Open AccessPrevalence and characteristics of breakthrough pain in patients receiving opioids for chronic back pain in pain specialty clinics
Author(s) -
Daniel S. Bennett,
Steven Simon,
M. Brennan,
Steven A. Shoemaker
Publication year - 2007
Publication title -
journal of opioid management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.331
H-Index - 39
eISSN - 2375-0146
pISSN - 1551-7489
DOI - 10.5055/jom.2007.0046
Subject(s) - medicine , breakthrough pain , chronic pain , opioid , pain ladder , back pain , specialty , anesthesia , tramadol , morphine , physical therapy , analgesic , alternative medicine , receptor , pathology
Objective: We sought to assess the prevalence and characteristics of breakthrough pain (BTP) in patients with chronic back pain.Design; Researchers utilized a telephone survey using a pain assessment algorithm. This report represents a subset of patients from a larger survey of228patients with chronic pain unrelated to cancer.Participants: This study employed 117subjects taking opioids for a primary diagnosis of back pain and receiving care at geographically dispersed pain treatment centers. Subjects had pain lasting at least six months and had “controlled” baseline pain.Results: Eighty-seven subjects (74 percent) experienced 93 types of BTP. The median number of BTP episodes per day was two; median time to maximum intensity was 10 minutes, and median duration was 55 minutes. Onset could not be predicted for 46 percent of pains. Eighty-three percent of subjects used shorter-acting opioids for BTP. Other medications used for pain included NSAIDs, antidepressants, anticonvulsants, skeletal muscle relaxants, intrathecal local anesthetics, and transdermal local anesthetics.Conclusions: These patients with opioid-treated chronic back pain commonly experienced BTP, which often had a rapid onset and a relatively short duration and was difficult to predict. Opioids were the mainstay of pharmacologic therapy, but nonopioid analgesics and adjuvant analgesics were commonly used.