Procedural pain in patients with cancer: a Delphi expert management consensus.

Autor:	Villegas Estévez FJ; Unidad del Dolor Pain United, Consorcio Hospitalario Provincial de Castellón, Castellón, Spain franvilles@hotmail.com., López Alarcón MD; Unidad del Dolor, Hospital General Universitario de Valencia, Valencia, Spain., Beato C; Departamento de Oncología Médica, Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera, Spain., Sanz-Yagüe A; Departamento Médico, Kyowa Kirin Farmacéutica S.L.U, Madrid, Spain., Porta-Sales J; Unidad de Cuidados Paliativos, Institut Catalá d'Oncologia, Girona, Spain., Morera López RM; Servicio de Oncología Radioterápica, Hospital Universitario La Paz, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	BMJ supportive & palliative care [BMJ Support Palliat Care] 2023 Dec 07; Vol. 13 (e2), pp. e428-e436. Date of Electronic Publication: 2023 Dec 07.
DOI:	10.1136/bmjspcare-2020-002668
Abstrakt:	Objectives: Diagnosis, treatment and care of cancer often involve procedures that may be distressing and potentially painful for patients. The PROCEDIO Study aimed to generate expert-based recommendations on the management of moderate to severe procedural pain in inpatients and outpatients with cancer. Methods: Using a two-round Delphi method, experts from pain and palliative care units, medical and radiation oncology and haematology departments expressed their agreement on 24 statements using a 9-point Likert scale, which were classified as appropriate (median 7-9), uncertain (4-6) or inappropriate (1-3). Consensus was achieved if at least two-thirds of the panel scored within the range containing the median. Results: With an overall agreement on the current definition of procedural pain, participants suggested a wider description based on evidence and their clinical experience. A strong consensus was achieved regarding the need for a comprehensive pre-procedural pain assessment and experts emphasised that healthcare professionals involved in procedural pain management should be adequately trained. Most panellists (98.2%) agreed that pharmacological treatment should be chosen considering the duration of the procedure. Transmucosal fentanyl (96.5%) and morphine (71.7%) were recommended as the most appropriate drugs. Oral and nasal transmucosal fentanyl were agreed as the most suitable for both outpatients and inpatients, while consensus was reached for intravenous and subcutaneous morphine for inpatients. Conclusions: These results provide updated expert-based recommendations on the definition, prevention and treatment of moderate to severe procedural pain, which could inform specialists involved in pain management of patients with cancer. Competing Interests: Competing interests: The following authors received honoraria for consultancy and/or lectures: FVE from Kyowa Kirin Farmacéutica, Grunenthal, Gebro Pharma, Ferrer and Mylan; MDLA from Kyowa Kirin Farmacéutica, Takeda, Gebro Pharma, Lab Esteve, Teva and Grunenthal; CB from Kyowa Kirin Farmacéutica, Ferrer and Angelini; JPS from Kyowa Kirin Farmacéutica and Ferrer; RMML from Astellas and Janssen. AS-Y is an employee of Kyowa Kirin Farmacéutica. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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