Aim To clarify the current usage of adjuvant analgesics for refractory cancer pain which responds poorly to opioid. Especially, we present it according to each pathophysiology of cancer pain.
Methods This study was a cross-sectional questionnaire-based survey. Two hundred and eight certified palliative care specialists (cPCS) were surveyed via an online.
Results A total of 87 (42%) cPCS responded. When an adjuvant analgesic was administered to patients with refractory cancer pain, median dosage of opioids after dose titration was 60 mg (calculation of morphine equivalent daily dose). Most cPCS considered pregabalin was effective for malignant painful radiculopathy and corticosteroids was effective for pain by cancer-related spinal cord compression (93.1%, 97.3%, respectively).
Discussion cPCS may select analgesic adjuvant according to pain`s pathophysiology or cancer pain syndrome of each case. The large prospective study of effectiveness of adjuvant analgesics for cancer pain from the view point of the pathophysiology is now performed.
Acknowledgements The authors thank Japanese Society for Palliative Medicine (Yoshiyuki Kizawa, President) for investigation and secretarial support.
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