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Breakthrough pain: definition, prevalence and characteristics.
Russell K Portenoy1, Neil A Hagen
1Pain Service, Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A.
Pain
|June 1, 1990
Summary
Breakthrough pain is common in cancer patients on opioids, with varied characteristics and causes. Understanding these pain flares is crucial for effective cancer pain management.
Area of Science:
- Oncology
- Pain Management
- Palliative Care
Background:
- Breakthrough pain in cancer patients on opioids is not well-defined.
- Its prevalence, characteristics, and impact on patient care are largely unknown.
Purpose of the Study:
- To define breakthrough pain and its characteristics in cancer patients.
- To assess the prevalence and impact of breakthrough pain in this population.
Main Methods:
- Prospective survey of cancer patients with chronic pain on stable opioid doses.
- Operational definitions for breakthrough pain and its characteristics were applied.
- Data collected over 3 months from 63 consecutive patients.
Main Results:
- 64% of patients reported breakthrough pain, with diverse characteristics.
- Pains varied in onset, duration, and precipitants (e.g., incident pain).
- Pain pathophysiology included somatic, visceral, neuropathic, and mixed types, often related to the tumor.
Conclusions:
- Breakthrough pain is a prevalent and complex issue in cancer patients.
- Characterizing these pain flares is essential for improving cancer pain management.
- Further research into diverse interventions is warranted for variable efficacy.