Cancer pain is one of the most common tumor-related symptoms and one of the most dreaded symptoms for patients. Uncontrolled pain will make patients feel uncomfortable (sleep, appetite, mood) and greatly affect their activities and overall quality of life. It needs to be treated with regular and appropriate analgesic medication.
Assessment of pain and three-step treatment.
Mild pain: 1-3 points, tolerable, normal life, sleep largely undisturbed. Use of non-steroidal anti-inflammatory drugs ± adjuvant medications: fenpropathrin, tylenol
Moderate pain: 4-6 points, persistent pain, disturbed sleep. Use of weak opioid medications ± adjuvant analgesics: tylenol, chimantin
Severe pain: 7-10 points, persistent severe pain, sleep severely disturbed Use of strong opioid medications ± adjuvant medications: OxyContin, fentanyl
When should opioid analgesics be used?
Opioid analgesic treatment should be started as soon as the pain is persistent and moderate to severe. Available: OxyContin, Mescaline, Morphine.
Myth 1: Use medication when it hurts, not when it doesn’t
Administering medication on time is a principle that should not be violated, rather than on demand, which will ensure continuous pain relief.
Myth 2: Long-term use of opioid-controlled extended-release analgesics is prone to addiction
The need of cancer pain patients for analgesia is “physical dependence” rather than “psychological dependence”, which is completely different from the feeling of “floating” of an addict. Reasonable and standardized use of opioid controlled and extended-release preparations can effectively avoid the formation of instantaneous blood concentration and thus reduce the occurrence of addiction.
Opioid adverse drug reactions and prevention
Constipation
The incidence of constipation is nearly 90% and can persist. Constipation can also be caused or aggravated by prolonged bed rest in oncology patients.
Prevention: take stool softeners, laxatives, drink more water, eat more coarse fiber food, fruits and vegetables.
Nausea and vomiting
The incidence is nearly 30%. Caused by opioids, or radiotherapy treatment, usually occurs in the early stage of drug use, and most of the symptoms are relieved in 4~7 days.
Prevention: Gastrofacial, morpholine, fenagan and other antiemetic drugs can be given for treatment.
Urinary retention
The incidence is less than 5%. Certain factors such as concomitant sedation, post-operative lumbar anesthesia, and combined prostatic hyperplasia may increase the risk of urinary retention.
Prevention: Avoid concomitant sedation and instruct patients to urinate regularly to avoid overfilling of the bladder. Apply heat or light massage to the bladder area, and catheterize if necessary.
Drowsiness, vertigo
May occur in a small number of patients, prone to occur in elderly, weak, anemic patients; may resolve on its own after a few days
Drug overdose or poisoning
Respiratory depression, respiratory rate Q8/min, drowsy-like or coma
Rarely occurs with oral opioids.
Prevention: closely monitor respiratory status and give naloxone treatment if necessary
There is no benefit to tolerate pain, tell your doctor about these symptoms, be positive and optimistic to cooperate with treatment, use oral analgesic opioids scientifically and standardized, and welcome a good life again!