Breakthrough pain has been defined in recent guidelines as ‘transitory exacerbations of pain that occur on a background of stable pain otherwise adequately controlled by around-the-clock opioid therapy’ or as ‘a transient exacerbation of pain that occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain.’
Types and diagnosis
In general, breakthrough pain can be characterized as incident pain, spontaneous pain, or end-of-dose pain. Assessment is a key step toward adequately managing breakthrough pain in cancer, which is an extraordinarily heterogeneous condition involving different underlying diseases, clinical features and natural histories.
Conclusion
All of the evidence-based guidelines on managing idiopathic breakthrough pain in cancer include rapid-acting opioids as a treatment option, most of which also include fentanyl formulations. A continuity of care is the key to provide the best possible outcome.
How to cite this article
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