REVIEW

Analgesia for patients with advanced disease: I

E J Hall and N P Sykes

St Christopher’s Hospice, London, UK

Correspondence to:
Correspondence to:
Dr Emma J Hall
St Christopher’s Hospice, 51–59 Lawrie Park Road, Sydenham, London SE26 6DZ, UK; emmahall{at}doctors.org.uk

This series of two articles explores the challenge of managing pain in patients with advanced malignant and non-malignant disease. Pain is a common symptom in advanced disease. Despite guidance from organisations such as the World Health Organisation, cancer pain is often inadequately managed. Managing pain in non-malignant conditions, such as end stage cardiac failure, presents an even greater challenge to healthcare professionals. This first article discusses epidemiology, definitions, pathophysiology, assessment, non-pharmacological approaches, the analgesic "ladder", and opioids. The second article will examine the use of non-opioids, anaesthetic techniques, and analgesia in dying patients as well as discussing future directions.

Keywords: malignant; non-malignant; pain; opioids; analgesia; adjuvants; non-opioids; non-pharmacological

Abbreviations: EAPC, European Association of Palliative Care; NMDA, N-methyl-D aspartate; OTFC, oral transmucosal fentanyl citrate; SIGN, Scottish Intercollegiate Guidelines Network; TENS, transcutaneous nerve stimulation; WHO, World Health Organisation

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This article has been cited by other articles:

• Hall, E J, Sykes, N P (2004). Analgesia for patients with advanced disease: 2. Postgrad. Med. J. 80: 190-195 [Abstract] [Full Text]