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Revista de Oncología

, Volume 6, Issue 5, pp 272–282 | Cite as

Manejo farmacológico del dolor crónico oncológico. Una aproximación actual

  • Ángel Segura HuertaEmail author
  • Roberto Díaz Beveridge
  • Verónica Calderero Aragón
  • Laura Palomar Abad
Revisiones

Resumen

El tratamiento del dolor es una de las prioridades de la Organización Mundial de la Salud (OMS) en la lucha contral el cáncer. La OMS aboga por su escala analgésica contresniveles.

Los opioides mayores son el tratamiento farmacológico fundamental del dolor oncológico crónico. La morfina oral de liberación inmediata tiene una duración de acción de 4 horas. La morfina oral de liberación retardada tiene 8–12 horas de duración. El fentanilo transdérmico es un sistema diseñado para liberar el fármaco durante 72 horas. Hay sistemas diseñados para liberar 25, 50, 75 y 100 μg/hora, según la superficie del parche. La buprenorfina transdérmica es el último medicamento comercializado para el tratamiento del dolor crónico. Existen tres presentaciones, cada una de ellas libera de forma respectiva 35, 52,5 y 70 μg/hora. El parche debe cambiarse cada 72 horas.

La terapéutica fundamental en el manejo del dolor incidental es el uso de dosis suplementarias de opioides de liberación inmediata. La dosis oscila entre el 10%–25% de la dosis opioide total diaria.

Palabras clave

dolor crónico morfina fentanilo buprenorfina cáncer 

Management of cancer-associated chronic pain with medication: a current approximation

Abstract

Treatment of pain is one of the priorities of the WHO in its fight against cancer: The WHO advocates a three-stage scale of analgesia:

The stronger opioids are the fundamental treatment of cancer-associated chronic pain. Immediate-release oral morphine has a duration of activity of 4 hours. Late-release oral morphine has an action of 8–12 hour duration. Transdermal fentanyl is a system designed to release the drug over 72 hours. There are systems designed to release 25, 50, 75 and 100 μg/h, depending of the surface area of the patch. Transdermal buprenorphine is the latest medication commercialised for the treatment of chronic pain. These are three preparations that release 35, 52.5 or 70 μg/h. The patch needs to be changed every 72 hours.

The fundamental therapy in the management of cancer-associated pain is the use of immediate-release opioid supplements. The dose can vary between 10%–25% of the total daily opioid dose.

Key words

chronic pain morphine fentanyl buprenorfine cancer 

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Copyright information

© FESEO 2004

Authors and Affiliations

  • Ángel Segura Huerta
    • 1
    Email author
  • Roberto Díaz Beveridge
    • 1
  • Verónica Calderero Aragón
    • 1
  • Laura Palomar Abad
    • 1
  1. 1.Servicio de Oncología MédicaHospital Universitario La FeValencia

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