Avaliação e tratamento da dor irruptiva oncológica

Autores

  • Juliana Santos Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto
  • Carina Raposo Centro Hospitalar do Porto, EPE, Porto
  • António Oliveira University College Hospital, UK
  • Ana Leonor Ribeiro Escola Superior de Enfermagem do Porto, Porto

Palavras-chave:

Dor irruptiva oncológica, DIO, dor oncológica, tratamento da dor, morfina, fentanilo

Resumo

A dor irruptiva oncológica (DIO) é definida como uma exacerbação transitória da dor que ocorre quer espontaneamente quer desencadeada por um fator específico (previsível ou imprevisível), apesar do relativamente estável e adequado controlo da dor basal. É fundamental identificar claramente que se trata de um episódio de DIO e não de dor crónica basal mal controlada.
O tratamento farmacológico consiste em medicação de resgate – formulações orais de libertação normal de morfina (p.ex. Sevredol®, Oramorph® - Short Acting Opioid - SAO) e formulações de libertação rápida como o fentanilo sublingual, película bucal e transmucoso (p.ex. Abstral®, Breakyl® e Actiq® - Rapid Onset Opioid - ROO).
É essencial que os enfermeiros saibam realizar uma avaliação adequada da DIO, saibam ensinar o doente a gerir o esquema terapêutico e saibam reavaliar. Os objetivos da reavaliação são determinar a eficácia e tolerabilidade do tratamento da DIO e se houve ou não alguma alteração da sua natureza. Uma reavaliação inadequada pode levar à continuação de um tratamento ineficaz e/ou inapropriado.

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Referências

Ripamonti, C.I. et al (2012). Management of cancer pain: ESMO Clinical Practice Guidelines. Annals of Oncology, 23 (Suppl 7), vii39-vii154.

Portenoy RN, Hagen NA (1990). Breakthrough pain: definition, prevalence and characteristics. Pain, 41(3), 273-281.

Zepetella, G (2011). Breakthrought pain in cancer patients. Clinical Oncology, 23, 393-398.

Davies A, Dickman A, Reid C, Stevens AM, Zeppetella G. (2009). The management of cancer-related breakthrough pain: recommendations

of a task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. European Journal of Pain, 13, 331-338.

Caraceni A, et al. (2012).Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet

Oncology, 13, 58-68.

Hjermstad M, Fainsinger R, Kaasa S. (2009). Assessment and classification of cancer pain. Current Opinion in Supportive and Palliative Care, 3, 24-30.

Mercadante S, et al (2013). Relationship between background cancer pain, breakthrough pain, and analgesic treatment: a preliminary study

for a better interpretation of epidemiological and clinical studies. Current Medical Research & Opinion, 29(6), 667-671.

Davies A. (2006). Cancer-related breakthrough pain. Oxford: Oxford University Press,.

Margarit C, et al (2012). Breakthrough cancer pain – still a challenge. Journal of Pain Research, 5, 559-566.

Ali G, Kopf A. (2010). Breaktrough pain, the pain emergency, and incident pain. In: International Association for Study of Pain. Guide to pain management in low-resource settings. Seattle: IASP, 277-282.

Portenoy RK (1997). Treatment of temporal variations in chronic cancer pain. Seminars in Oncology, 5 (Suppl 16), 7-12.

Davies A, Vriens J, Kennett A, McTaggart M. (2008). An observational study of oncology patients’ utilisation of breakthrough pain medication. Journal of Pain and Symptom Management, 35(4), 406-11.

Davies A, Zeppetella G, Andersen S, et al (2011). Multi-centre European study of breakthrough cancer pain: pain characteristics and patient

perceptions of current and potencial management strategies. European Journal of Pain, 15(7), 756-763.

Swanwick M, Haworth M, Lennard RF (2001). The prevalence of episodic pain in cancer: a survey of hospice patients on admission. Palliative

Medicine, 15 (1), 9-18.

Caraceni, A. et al (2013). Guidelines for the Management of Breakthrough Pain in Patients With Cancer. Journal of the National Comprehensive Cancer Network. Volume 11 Supplement 1 – March S29- S36

Wengström, Y; Geerling, J., Rustøen, T. (2014). European Oncology Nursing Society breakthrough cancer pain guidelines. European Oncology Journal of Oncology Nursing, April, 18 (2), 127 – 131.

Associação de Enfermagem Oncológica Portuguesa: Dor irruptiva oncológica - Guidelines 2013 - Guia de bolso. Consultado em 14 de Fevereiro de 2015. Disponível em:http://www.aeop.net/sgc/Plugins/Uploads/files/DIO_guidelines2013_11mar%20%20revisao%20final%2012%20marco.pdf

Hagen NA, Stiles C, Nckolaichuk C, et al (2008). The Alberta Breakthrough Pain Assessment Tool for cancer patients: a validation study using a Delphi process and patient think-aloud interviews. Journal of Pain Sympton Management, 35, 136-152.

Zeppetella, G.; Ribeiro, MD (2002). Episodic pain in patients with advanced cancer. American journal Of hospice and Palliative Care, 19, 267-76.

Webber, K.; Davies, AN; Cowie, MR (2010). Development of the Breakthrough Pain Assessment Tool (BAT). In Proceedings of the 13th World Congress on Pain. 29 august – 2 september, Montreal, Canada.

WHO Expert Committee (1996). Cancer pain relief. World Health Organization, Geneva.

Christie JM, Simmonds M, Patt R, Coluzzi P, Busch MA, Nordbrock E, et al (1998). Dose-titration, multicenter study of oral transmucosal fentanyl citrate for the treatment of breakthrough pain in cancer patients using transdermal fentanyl for persistent pain. Journal of Clinical Oncology, 16, 3238-45.

Portenoy RK, Payne R, Coluzzi P, Raschko JW, Lyss A, Busch MA, et al (1999). Oral transmucosal fentanyl citrate (OTFC) for the treatment of

breakthrough pain in cancer patients: a controlled dose titration study. Pain, 79: 303-12.

Coluzzi PH, Schwartzberg L, Conroy Jr JD, Charapata S, Gay M, Busch MA, et al (2001). Breakthrough cancer pain: a randomized trial comparing oral transmucosal fentanyl citrate (OTFC) and morphine sulfate immediate release (MSIR). Pain, 91, 123-30.

Portenoy RK, Taylor D, Messina J, Tremmel L. (2006). A randomized, placebo-controlled study of fentanyl buccal tablet for breakthrough pain in opioid-treated patients with cancer. Clinical Journal of Pain, 22, 805-11.

Slatkin NE, Xie F, Messina J, Segal TJ. (2007). Fentanyl buccal tablet for relief of breakthrough pain in opioid-tolerant patients with cancer-related chronic pain. Journal of Support Oncology, 5, 327-34.

Hanks GW, De Conno F, Cherny N et al (2001). Morphine and alternative opioids in cancer pain: the EAPC recommendations. British Journal of

Cancer, 84, 587-593.

Mercadante S, Villari P, Ferrera P, et al. (2006). Safety and effectiveness of intravenous morphine for episodic breakthrough pain in patients

receiving transdermal buprnorphine. J Pain Symptom Manage 2006; 32, 175-179.

Payne R, Coluzzi P, Hart L, et al. (2001). Long-term safety of oral transmucosal fentanyl citrate for breakthrough cancer pain. Journal of Pain Symptom Management, 22(1), 575-83.

INFARMED – RCM AbstraL (2014). Consultado em 17 de Fevereiro de 2015, em

http://www.infarmed.pt/infomed/download_ficheiro.php?med_id=42339&tipo_doc=rcm

INFARMED – RCM Actiq (2012). Consultado em 17 de Fevereiro de 2015,

em http://www.infarmed.pt/infomed/download_ficheiro.php?med_id=31844&tipo_doc=rcm

INFARMED – RCM Breakyl (2014). Consultado em 17 de Fevereiro de 2015, em

http://www.infarmed.pt/infomed/download_ficheiro.php?med_id=46885&tipo_doc=rcm

INFARMED – GUIA DO PRESCRITOR ABSTRAL - Versão 2, Janeiro de 2015 - Consultado em 19 de Fevereiro de 2015,

em http://www.infarmed.pt/portal/page/portal/INFARMED/MEDICAMENTOS_USO_HUMANO/FARMACOVIGILANCIA/INFORMACAO_SEGURANCA/MATERIAIS_EDUCACIONAIS/A_E/Guia%20Prescritor%202015_01_27_final%20pdf.pdf

Perdigão, Carlos (2012). Gestão do Risco dos Medicamentos - Interacção da toranja com diversos fármacos de uso corrente. Revista

Factores de Risco, nº 27 OUT-DEZ pág. 53.

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Publicado

10-09-2015

Como Citar

1.
Santos J, Raposo C, Oliveira A, Leonor Ribeiro A. Avaliação e tratamento da dor irruptiva oncológica. Onco.News [Internet]. 10 de Setembro de 2015 [citado 10 de Dezembro de 2024];(28):10-8. Disponível em: https://onco.news/index.php/journal/article/view/127

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