Encyclopedia of Pain

2007 Edition

Adjuvant Analgesics in Management of Cancer-Related Neuropathic Pain

  • David Lussier
  • Russell K. Portenoy
Reference work entry
DOI: https://doi.org/10.1007/978-3-540-29805-2_106

Definition

An adjuvant analgesic (see  adjuvant analgesics) is any drug that has a primary indication other than pain, but is analgesic in some painful conditions.

Characteristics

Cancer pain caused by neuropathic mechanisms is relatively less responsive to opioid drugs than pain caused by nociceptive mechanisms (Cherny et al. 1994). However, when adjuvant analgesics are appropriately combined with opioid and non-opioid analgesics (anti-inflammatory drugs, acetaminophen), it is possible to obtain a degree of analgesia similar to the one achieved in nociceptive pain (Grond et al. 1999). Several classes of adjuvant analgesics can be used in neuropathic pain. Some are useful in a variety of pain syndromes (nociceptive pain, bone pain, myofascial pain) and are, therefore, termed multipurpose adjuvant analgesics, whereas others are used specifically for neuropathic pain. Although adjuvant analgesics are used extensively to treat cancer-related pain, the scientific evidence is often limited...

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References

  1. 1.
    Argoff CE (2000) New Analgesics for Neuropathic Pain: The Lidocaine Patch. Clin J Pain 16:S62–S66Google Scholar
  2. 2.
    Ben Abraham R, Marouani N, Weinbroum AA (2003) Dextromethorphan Mitigates Phantom Pain in Cancer Amputees. Ann Surg Oncol 10:268–274Google Scholar
  3. 3.
    Bernard SA, Bruera E (2000) Drug Interactions in Palliative Care. J Clin Oncol 18:1780–1799Google Scholar
  4. 4.
    Campbell FA, Tramer MR, Carroll D et al. (2001) Are Cannabinoids an Effective and Safe Treatment Option in the Management of Pain? A Qualitative Systematic Review. Br Med J 323:13–16Google Scholar
  5. 5.
    Cherny NI, Thaler HT, Friedlander-Klar H et al. (1994) Opioid Responsiveness of Cancer Pain Syndromes Caused by Neuropathic or Nociceptive Mechanisms. Neurol 44:857–861Google Scholar
  6. 6.
    Ellison N, Loprinzi CL, Kugler J et al. (1997) Phase III Placebo-Controlled Trial of Capsaicin Cream in the Management of Surgical Neuropathic Pain in Cancer Patients. J Clin Oncol 15:2974–2980Google Scholar
  7. 7.
    Farrar JT, Portenoy RK (2001) Neuropathic Cancer Pain: The Role of Adjuvant Analgesics. Oncol 15:1435–1445Google Scholar
  8. 8.
    Fromm GH (1994) Baclofen as an Adjuvant Analgesic. J Pain Sympt Manage 9:500–509Google Scholar
  9. 9.
    Grond S, Radbruch L, Meuser T et al. (1999) Assessment and Treatment of Neuropathic Cancer Pain following WHO Guidelines. Pain 79:15–20Google Scholar
  10. 10.
    Jackson K, Ashby M, Martin P et al. (2001) ‘Burst’ Ketamine for Refractory Cancer Pain: An Open-Label Audit of 39 Patients. J Pain Symptom Manage 23:60–65Google Scholar
  11. 11.
    Mao J, Chen LL (2000) Systemic Lidocaine for Neuropathic Pain Relief. Pain 87:7–17Google Scholar
  12. 12.
    Mercadante S, Arcuri E, Tirelli W et al. (2000) Analgesic Effect of Intravenous Ketamine in Cancer Patients on Morphine Therapy: A Randomized, Controlled, Double-Blind, Crossover, Double-Dose Study. J Pain Symptom Manage 20:246–252Google Scholar
  13. 13.
    Portenoy RK (1998) Adjuvant Analgesics in Pain Management. In: Doyle D, Hanks GW, MacDonald N (eds) Oxford Textbook of Palliative Medicine, 2nd edn. Oxford University Press, Oxford, pp 361–390Google Scholar
  14. 14.
    Pud D, Eisenberg E, Spitzer A et al. (1998) The NMDA Receptor Antagonist Amantadine Reduces Surgical Neuropathic Pain in Cancer Patients: A Double Blind, Randomized, Placebo-Controlled Trial. Pain 75:349–354Google Scholar
  15. 15.
    Rowland et al. (1997)Google Scholar
  16. 16.
    Watanabe S, Bruera E (1994) Corticosteroids as Adjuvant Analgesics. J Pain Symptom Manage 9:442–445Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2007

Authors and Affiliations

  • David Lussier
    • 1
  • Russell K. Portenoy
    • 2
  1. 1.McGill UniversityMontrealQCCanada
  2. 2.Department of Pain and Palliative CareBeth Israel Medical CenterNew YorkUSA