Zusammenfassung
Gastrointestinale Neoplasien gehen häufig mit behandlungsbedürftigen Schmerzen einher. Die zur Verfügung stehenden schmerztherapeutischen Optionen ermöglichen eine effektive Schmerzkontrolle. In der Regel helfen einfach strukturierte und gut validierte Therapiealgorithmen. Orale Opioide sind die Grundlage der Tumorschmerztherapie. Bei korrekter Anwendung und Kombination mit Koanalgetika, Adjuvantien und nichtmedikamentösen Verfahren können unerwünschte Wirkungen minimiert werden. Nur bei einer Minderheit von Patienten mit therapierefraktären Schmerzen sind spezielle schmerztherapeutische Interventionen indiziert, für die Schmerztherapeuten konsultiert werden sollten. Bei Unwirksamkeit oder Unverträglichkeit systemischer Pharmakotherapie haben auch rückenmarknahe und neurolytische Therapieverfahren ihren Stellenwert.
Abstract
Abdominal cancer is commonly associated with pain needing medical attention. Effective pain management is available to control pain. Oral opioids are the foundation of analgesic therapy. With adequate implementation of therapeutic guidelines into clinical practice including the use of co-analgesics, adjuvants and non-pharmacological treatment options the quality of life of abdominal cancer patients can be considerably improved. Only in a minority of patients with refractory pain more sophisticated options of pain management will be necessary, e. g., epidural, intrathecal or neurolytic techniques. In this situation the consultation of a pain therapist is recommended.
Schlüsselwörter
Tumorschmerz - Abdominalschmerz - gastrointestinale Tumoren - Schmerztherapie - Opioide - Plexus coeliacus
Key words
Cancer pain - visceral pain - gastrointestinal cancer - pain management - opioids - coeliac plexus
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Dr. Andreas Kopf
Schmerz-Zentrum, Klinik für Anaesthesiologie und operative Intensivmedizin, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin
Hindenburgdamm 30
12200 Berlin
Phone: ++49/30/84 45-33 86
Fax: ++49/30/84 45-44 69
Email: andreas.kopf@charite.de
