines for Adult Cancer Pain (2021 Edition) (2) Cancer Pain Outside Traditional Chinese Medicine Expert consensus on treatment and diagnosis and treatment standards (2014 edition) (3) Cancer pain diagnosis and treatment standards (2011 edition) (4) Fei Yong, Yao Ming, Liu Yanqing, et al.
Individualized and precise treatment of cancer pain[J].
Chinese Medical Journal, 2019, 9 (17):1281-1285.
(5) Sun Laibao, Liu Song, Chen Bingxue.
Progress in the treatment of advanced cancer pain[J].
Journal of Practical Pain, 2006(3):186-189.
.
Pain is one of the most common symptoms of cancer patients, which seriously affects the quality of life of cancer patients
.
The incidence of pain in newly diagnosed cancer patients is about 25%; the incidence of pain in patients with advanced cancer is about 60%-80%, of which 1/3 of patients have severe pain
.
If cancer pain is not relieved, the patient will feel extremely uncomfortable, which may cause or aggravate the patient’s symptoms such as anxiety, depression, fatigue, insomnia, and loss of appetite, which will seriously affect the patient’s daily activities, self-care ability, communication skills and overall quality of life
.
Cancer Pain Etiology Pain Assessment 01 Numerical Grading Method (NRS) Mild Pain (1-3) Moderate Pain (4-6) Severe Pain (7-10) 02 Pain Facial Score Scale 03 Complaint Pain Degree Grading Method (VRS) )(1) Mild pain: Pain but tolerable, normal life, no sleep
.
(2) Moderate pain: The pain is obvious and cannot be tolerated, requiring analgesics and disturbed sleep
.
(3) Severe pain: The pain is severe and unbearable, analgesics are needed, sleep is severely disturbed, and it may be accompanied by autonomic disorders or passive posture
.
Cancer pain analgesic drug classification principle 01 non-steroidal drugs commonly used in the treatment of cancer pain, non-steroidal anti-inflammatory agents include: ibuprofen, diclofenac, acetaminophen, indomethacin, celecoxib and the like
.
Common non-steroidal anti-inflammatory drugs adverse reactions are: peptic ulcers, gastrointestinal bleeding, platelet dysfunction, kidney damage, liver damage
.
The occurrence of its adverse reactions is related to the dosage and duration of use
.
The daily limited doses of non-steroidal anti-inflammatory drugs are: ibuprofen 2400 mg/d, acetaminophen 2000 mg/d, and celecoxib 400 mg/d
.
When using non-steroidal anti-inflammatory drugs, when the dosage reaches a certain level, increasing the dosage will not enhance its analgesic effect, but the toxicity of the drug will increase significantly ("ceiling effect")
.
Therefore, if long-term use of non-steroidal anti-inflammatory drugs is required, or when the daily dose has reached the limit, you should consider switching to opioid analgesics; if it is a combination drug, only increase the dose of opioid analgesics
.
02 Opioids The short-acting opioids commonly used clinically for the treatment of cancer pain are immediate-release morphine tablets, and long-acting opioids are morphine sustained-release tablets, oxycodone sustained-release tablets, fentanyl transdermal patches, etc.
.
For the treatment of chronic cancer pain, opioid receptor agonists are recommended
.
When opioid analgesics are used for long-term maintenance, oral administration is the first choice.
Subcutaneous injection, intravenous injection, transdermal administration can be used when clear indications are available, and self-controlled analgesics can be administered if necessary
.
Opioid Dose Conversion Table 03 Adjuvant medications in the treatment of cancer pain 04 Side effects of opioids and their treatment of constipation, nausea, vomiting and respiratory depression References (1) NCCN Guidelines for Adult Cancer Pain (2021 Edition) (2) Cancer Pain Outside Traditional Chinese Medicine Expert consensus on treatment and diagnosis and treatment standards (2014 edition) (3) Cancer pain diagnosis and treatment standards (2011 edition) (4) Fei Yong, Yao Ming, Liu Yanqing, et al.
Individualized and precise treatment of cancer pain[J].
Chinese Medical Journal, 2019, 9 (17):1281-1285.
(5) Sun Laibao, Liu Song, Chen Bingxue.
Progress in the treatment of advanced cancer pain[J].
Journal of Practical Pain, 2006(3):186-189.
