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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Patient’s rights mandate that every patient in chronic pain has the right to receive proper and effective treatment. It is widely acceptable that opioids can significantly improve the patient’s quality of life, irrespectable of the etiology of pain, either cancer or non-cancer.

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The aim of this study was to examine and compare the efficacy and safety of combining strong opioids (transdermal fentanyl) with weak opioids (codeine or tramadol) for the management of severe cancer pain. Forty six patients (25 male / 21 female) aged 42-80 years were studied. According to an eleven-grade numeric rating scale (NRS; 0 = no pain, 10 = severe pain), they all had severe steady pain intensity greater than 5 (NRS >5) despite treatment with weak opioids and adjuvant drugs, as proposed by the 2nd step of the World Health Organization (WHO) analgesic ladder, at the maximum tolerated doses.

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Όπως όλοι γνωρίζουμε, υπάρχουν σοβαροί περιορισμοί στη δημιουργία ανθρώπινων μοντέλων σχετικά με την επιτέλεση πειραμά-των, που αφορούν τους μηχανισμούς και τις οδούς αίσθησης του πόνου. Τα ερεθίσματα, που μπορούν να εφαρμοστούν σε εθελοντές, είναι απαραίτητα μικρής έως μέσης έντασης και συνήθως εξαρτώνται από τις χειρουργικές συν-θήκες και την υποκείμενη νόσο.

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NSAIDs are widely used compounds in the management of several acute and chronic pain syndromes. NSAIDs induce their action by blocking the cyclooxygenase enzymes, cox-1 and cox-2, during the conversion of arachidonic acid to prostaglandins. Conventional NSAIDs inhibit both cox isoforms and are therefore at risk of serious complications as gastrointestinal irritation, postoperative bleeding, renal failure, water and sodium retention and hepatic failure.

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Since its identification as the active metabolite of nitroglycerin identical to endothelium derived relaxing factor, in mid-eighties, nitric oxide has been found over-all distributed in all body tissues implicated in many normal functions as well as pathophysiologic states, so that it has been aptly called biological jack-ofall- trades.

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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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