Despite stable background pain, most cancer patients suffer 3-4 episodes of breakthrough pain daily. Aim of the present study was the evaluation of potential correlation between effective doses of sublingual fentanyl citrate, administered for controlling breakthrough pain, with transdermal fentanyl used for background pain. Fifty-six cancer patients were prospectivelly recruited. All patients were suffering episodes of breakthrough pain and managed with transdermal fentanyl 25-300μg/h for their background pain.

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Opioid analgesics are widely accepted as first-line treatment for moderate to severe cancer pain: while their use in patients with non-cancer pain syndromes has increased substantially over the last years. However, opioid analgesia produces numerous adverse effects. These effects have a negative impact on patient’s quality of life, may impair adherence to treatment and finally limitate opioid use.

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Our study compared the effectiveness between two of the proposed as rescue manoeuvres to overcome difficulty, in advancing a tracheal tube, during railroading over the fibreoptic bronchoscope. A ninety degrees anti-clockwise rotation (90ΑCWR) of the tube or cricoid cartilage pressure application (CCPA) was randomly performed in eighty patients undergoing fibreoptic orotracheal intubation under general anaesthesia, in whom first attempt to railroad the tracheal tube had failed.

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Gabapentin was tested as complementary analgesic in 25 cancer patients in whom pain was not sufficiently controlled by transdermal fentanyl. Neuropathic pain syndrome in these patients consisted of burning pain and allodynia. Gabapentin was administered at a dose of 648±206,4mg, while dosage of transdermal fentanyl was fixed (261±98,1μg/h).

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