breakthrough pain (BTP)

Introduction

Intermittent exacerbations of pain that can occur spontaneously or in relation to specific activity.

Management

• common misconceptions:
  • maintenance opiates provide analgesia
  • opiate use for acute pain may result in addiction relapse
  • treatment breakthrough pain with opiates, in addition to maintenance opiates, may cause respiratory depression & CNS depression
• general guidelines (opiates)
  • reassurance that pain will be treated adequately, verify & continue maintenance opiate
  • use non-opiate analgesics for breakthrough pain when feasible
  • use short-acting opiate when necessary, in addition to long-acting maintenance opiates
  • anticipate the need for higher scheduled doses due to tolerance.
  • prescribe scheduled rather than PRN doses
  • see opioid prescribing practices for dosing guidelines

More general terms

• pain [odyn-]

More specific terms

• incident pain; movement-related pain

Additional terms

• opioid prescribing practices