Tratamiento del dolor irruptivo

Breakthrough cancer pain is a transient, short-lasting (usually less than 60 minutes) exacerbation of pain that reaches maximum intensity within 15 minutes and occurs despite adequate treatment of background pain with around-the-clock analgesia. These episodes of breakthrough pain are treated with “rescue” analgesia. Due to the clinical characteristics and intensity of these exacerbations, the ideal drug for the treatment of breakthrough pain would be a rapid-onset, short-acting opioid with few secondary effects. Traditionally, oral rapid-release opioids have been used in this situation. However, the new fentanyl formulations, which are rapidly absorbed through the mucous membranes (oral, intranasal), seem to be better adapted to the temporal pattern of episodes of breakthrough pain. The success of the management of these episodes depends on adequate identification and evaluation.