Ongoing strategies and updates on pain management in gynecologic oncology patients.
Gynecol Oncol
; 149(2): 410-419, 2018 05.
Article
en En
| MEDLINE
| ID: mdl-29409684
ABSTRACT
The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered. In this review, we discuss the various etiologies of pain experienced by gynecologic oncology patients and discuss modalities frequently used to treat this pain. We highlight strategies to reduce the number of opioids prescribed and focus on incorporating non-opioid pain relief management principles in this review. We also discuss the mechanisms and etiology of various types of pain, with a focus on multimodal treatment strategies including preoperative counseling, strategies to identify individuals at risk of developing opioid dependence, and the role of symptom management and palliative care teams. Finally, we provide a blueprint for gynecologic oncology practices to develop their practice-specific pain management contracts to engage patients in a meaningful conversation around the addictive potential of opioids.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Manejo del Dolor
/
Dolor en Cáncer
/
Neoplasias de los Genitales Femeninos
Tipo de estudio:
Guideline
Límite:
Female
/
Humans
Idioma:
En
Revista:
Gynecol Oncol
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos