Pain/Palliative Care – Pubmed

BACKGROUND: Palliative analgesic radiotherapy is commonly used to alleviate pain in patients with bone metastases. Traditionally, this approach involved irradiating the vertebrae above and below the painful lesion. The 2D/3D radiotherapy technique, characterized by a physical penumbra that could extend up to 50% of the vertebral height, often resulted in underdosing of the target volume and potentially reduced analgesic effectiveness. However, the advent of CT and MRI imaging, along with...

CONCLUSION: This review provides a comprehensive overview of the mechanisms, indications, benefits, and safety of phenol neurolysis in pain and palliative medicine, aiming to support its evidence-based use in clinical practice.

It has been well documented that pain is among the most prevalent and distressing symptoms experienced by people in the palliative care phase of dying. The diversity in types of pain makes it challenging to alleviate and manage, and yet effective pain management is the cornerstone for enhancing quality of life for those who are dying. Any strategy to manage pain requires current evidence, a multidimensional, yet individualised, approach to ensure its uniqueness and tailored to that person....

CONCLUSION: Patients who received a palliative care consultation showed different patterns of end-of-life opioid prescribing, especially for strong opioids. Understanding such variation may support ongoing efforts to improve symptom management near the end of life.

There are no clinical guidelines for the perioperative management of cancer pain among opioid users, and a lack of literature exists concerning this topic. This study aimed to retrospectively investigate the actual perioperative management of patients with cancer who received general anesthesia while using strong opioids. We conducted a chart review of the perioperative management of patients with cancer who received general anesthesia while using strong opioids. The primary outcome was the...

CONCLUSION: No differences were observed in retreatment rates, pain response, or QOL between 8 Gy x 1 and 8 Gy x 2. Single-fraction palliative RT remains a standard for patients with painful bone metastases.

CONCLUSION: Using the PCOC framework for standardized patient assessment, we found that pain and fatigue are associated and comprehensive assessment is important as treatment of one may alleviate the other.

CONCLUSION: Metastatic cancer patients with high performance status without liver damage may benefit from a higher, proactively titrated starting dose of adjunct methadone.