Pain and Chemical Dependency News

Prevalence and characteristics of breakthrough pain in opioid-treated patients with chronic noncancer pain

Breakthrough pain is well-characterized in cancer patients but not in patients with chronic noncancer pain. The investigators recruited 228 patients with various types of chronic noncancer pain from 9 pain programs and administered a telephone questionnaire with a breakthrough pain assessment algorithm originally designed for cancer patients. All patients had controlled baseline pain, and 168 (74%) experienced severe to excruciating breakthrough pain. Among those with breakthrough pain, the most common syndrome was low back pain (52%), and the underlying pathophysiology was variably characterized as somatic (38%), neuropathic (18%), visceral (4%), or mixed (40%). A total of 189 different types of breakthrough pain were reported. The median number of episodes per day was 2. Median time to maximum intensity was 10 minutes. Median duration of the breakthrough pain was 60 minutes. Patients identified a precipitant for 69% of pains; 92% of these were activity-related. Onset could never be predicted for 45% of pains and only sometimes predicted for 31% of pains. Breakthrough pain was highly prevalent and varied in this population. Further studies are needed to clarify whether the clinical impact and therapeutic challenges posed by this phenomenon are comparable to the cancer population. This study suggests that breakthrough pain is highly prevalent and varied in opioid-treated patients with chronic noncancer pain. Portenoy RK, Bennett DS, Rauck R, Simon S, Taylor D, Brennan M, Shoemaker S. Adapted from J Pain. 2006 Aug;7(8):583-91.

PMID: 16885015

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

Credit: PubMed, developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM).

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Department of Pain Medicine and Palliative Care
©2005 Continuum Health Partners, Inc.
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