Dialog Box

Pain

Pain is one of the most common symptoms in palliative care. Pain can also be a much feared symptom which can contribute to its intensity. 

The aim of palliative care is to allow patients to be pain free or for their pain to be sufficiently controlled so that it does not interfere with their ability to function or detract from their quality of life.

Good Pain Control Requires:

  • accurate and detailed assessment, and reassessment, of each pain
  • knowledge of the different types of pains
  • a different therapeutic approach to chronic pain
  • knowledge of which treatment modalities to use
  • knowledge of the actions, adverse effects and pharmacology of analgesics
  • multidisciplinary assessment and treatment of other aspects of suffering that may aggravate pain – physical, psychological, social, cultural and spiritual distress.

The use of medication for the treatment of acute pain is the same as for non-palliative care patients. The treatment of chronic pain, that is often poorly managed, requires a different approach to acute pain.

In Palliative Care:

  • the analgesic program should be kept simple, even for patients in severe pain
  • oral medication is the mainstay of treatment and should only be abandoned if the patient is unable to take or retain oral preparations.

There is a myriad of pain medications available as they treat different types of pain.



Useful Resources

CareSearch - Pain

Evidence-based information and resources on pain assessment and management in palliative care collated by CareSearch.

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Opioid Conversion

Opioid conversion is a specialist skill used by palliative care clinicians to ensure appropriate use of palliative medicines and that the patient receives optimal pain management.

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Syringe Driver Drug Compatibilities

This guidance is intended for specialist palliative care teams and clinicians that deliver palliative care to people in specialist and non-specialist settings. It is intended to be used with the support of specialist palliative care clinicians. 

It details an overview of clinical principles, advice on specific medications as well as opioid and non-opioid compatibility charts. 

Clinicians who are not trained or authorised to prescribe or administer these medications should not use this guidance.

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Managing breakthrough and episodic pain

This podcast addresses the assessment and treatment of breakthrough and episodic pain and the management of different types of pain.

Dr Peter Martin is Clinical Director of Palliative Care for Barwon Health and Associate Professor at Deakin University.



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