Palabras clave
Manejo del dolor
Analgésicos
Guía de práctica clínica
Cómo citar
Resumen
Introducción: El dolor es el síntoma más común en pacientes con cáncer, y se ha convertido en un reto para el personal de salud en el quehacer diario debido a que su abordaje y manejo es multidimensional y complejo. El inadecuado control del dolor genera incapacidad física o emocional afectando la calidad de vida del paciente. Objetivo: Desarrollar una guía de práctica clínica para ofrecer a los especialistas en medicina de dolor y cuidados paliativos, y otros profesionales de salud implicados en la atención del paciente con dolor oncológico, recomendaciones sobre las intervenciones terapéuticas disponibles para el manejo de esta condición. Métodos: Para la elaboración de la presente guía de práctica clínica se siguieron los lineamientos contenidos en la “Guía metodológica para la elaboración de Guías de Práctica Clínica” del Ministerio de Salud y Protección Social. Se conformó un grupo desarrollador de la guía que diseñó 20 preguntas clínicas con la estrategia PICO. Se realizó la búsqueda de guías preexistentes en sitios reconocidos. Un consenso informal de expertos, basados en la literatura encontrada, definió las recomendaciones para su elaboración, socialización y aprobación institucional. Resultados: Se dio respuesta a las preguntas clínicas sobre definición, clasificación, evaluación, y manejo del dolor oncológico mediante las recomendaciones basadas en la revisión de literatura no sistemática. Conclusión: La presenta guía ayuda al soporte de las decisiones clínicas en el manejo del dolor oncológico acorde con las necesidades del paciente y de los recursos disponibles en la institución.
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Vejlgaard T, Addington-Hall JM. Attitudes of Danish doctors and nurses to palliative and terminal care. Palliat Med. 2005;19(2):119-27. https://doi.org/10.1191/0269216305pm988oa
World Health Organization. WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. World Health Organization. 2018.
Van den Beuken-van Everdingen MHJ, de Graeff A, Jongen JLM, Dijkstra D, Mostovaya I, Vissers KC. Pharmacological Treatment of Pain in Cancer Patients: The Role of Adjuvant Analgesics, a Systematic Review. Pain Pract. 2017;17(3):409-19. https://doi.org/10.1111/papr.12459
Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, et al. Cancer-related pain: A pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009;20(8):1420-33. https://doi.org/10.1093/annonc/mdp001
Swarm RA, Paice JA, Anghelescu DL, Are M, Bruce JY, Buga S, et al. Adult cancer pain, version 3.2019. JNCCN J Natl Compr Cancer Netw. 2019;17(8):977-1007.
Paice J, Ferrell BR. The Management of Cancer Pain. CANCER J CLIN. 2011;61(3):157-82.
https://doi.org/10.3322/caac.20112
Boland EG, Ahmedzai SH. Persistent pain in cancer survivors. Curr Opin Support Palliat Care. 2017 Sep;11(3):181-90. https://doi.org/10.1097/SPC.0000000000000292
Seretny M, Currie GL, Sena ES, Ramnarine S, Grant R, MacLeod MR, et al. Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis. Pain. 2014 Dec;155(12):2461-70. https://doi.org/10.1016/j.pain.2014.09.020
Bennett MI, Eisenberg E, Ahmedzai SH, Bhaskar A, O'Brien T, Mercadante S, et al. Standards for the management of cancer-related pain across
Europe-A position paper from the EFIC Task Force on Cancer Pain. Eur J Pain (United Kingdom). 2019;23(4):660-8. https://doi.org/10.1002/ejp.1346
Te Boveldt N, Vernooij-Dassen M, Burger N, Ijsseldijk M, Vissers K, Engels Y. Pain and its interference with daily activities in medical oncology outpatients. Pain Physician. 2013;16(4):379-89. https://doi.org/10.36076/ppj.2013/16/379
Paice JA, Portenoy R, Lacchetti C, Campbell T, Cheville A, Citron M, et al. Management of chronic pain in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2016;34(27):3325-45. https://doi.org/10.1200/JCO.2016.68.5206
Australia. CC. Australian Adult Cancer Pain Management Guideline Working Party. Cancer pain management in adults. 2016.
Ministry of Health Malaysia. Management of cancer pain book.pdf. 2010; Available from: www.moh.gov.my
Mona Sawhney, Glenn G Fletcher, Jill Rice, Judy Watt-Watson TR, An. A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care
Ontario (CCO) Guidelines on Management of Pain in Cancer and/or. 2017; Available from: www.moh.gov.my
Fallon M, Giusti R, Aielli F, Hoskin P, Rolke R, Sharma M, et al. Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2018;29(July): iv166-91.
https://doi.org/10.1093/annonc/mdy152
Swarm RA. The management of pain in patients with cancer. Vol. 11, JNCCN Journal of the National Comprehensive Cancer Network. 2013. 702-704 p. https://doi.org/10.6004/jnccn.2013.0206
Ministerio de Salud y Protección Social, Instituto de Evaluación Tecnológica en Salud. Guía metodológica Adopción-Adaptación de Guías de Práctica
Clínica Basadas en Evidencia. Minist Salud y Protección Soc Inst Evaluación Tecnológica en Salud [Internet]. 2017;1-63. Available from: http://www.iets.org.co/Archivos/79/Guia_de_Adopcion_VF.pdf%0Ahttp://www.iets.org.co/Documents/Guia_de_Adopcion_VF.pdf
IASP. https://www.iasppain.org/Education/Content.aspx?ItemNumber=1698#Nociceptivepain [Internet]. 2017. Available from: https://www.iasppain. org/Education/Content.aspx?ItemNumber=1698#Nociceptivepain
Jensen-Seaman K, Hebert RS. Palliative care education in nurse practitioner programs: A survey of academic deans. Nurse Educ. 2016;41(3):130-3. https://doi.org/10.1097/NNE.0000000000000247
Wiffen P, Wee B, Bell R, Moore R. Cochrane Database of Systematic Reviews Opioids for cancer pain -an overview of Cochrane reviews (Review).
Cochrane Database Syst Rev [Internet]. 2017;2017(7):CD012592. Available from: http://as.wiley.com/WileyCDA/Brand/id-6.html%0Ahttp://ovidsp. ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emexa&NEWS=N&AN=617155041
Derry S, Pj W, Ra M, Ed M, Rf B, Db C, et al. Oral nonsteroidal anti-inflammatory drugs ( NSAIDs ) for cancer pain in adults ( Review ) SUMMARY OF FINDINGS FOR THE MAIN COMPARISON. 2017;(7).
Public statement European Medicines Agency announces regulatory action on COX-2 inhibitors. 2005;(February):62838.
Ciszkowski C, Madadi P, Phillips MS, Lauwers AE, Koren G. Codeine, ultrarapid-metabolism genotype, and postoperative death. Vol. 361, The New England journal of medicine. United States; 2009. p. 827-8. https://doi.org/10.1056/NEJMc0904266
Wang X, Narayan SW, Penm J, Patanwala AE. Efficacy and Safety of Tapentadol Immediate Release for Acute Pain: A Systematic Review and Meta- Analysis. Clin J Pain. 2020;36(5):399-409. https://doi.org/10.1097/AJP.0000000000000809
Radbruch L, Trottenberg P, Elsner F, Kaasa S, Caraceni A. Systematic review of the role of alternative application routes for opioid treatment for moderate to severe cancer pain: An EPCRC opioid guidelines project. Palliat Med. 2011;25(5):578-96.
https://doi.org/10.1177/0269216310383739
Stone P, Minton O. European Palliative Care Research collaborative pain guidelines. Central side-effects management: what is the evidence to support best practice in the management of sedation, cognitive impairment and myoclonus? Palliat Med. 2011 Jul;25(5):431-41.
https://doi.org/10.1177/0269216310380763
SIGN. SIGN 136 • Management of chronic pain KEY TO EVIDENCE STATEMENTS AND GRADES OF RECOMMENDATIONS. 2013;(December):65. Available from: http://www.sign.ac.uk/pdf/SIGN136.pdf
Mercadante S, Bruera E. Opioid switching in cancer pain: From the beginning to nowadays. Crit Rev Oncol Hematol [Internet]. 2016;99:241-8. Available from:
https://doi.org/10.1016/j.critrevonc.2015.12.011
Mercadante S, Caraceni A. Conversion ratios for opioid switching in the treatment of cancer pain: A systematic review. Palliat Med. 2011;25(5):504-15.
https://doi.org/10.1177/0269216311406577
Mehta V, Langford R. Acute Pain Management in Opioid Dependent Patients. Rev pain. 2009 Oct;3(2):10-4. https://doi.org/10.1177/204946370900300204
Huxtable CA, Roberts LJ, Somogyi AA, Macintyre PE. Acute pain management in opioid-tolerant patients: A growing challenge. Anaesth Intensive Care. 2011;39(5):804-23.
https://doi.org/10.1177/0310057X1103900505
Radbruch L, Trottenberg P, Elsner F, Kaasa S, Caraceni A. Systematic review of the role of alternative application routes for opioid treatment for moderate to severe cancer pain: an EPCRC opioid guidelines project. Palliat Med. 2011 Jul;25(5):578-96. https://doi.org/10.1177/0269216310383739
Mercadante S, Villari P, Ferrera P, Casuccio A, Mangione S, Intravaia G. Transmucosal fentanyl vs intravenous morphine in doses proportional to basal opioid regimen for episodic-breakthrough pain. Br J Cancer. 2007 Jun;96(12):1828- https://doi.org/10.1038/sj.bjc.6603811
Minoura T, Takeuchi M, Morita T, Kawakami K. Practice Patterns of Medications for Patients With Malignant Bowel Obstruction Using a Nationwide
Claims Database and the Association Between Treatment Outcomes and Concomitant Use of H2-Blockers/Proton Pump Inhibitors and Corticosteroids With Octreotide. J Pain Symptom Manage. 2018 Feb;55(2):413-419.e2. https://doi.org/10.1016/j.jpainsymman.2017.10.019
Eilers J, Harris D, Henry K, Johnson LA. Evidence-based interventions for cancer treatment-related mucositis: Putting evidence into practice. Clin J Oncol Nurs. 2015;18(6):80-96.
https://doi.org/10.1188/14.CJON.S3.80-96
Petrelli F, Ghidini A, Cabiddu M, Tomasello G, De Stefani A, Bruschieri L, et al. Addition of radiotherapy to the primary tumour in oligometastatic NSCLC: A systematic review and meta-analysis. Lung Cancer. 2018 Dec;126:194-200. https://doi.org/10.1016/j.lungcan.2018.11.017
Connor SR, Sepulveda Bermedo MC. Global atlas of palliative care at the end of life [Internet]. World Palliative Care Alliance. 2014. 111 p. Available from: http://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf
Lutz S, Berk L, Chang E, Chow E, Hahn C, Hoskin P, et al. Palliative radiotherapy for bone metastases: An ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys. 2011;79(4):965-76. https://doi.org/10.1016/j.ijrobp.2010.11.026
Sachdev AH, Gress FG. Celiac Plexus Block and Neurolysis: A Review. Gastrointest Endosc Clin N Am. 2018 Oct;28(4):579-86. https://doi.org/10.1016/j.giec.2018.06.004
Lyman GH, Greenlee H, Bohlke K, Bao T, DeMichele AM, Deng GE, et al. Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. J Clin Oncol. 2018 Sep;36(25):2647-55. https://doi.org/10.1200/JCO.2018.79.2721