Acute pain
☛ treatment of acute pain in palliative care is the same as for patients not requiring palliative care
☛ palliative care patients may recover more slowly and require analgesics for longer periods if their general condition is poor
Incident pain
☛ occurs only in certain circumstances, such as after a particular movement or on standing
☛ where possible, it should be treated with local measures
☛ analgesics may be used if the pain is mild and the side effects of constant administration tolerable
☛ if the pain is severe, modification of the patient’s activity may be preferable to taking strong opioid analgesics on a regular basis for pain that occurs infrequently
Chronic pain
☛ the aim of treatment is the prompt relief of pain and prevention of its recurrence
☛ the principles involved in the treatment of chronic pain are
↳ thorough assessment
↳ good communication reassurance about pain relief
↳ discourage acceptance of pain
↳ encourage patient participation
☛ the treatment of chronic pain in palliative care is
↳ an integrated part of the interdisciplinary plan of total care
☑ including management of psychosocial issues
↳ should be appropriate to the stage of the patient’s disease
☑ treatment for an ambulant patient will differ from one confined to bed
↳ employs the appropriate modality or modalities
↳ must be consistent, not variable
☑ avoid repeated changes of analgesics; titrate each drug to its optimal level
↳ requires continuity of care
↳ involves repeated reassessment
☛ the modalities of treatment available for chronic pain are
↳ treatment of the underlying disease
↳ analgesics
↳ adjuvant analgesics
↳ neurostimulatory treatment
↳ anaesthetic, neurolytic and neurosurgical procedures
↳ physiotherapy
↳ psychological therapy
↳ lifestyle modification
↳ treatment of psychosocial issues that cause or aggravate pain
↳
Source:
The IAHPC Manual of Palliative Care 3rd Edition
https://web.archive.org/web/20210122105526/https://hospicecare.com/uploads/2013/9/The%20IAHPC%20Manual%20of%20Palliative%20Care%203e.pdf
