Renal Cell Cancer Miscellenous
Oncological Pain Management- Why does pain remain refractory to usual measures in some patients?
- Non-physiological Causes
- existential suffering,
- spiritual distress,
- addiction, and
- psychological secondary
gain.
- Physiological Causes
- Opiates induced Hyperalgesia
- Why does opiate therapy worsen the pain in some patients?
- Opiates induced Hyperalgesia : is a phenomenon whereby exposure to
opioids sensitizes a patient to a pain stimulus,
causing a paradoxical increase in pain
- Central activation
of the N-methyl-d-aspartate (NMDA) receptor
has been suggested as one possible cause, and administration of NMDA antagonists (ketamine and methadone) has
been recommended when opioid-induced hyperalgesia is suspected.
- Reference:
- Case 17-2015: A 44-Year-Old Woman with Intractable Pain Due to Metastatic Lung Cancer
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