Cancer Pain at the Emergency Department and its Approach

Abstract

Introduction: Pain is reported to be a chief complaint in emergency departments (ED), however, few studies have examined pain management in the ED, and fewer in oncologic patients. Objective: The purpose of this study was to determine the prevalence of pain complaints in the ED in cancer patients at an oncologic center. Methods: We conducted a retrospective study in which we analyzed the consecutive, nonrandomized records of patients who arrived at the ED of the National Cancer Institute of Mexico, during the period from January 2015 to March 2015. Results: Of 2676 patients, 30.7% complained of pain at the ED. Visceral pain was the most frequent type of pain (55.5%), followed by somatic pain (27.4%). The mean VAS score of background pain was 6 (RIC 4-8), while for break through cancer pain (BTCP) the mean was 8 (RIC 7-10). In 92.2% of patients referred to a pain clinic office, an opioid was prescribed. Morphine, followed by tramadol and buprenorphine were the most frequent opioids prescribed. Conclusion: This is the first study that identifies types of pain, intensity and treatment in cancer population at an ED. Recognizing pain as a prevalent problem, may be helpful to implement preventive measures or treat pain opportunely and appropriately in cancer patients. We suggest prospectively long-term studies to properly evaluate the impact of a pain clinic office in an ED at an Oncologic Center.