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Managing an Acute Pain Crisis in a Patient With Advanced Cancer

Managing an Acute Pain Crisis in a Patient With Advanced Cancer CLINICIAN’S CORNER PERSPECTIVES ON CARE AT THE CLOSE OF LIFE Managing an Acute Pain Crisis in a Patient With Advanced Cancer “This Is as Much of a Crisis as a Code” Natalie Moryl, MD The assessment and management of an acute pain crisis in Nessa Coyle, NP, PhD the setting of advanced illness is challenging. Using the Kathleen M. Foley, MD case of Mr X, a 33-year-old man with advanced metastatic mucinous adenocarcinoma of the appendix and “15 out of THE PATIENT’S STORY 10” pain, we explore the issues of acute pain and its man- Mr X is a 33-year-old man with a 4-year history of meta- agement. We define a pain crisis as an event in which the static mucinous adenocarcinoma of the appendix. Over the patient reports pain that is severe, uncontrolled, and caus- course of his illness, Mr X completed several cycles of che- ing distress for the patient, family members, or both. Our motherapy and had several percutaneous draining osto- mies for small-bowel obstruction due to peritoneal carci- management strategy focuses on making a pain diagno- nomatosis. His most recent admissions were triggered by sis, differentiating reversible from intractable causes of pain, protracted nausea and http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Managing an Acute Pain Crisis in a Patient With Advanced Cancer

JAMA , Volume 299 (12) – Mar 26, 2008

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References (111)

Publisher
American Medical Association
Copyright
Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.299.12.1457
pmid
18364488
Publisher site
See Article on Publisher Site

Abstract

CLINICIAN’S CORNER PERSPECTIVES ON CARE AT THE CLOSE OF LIFE Managing an Acute Pain Crisis in a Patient With Advanced Cancer “This Is as Much of a Crisis as a Code” Natalie Moryl, MD The assessment and management of an acute pain crisis in Nessa Coyle, NP, PhD the setting of advanced illness is challenging. Using the Kathleen M. Foley, MD case of Mr X, a 33-year-old man with advanced metastatic mucinous adenocarcinoma of the appendix and “15 out of THE PATIENT’S STORY 10” pain, we explore the issues of acute pain and its man- Mr X is a 33-year-old man with a 4-year history of meta- agement. We define a pain crisis as an event in which the static mucinous adenocarcinoma of the appendix. Over the patient reports pain that is severe, uncontrolled, and caus- course of his illness, Mr X completed several cycles of che- ing distress for the patient, family members, or both. Our motherapy and had several percutaneous draining osto- mies for small-bowel obstruction due to peritoneal carci- management strategy focuses on making a pain diagno- nomatosis. His most recent admissions were triggered by sis, differentiating reversible from intractable causes of pain, protracted nausea and

Journal

JAMAAmerican Medical Association

Published: Mar 26, 2008

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