Tatiana Pietrzyńska1, Łukasz Pietrzyński2. 1. Medical University of Silesia, Health Care Unit in Czeladź, Department of Palliative Medicine. 2. Student of Medical University of Silesia.
Abstract
The use of strong opioids for the treatment of chronic non-cancer pain (CNCP) has gained undisputed acceptance among specialists and should be considered when other pharmacological treatments are not effective or cause serious side effects. However, drugs from the third step of analgesic ladder still raise concerns among doctors and patients in the case of long-term therapy. A CASE REPORT: The authors present reports of three cases of patients with CNCP caused by musculoskeletal disorders and numerous comorbidities. In all cases, multidisciplinary treatment, that consisted of pharmacotherapy with strong opioids (72-hour transdermal fentanyl), physiotherapy, rehabilitation and psychotherapy, have been introduced. It allowed for good control of pain without significant side effects, symptoms of addiction nor tolerance. CONCLUSIONS: The presented cases illustrate the difficulties that occur during introducing opioid therapy in chronic non-cancer pain, particularly in the initial phase of treatment during setting of a transdermal opioid dose. They also confirm the safety and usefulness of opioid therapy in patients suffering from CNCP.
The use of strong opioids for the treatment of chronic non-cancer pain (CNCP) has gained undisputed acceptance among specialists and should be considered when other pharmacological treatments are not effective or cause serious side effects. However, drugs from the third step of analgesic ladder still raise concerns among doctors and patients in the case of long-term therapy. A CASE REPORT: The authors present reports of three cases of patients with CNCP caused by musculoskeletal disorders and numerous comorbidities. In all cases, multidisciplinary treatment, that consisted of pharmacotherapy with strong opioids (72-hour transdermal fentanyl), physiotherapy, rehabilitation and psychotherapy, have been introduced. It allowed for good control of pain without significant side effects, symptoms of addiction nor tolerance. CONCLUSIONS: The presented cases illustrate the difficulties that occur during introducing opioid therapy in chronic non-cancer pain, particularly in the initial phase of treatment during setting of a transdermal opioid dose. They also confirm the safety and usefulness of opioid therapy in patients suffering from CNCP.
Entities:
Keywords:
analgesic efficacy; best practice guidelines; chronic noncancer pain; opioid analgesics; transdermal fentanyl