Citations 2
Adult Cancer Pain, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology
Swarm, Robert A., Youngwerth, Jeanie, Anițescu, Magdalena , Are, Madhuri , Buga, Sorin , Butler, Taylor, Cleary, James F. , Copenhaver, David, Coyne, Christopher , Craig, David S., Finnes, Heidi D. , Greenlee, Heather , Gupta, Mona, Hansen, Eric, Javed, Saba , Kandil, Enas , Mackey, Sean , McGrath, Kathryn, Moryl, Natalie , Nesbit, Suzanne , Noonan, Michael , Norris, Joseph, Pršić, Elizabeth , Rabow, Michael W. , Rickerson, Elizabeth , Sindt, Jill E. , Vorenkamp, Kevin E. , Cunningham, Rebecca, Gurski, Lisa A., Jones, Frankie, Finnes, Heidi, Agne, Julia L. , Butler, Taylor, Chwistek, Marcin , Gupta, Mona, Javed, Saba , McDonald, Andrew, Noonan, Michael, Paice, Judith A. , SMITH, MICHAEL D. , Bruce, Justine Y. , Yoo, Sun
Journal of the National Comprehensive Cancer Network | July 10, 2025 | Volume: 23 | Issue: 7 | Pages: No page available
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain provide recommendations for the comprehensive management of pain in patients with cancer. This article will focus on methods for screening for pain, safe and appropriate prescription of opioid and miscellaneous analgesics, and the optimization of nonpharmacologic interventions including integrative and interventional strategies for treatment of cancer-related pain. Additionally, the NCCN Guidelines discuss methods for the safe reduction of opioids when appropriate, as well as techniques for encouraging the judicious use of opioids. The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional issues that are not covered here, including management of pain during a pain crisis, management of procedure-related pain and anxiety, pain management for cancer survivors, and the use of nonopioid and adjuvant analgesics for cancer-related pain.
Postoperative Pain Management following Bilateral Lung Volume Reduction Surgery for Severe Emphysema
Hooten, W. Michael , Swarm, Robert A., Huntoon, Marc A. , Καρανικόλας, Μενέλαος
Anaesthesia and Intensive Care | January 22, 2019 | Volume: 33 | Issue: 5 | Pages: 591-596
This study was conducted to audit the clinical management of a continuous local anaesthetic infusion delivered by a fluoroscopically placed thoracic epidural catheter in conjunction with supplemental intravenous opioid patient controlled analgesia for postoperative pain control following bilateral lung volume reduction surgery for severe emphysema. This retrospective case series involved a random sample of 43 patients from a possible 65 patients. The mean dose of epidural bupivacaine 0.15% was 6.7 ml/h (SD 1.5), while the mean daily dose of morphine or hydromorphone was 22.5 mg/day (SD 17.9) and 4.3 mg/day (SD 3.1), respectively. Inadequate analgesia was reported by 19 (44%) patients during the first two postoperative days, but was successfully treated by individual titration of these medications. The incidence of atrial fibrillation (n=6), premature epidural catheter dislodgement (n=6) or respiratory failure (n=3) appeared to be greater among patients who had inadequate analgesia at some stage. One patient developed excessive sedation; otherwise, there were no major complications. The use of an epidural bupivacaine infusion in conjunction with intravenous opioid patient controlled analgesia proved to be a safe and effective pain medication regimen when accompanied by individual titration of these agents in response to acute exacerbations of postoperative pain.