Breakthrough pain

The breakthrough pain ( English break through pain is) occurring especially in tumor patients pain tip (temporary pain exacerbation ), the duration of pre-existing pain occurs despite adequate control. This pain can last up to 30 minutes. On average, breakthrough pain peaks three to five minutes after the onset of pain.

causes

Breakthrough pain is usually associated with illness. Breakthrough pain can therefore have many indirect causes.

Malignant diseases are an example of this . Breakthrough pain can also occur in chronic pain. Breakthrough pain does not have to be an indication of deterioration, but it can.

They will also be observed at the end of a baseline pain management dosing interval.

frequency

The incidence of breakthrough pain is very variable. Very often such pain can be seen in cancer patients. Many patients report two to six pain attacks a day.

therapy

Treatment is often carried out according to the following scheme:

Basic medication

A retarded opioid is often used for this medication . The patient takes this at fixed times, preferably orally .

Reliever medication

With this medication, an opioid of WHO level III is often used in this case . This does not have to be retarded because it is intended to treat breakthrough pain. This usually does not last longer than 30 minutes.

There is also an option to treat breakthrough pain with a nonsteroidal anti-inflammatory drug .

Since the route via oral intake is not always the fastest, the following option has arisen to treat breakthrough pain as quickly and efficiently as possible:

Patient-directed analgesia

With patient-controlled analgesia (PCA), the patient can apply an analgesic himself if necessary. However, only individual forms of application come into question here.

There are now a wide variety of ways to apply opioids, such as fentanyl , to combat breakthrough pain. A modified form of the classic PCA is a nasal spray with fentanyl or a device that nebulises fentanyl and thus inhales it. In this way, breakthrough pain can also be combated “from home”.

In addition, consideration should be given to consulting a palliative care practitioner, especially for cancer patients.

consequences

If breakthrough pain is left untreated, it can severely affect quality of life. These can manifest themselves in the form of sleep disorders or increased feelings of fear.

Web links

PharmaWiki: Breakthrough Pain .

Individual evidence

↑ RK Portenoy, NA Hagen: Breakthrough pain: definition, prevalence and charac-teristics. In: Pain. Volume 41, No. 3, 1990, pp. 273-281.
↑ ^a ^b ^c ^d ^e Enno Freye: Opioids in medicine . 8th, updated edition. Springer Medizin Verlag, Heidelberg 2010, ISBN 978-3-540-88797-3 .
↑ ^a ^b ^c ^d ^e ^f ^g Breakthrough pain: trigger, frequency, treatment. Retrieved April 9, 2020 .
^ ^A ^b ^c DocCheck Medical Services GmbH: Breakthrough pain. Retrieved April 9, 2020 .
↑ ^a ^b ^c ^d PharmaWiki - breakthrough pain. Retrieved April 9, 2020 .
↑ Koppert, Wolfgang., Strumpf, Michael., Willweber-Strumpf, Anne .: Practical pain medicine: Interdisciplinary diagnostics - multimodal therapy. 4th ed.Springer, Berlin, Heidelberg 2019, ISBN 978-3-662-57487-4 .

[1] RK Portenoy, NA Hagen: Breakthrough pain: definition, prevalence and charac-teristics. In: Pain. Volume 41, No. 3, 1990, pp. 273-281.

[:2-2] Enno Freye: Opioids in medicine . 8th, updated edition. Springer Medizin Verlag, Heidelberg 2010, ISBN 978-3-540-88797-3 .

[:0-3] ↑ ^a ^b ^c ^d ^e ^f ^g Breakthrough pain: trigger, frequency, treatment. Retrieved April 9, 2020 .

[:1-4] A ^b ^c DocCheck Medical Services GmbH: Breakthrough pain. Retrieved April 9, 2020 .

[:3-5] PharmaWiki - breakthrough pain. Retrieved April 9, 2020 .

[6] Koppert, Wolfgang., Strumpf, Michael., Willweber-Strumpf, Anne .: Practical pain medicine: Interdisciplinary diagnostics - multimodal therapy. 4th ed.Springer, Berlin, Heidelberg 2019, ISBN 978-3-662-57487-4 .