Douleurs chroniques, accès douloureux paroxystiques (ADP) : les challenges

This article focuses on three key challenges for the management of chronic pain and breakthrough pain for cancer and non cancer patients. The first question concerns the use of transdermal fentanyl in the management of severe chronic pain. The second question approaches the problem of breakthrough pain in cancer patients discussing its identification and management in clinical practice. The third question focuses on the treatment options available for breakthrough pain, and the pharmacological aspects of mucosal administration of fentanyl. Each question examined in detail by one of the three authors of this article.