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Prevalence, etiology, and management of neuropathic pain in an Indian cancer hospital
Journal Of Pain & Palliative Care Pharmacotherapy, 07/28/09
Jain PN et al. - In a trial to detect the prevalence, etiology, and treatment profile of neuropathic pain in cancer, it was shown that the most common and challenging pts were those with orofacial pain. Nerve blocks techniques have a limited role in neuropathic pain.
Methods- During January-December 2007, 716 new cancer pain pts were examined in Tata Memorial Hospital Pain Clinic.
- 180 pts with a mean age of 47.14 yrs were found to have neuropathic pain characteristics on the basis of clinical impression, site of pain, and underlying cause i.e. due to tumor itself or cancer therapy.
- Head and neck cancer (32.2%) was the most common cause of neuropathic pain, followed by breast (20.6%), thoracic (14.4%), genitourinary or gynecology (10.0% each), GI (9.4%), and medical oncology (2.8%).
- About 56% pts were post-surgery, 44.4% post-chemotherapy, and 51.1% pts were post-radiotherapy.
- Most common site of pain was thoracic (36.7%) due to primary or secondary metastatic disease.
- Pricking type of pain was the most characteristic feature (47.8%) followed by shooting pain (38.3%).
- Mean pain score was 5.96 ± 1.5 (SD) and mean duration (mos) of pain was 2.8 ± 2.5.
- Neuropathic pain was found commonly associated with somatic pain (59.4%).
- Most common pharmacological agents prescribed were: tricyclic antidepressants (93.9%), anticonvulsants (66%), opioids (85%), and nonsteroidal anti-inflammatory drugs (NSAIDs) (97.2%).
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