Protocolo terapéutico del dolor en el paciente oncológico

Abstract

Cancer pain is multidimensional and requires a comprehensive approach. A good anamnesis is essential in order to identify the characteristics of the pain and to be able to categorize it as nociceptive or neuropathic; background or breakthrough; or mild, moderate, or severe pain. Depending on these characteristics, treatment will be initiated with non-opioid analgesics or weak or potent opioids. Additional adjuvant therapies will be added depending on the cause of the pain, managing at all times the adverse effects that appear. In addition, the possibility of local treatment with radiotherapy or surgery or interventional treatment will be evaluated.

In regard to the use of potent opioids, the most suitable option will be chosen for each patient, treatment will be initiated with the corresponding dose, and it will be titrated with an extra dose until reaching the specific dose for each patient, which may vary during the oncologic process. In case of therapeutic failure or toxicity, rotation from one opioid to another can be considered, monitoring adverse effects for specific management.