Temporary Sedation with Midazolam for Control of Severe Incident Pain

Rosario, Miguel Ángel Benítez del; Martín, Antonio Salinas; Ortega, José Javier Martı́n; Feria, Manuel

doi:10.1016/s0885-3924(01)00254-8

Cited by 19 publications

(8 citation statements)

References 14 publications

(16 reference statements)

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“…A number of other non‐opioid analgesics have been utilised by clinicians to manage episodes of breakthrough pain, including ketamine (Carr et al, 2004), midazolam (del Rosario et al, 2001) and nitrous oxide (Parlow et al, 2005). Again, there is relatively little evidence to support the use of these interventions in the treatment of breakthrough pain episodes.…”

Section: Recommendationsmentioning

confidence: 99%

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

Davies

Dickman

Reid

et al. 2009

European Journal of Pain

444

411

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A task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland (APM) was convened to produce some up-to-date, evidence-based, practical, clinical guidelines on the management of cancer-related breakthrough pain in adults. On the basis of a review of the literature, the task group was unable to make recommendations about any individual interventions, but was able to make a series of 12 recommendations about certain generic strategies. However, most of the aforementioned recommendations are based on limited evidence (i.e., case series, expert opinion). The task group also proposed a definition of breakthrough pain, and some diagnostic criteria for breakthrough pain.

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Section: Recommendationsmentioning

confidence: 99%

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

Davies

Dickman

Reid

et al. 2009

European Journal of Pain

444

411

View full text Add to dashboard Cite

show abstract

“…Newer strategies to manage incident pain have included rapid-onset, short-acting potent opioids such as sufenta-nil, delivered sublingually, and potent intravenous sedatives. [14][15][16] Nitrous oxide is an inhaled agent with potent analgesic properties and a low incidence of side effects. It is a commonly used adjunct to general anaesthesia which reduces the required concentration of the primary anaesthetic agent.…”

Section: Discussionmentioning

confidence: 99%

Self-administered nitrous oxide for the management of incident pain in terminally ill patients: a blinded case series

Parlow¹,

Milne²,

Tod³

et al. 2005

Palliat Med

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The treatment of incident pain in terminally ill cancer patients receiving long-term opioid therapy remains a challenge. Self-administered inhaled nitrous oxide has been used for short-term analgesia in this setting, with mixed results. It is unclear whether nitrous oxide exhibits cross-tolerance with opioids, and there is the possibility of a strong placebo effect in previous unblinded reports. We report on a double-blind crossover case series, in which seven patients received either nitrous oxide/oxygen or a placebo air/oxygen mixture on each day of a two-day trial. Outcome indices were obtained before, during and after each use of the gas for anticipated incident pain. The patient population was very heterogeneous with respect to disease, pain scores and concurrent treatments. Nitrous oxide was beneficial during incidents in five of seven patients; the remaining two patients reported an overall preference for the nitrous oxide day. We conclude that a trial of self-administered inhaled nitrous oxide should be considered in patients with difficult incident pain.

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“…2 Non-opioid analgesics and adjuvant analgesics have been used/ investigated as supplemental medication for episodes of breakthrough pain, but they typically have a slow onset and relatively long duration of action. [15][16][17] For this reason, in the majority of cases the most appropriate supplemental medication will be an opioid analgesic.…”

Section: Supplemental Analgesiamentioning

confidence: 99%

Breakthrough Pain in Cancer Patients— Pharmacologic Symptomatic Treatment

Pappagallo¹

2011

Oncology &Amp; Hematology Review (US)

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Breakthrough pain is experienced by many cancer patients who are being treated with opioids for the management of chronic persistent pain. There is currently no ‘gold standard’ approach for the pharmacologic symptomatic treatment of breakthrough pain but proposed strategies include the implementation of primary therapies (e.g. chemotherapy, radiotherapy, and surgery) for the underlying cause of the pain; optimization of scheduled analgesia; use of adjuvants; and specific supplemental analgesia for breakthrough pain (the most common pharmacologic strategy). Individualization of treatment is important and a combination of these strategies may be required. In this article, pharmacotherapeutic approaches to managing breakthrough pain are discussed, including different routes of administration and newer opioid formulations. In addition, the current guidelines for managing breakthrough pain are examined.

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Temporary Sedation with Midazolam for Control of Severe Incident Pain

Abstract: Incident pain frequently complicates cancer-related pain. Its treatment is sometimes very difficult due to poor responsiveness to opioids. Two cases are presented in which a temporary or intermittent sedation with midazolam was successfully used to control excruciating incident pain.

Cited by 19 publications

References 14 publications

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

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

Self-administered nitrous oxide for the management of incident pain in terminally ill patients: a blinded case series

Breakthrough Pain in Cancer Patients— Pharmacologic Symptomatic Treatment

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