Indian society for study of pain, cancer pain special interest group guidelines on pharmacological management of cancer pain (Part II)

Raghu S Thota, Raghavendra Ramanjulu, Arif Ahmed, Parmanand Jain, Naveen Salins, Sushma Bhatnagar, Aparna Chatterjee, Dipasri BhattacharyaIndian Journal of Palliative Care 2020 26(2):180-190 The Indian Society for Study of Pain (ISSP), Cancer Pain Special Interest Group (SIG) guidelines on pharmacological management of cancer pain in adults provide a structured, stepwise approach, which will help to improve the management of cancer pain and to provide the patients with a minimally acceptable quality of life. The guidelines have been developed based on the available literature and evidence, to suit the needs, patient population, and situations in India. A questionnaire, based on the key elements of each sub draft addressing certain inconclusive areas where evidence was lacking, was made available on the ISSP website and circulated by e-mail to all the ISSP and Indian Association of Palliative Care members. We recommend that analgesics for cancer pain management should follow the World Health Organization 3-step analgesic ladder appropriate for the severity of pain. The use of paracetamol and nonsteroidal anti-inflammatory drugs alone or in combination with opioids for mild-to-moderate pain should be used. For mild-to-moderate pain, weak opioids such as tramadol, tapentadol, and codeine can be given in combination with nonopioid analgesics. We recommend morphine as the opioid of the first choice for moderate-to-severe cancer pain. Sustained-release formulations can be started ...
Source: Indian Journal of Palliative Care - Category: Palliative Care Authors: Source Type: research