Deutsche medizinische Wochenschrift (1946) · 2026
["Standard Operating Procedure" (SOP) - Pain Therapy in Various Tumor Constellations].
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Brinkers Michael, Pfau Giselher, Bergner Jana, Meyer Frank
Аннотация
BACKGROUND: Pain therapy has obtained a high importance in clinical practice in the meantime and has become indispensable, in particular, with regard to a sufficient perioperative/-interventional case management but also related to a certain approach, specific (problematic) diagnoses, syndromes and special symptomatologies.
AIM: To provide a prompt and standardized access to a competently developed compact "Standard Operating Procedure" (SOP) on interdisciplinary pain therapy in tumor patients with a broad profile of (possible) diagnoses at a subspecialized medical center based on i) experiences from long-term clinical practice and ii) current references from the scientific medical literature (not to substitute completely earlier publications and text books).
METHOD: Narrative short overview on the "SOP - Pain Therapy in tumor diseases/patients" (provided as QR code at the end).
RESULTS (CORNER POINTS): In case of tumor-associated pain, opioids represent the primarily considered group of drugs for an efficient medication. Medication with opioids is limited by hepatic and renal insufficiency, type of opioid (e.g., Tapentadol's effect is not sufficient), further contraindications (e.g., MST in chronic obstructive pulmonary disease [COPD]) and mode of possible drug administration (patients cannot swallow or in lack of consciousness). In patients with tumor-associated pain, it needs to be asked for anxiety.
DISCUSSION: A couple of years ago, the interdisciplinary working group at the University Hospital of Magdeburg (Germany) created and established SOP's for postoperative pain therapy in general and abdominal surgery followed by vasculary surgery/medicine in 2024.
CONCLUSION: Tumor-associated pain belongs to the type of pain (in addition to birth pang and postoperative pain), which can be approached best. This represents a call to action. It comprises consequent, adequate drug administration with sufficient dosage according to the WHO scheme (WHO I actually not necessary), psychotropics and drug-free procedures.
AIM: To provide a prompt and standardized access to a competently developed compact "Standard Operating Procedure" (SOP) on interdisciplinary pain therapy in tumor patients with a broad profile of (possible) diagnoses at a subspecialized medical center based on i) experiences from long-term clinical practice and ii) current references from the scientific medical literature (not to substitute completely earlier publications and text books).
METHOD: Narrative short overview on the "SOP - Pain Therapy in tumor diseases/patients" (provided as QR code at the end).
RESULTS (CORNER POINTS): In case of tumor-associated pain, opioids represent the primarily considered group of drugs for an efficient medication. Medication with opioids is limited by hepatic and renal insufficiency, type of opioid (e.g., Tapentadol's effect is not sufficient), further contraindications (e.g., MST in chronic obstructive pulmonary disease [COPD]) and mode of possible drug administration (patients cannot swallow or in lack of consciousness). In patients with tumor-associated pain, it needs to be asked for anxiety.
DISCUSSION: A couple of years ago, the interdisciplinary working group at the University Hospital of Magdeburg (Germany) created and established SOP's for postoperative pain therapy in general and abdominal surgery followed by vasculary surgery/medicine in 2024.
CONCLUSION: Tumor-associated pain belongs to the type of pain (in addition to birth pang and postoperative pain), which can be approached best. This represents a call to action. It comprises consequent, adequate drug administration with sufficient dosage according to the WHO scheme (WHO I actually not necessary), psychotropics and drug-free procedures.