Advertisement

Acute Pain in Critical Care Oncologic Patients

  • Keyuri PopatEmail author
  • Catherine Vu
Reference work entry

Abstract

Acute pain is a common symptom in the ICU, which can hinder progress of a patient. If this pain is not treated adequately, there is increased risk of developing chronic pain. Acute pain in the oncologic patient population is multifactorial. Understanding the various types of pain and their etiology helps us select the appropriate modality of pain management. In this era of opioid crisis, finding non-opioid alternatives to control acute pain is very important. In this chapter, we discuss in detail the types of pain, their symptom characteristics and type of opioid and non-opioid treatment options, doses, mechanism of action, and side effects. Another important treatment arm highlighted here is the non-pharmacologic options for pain control. To assess success of these methods, it is probably prudent to move away from pain scores only but also keep in mind the patient’s pain goal and even more importantly the patient’s functional recovery.

Keywords

Acute pain Neuropathic pain Nociceptive pain Analgesic intervention Pain assessment Postoperative pain Regional anesthesia Peripheral nerve block Non-opioid intervention Multimodal analgesia Functional goals 

References

  1. 1.
    Macintyre P, Schug S, Scott D, Visser E, Walker S. Acute pain management: scientific evidence. 3rd. Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine, Melbourne; 2010.Google Scholar
  2. 2.
    Schug SA, Chandrasena C. Pain management of the cancer patient. Expert Opin Pharmacother. 2015;16:5–15.CrossRefGoogle Scholar
  3. 3.
    Popat K, McQueen K, Feeley TW. The global burden of cancer. Best Pract Res Clin Anaesthesiol. 2013;27:399–408.CrossRefGoogle Scholar
  4. 4.
    Centers for Disease Control and Prevention. Inpatient surgery. 2015. www.cdc.gov/nchs/fastats/inpatient-surgery.htm. Accessed 17 July 2015.
  5. 5.
    Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97:534–40, table of contentsCrossRefGoogle Scholar
  6. 6.
    Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014;30:149–60.CrossRefGoogle Scholar
  7. 7.
    Fischer DJ, Villines D, Kim YO, Epstein JB, Wilkie DJ. Anxiety, depression, and pain: differences by primary cancer. Support Care Cancer. 2010;18:801–10.CrossRefGoogle Scholar
  8. 8.
    Krakauer EL, Wenk R, Buitrago R, Jenkins P, Scholten W. Opioid inaccessibility and its human consequences: reports from the field. J Pain Palliat Care Pharmacother. 2010;24:239–43.CrossRefGoogle Scholar
  9. 9.
    Cherny NI, Baselga J, de Conno F, Radbruch L. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Europe: a report from the ESMO/EAPC opioid policy initiative. Ann Oncol. 2010;21:615–26.CrossRefGoogle Scholar
  10. 10.
    von Gunten CF. Pathophysiology of pain in cancer. J Pediatr Hematol Oncol. 2011;33(Suppl 1):S12–8.CrossRefGoogle Scholar
  11. 11.
    Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17:131–57.CrossRefGoogle Scholar
  12. 12.
    Wang Y, Li H, Zou H, Li Y. Analysis of complaints from patients during mechanical ventilation after cardiac surgery: a retrospective study. J Cardiothorac Vasc Anesth. 2015;29:990–4.CrossRefGoogle Scholar
  13. 13.
    Jafarizadeh H, Lotfi M, Ajoudani F, Kiani A, Alinejad V. Hypnosis for reduction of background pain and pain anxiety in men with burns: a blinded, randomised, placebo-controlled study. Burns. 2018;44:108–17.CrossRefGoogle Scholar
  14. 14.
    Garland EL, Baker AK, Larsen P, et al. Randomized controlled trial of brief mindfulness training and hypnotic suggestion for acute pain relief in the hospital setting. J Gen Intern Med. 2017;32:1106–13.CrossRefGoogle Scholar
  15. 15.
    Beltaief K, Grissa MH, Msolli MA, et al. Acupuncture versus titrated morphine in acute renal colic: a randomized controlled trial. J Pain Res. 2018;11:335–41.CrossRefGoogle Scholar
  16. 16.
    Fan AY, Miller DW, Bolash B, et al. Acupuncture’s role in solving the opioid epidemic: evidence, cost-effectiveness, and care availability for acupuncture as a primary, non-pharmacologic method for pain relief and management-white paper 2017. J Integr Med. 2017;15:411–25.CrossRefGoogle Scholar
  17. 17.
    Theunissen M, Peters ML, Bruce J, Gramke HF, Marcus MA. Preoperative anxiety and catastrophizing: a systematic review and meta-analysis of the association with chronic postsurgical pain. Clin J Pain. 2012;28:819–41.CrossRefGoogle Scholar
  18. 18.
    Katz J, Seltzer Z. Transition from acute to chronic postsurgical pain: risk factors and protective factors. Expert Rev Neurother. 2009;9:723–44.CrossRefGoogle Scholar
  19. 19.
    Nicholls JL, Azam MA, Burns LC, et al. Psychological treatments for the management of postsurgical pain: a systematic review of randomized controlled trials. Patient Relat Outcome Meas. 2018;9:49–64.CrossRefGoogle Scholar
  20. 20.
    Rolving N, Nielsen CV, Christensen FB, Holm R, Bunger CE, Oestergaard LG. Preoperative cognitive-behavioural intervention improves in-hospital mobilisation and analgesic use for lumbar spinal fusion patients. BMC Musculoskelet Disord. 2016;17:217.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.The University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of AnesthesiologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

Personalised recommendations