An Insight into Pain Perception and Management in Oncologic Patients at a Tertiary Care Teaching Hospital

Abstract

Introduction: Pain is one of the most debilitating symptom of cancer, with a significant proportion of oncologic patients experiencing varying intensities of pain. Asignificant proportion of patients and physicians also report dissatisfaction with pain management. Therefore, a thorough understanding of variability in the perception of pain and effective pain relief strategies is vital to optimize pain management in cancer patients. Methodology: A descriptive, observational study was carried out after due approval under STS-ICMR. A total of 200 patients attending Medical Oncology OPD were enrolled. Subsequently, the adequacy of pain management was analyzed using the pain management index (PMI) and calculated using the analgesic score and mean pain index. Patients with severe pain requiring strong opioids were referred to a palliative care center and were excluded. Results: Cancers of head and neck (15.5%), breast (15%), blood (14%), liver (9%), and lung (7.5%) were the most prominent cancers reported in the present study. Platinum compounds followed by anti-metabolites and taxols (Paclitaxel) were the most commonly prescribed chemotherapeutics. Tramadol, NSAIDs (Diclofenac, Aceclofenac), antidepressants, and anticholinergics were the analgesics of choice depending on the nature of pain. Out of 69% (138) patients who experienced pain, 86 had a positive PMI. Conclusion: Pain management adequacy is significantly influenced by age and severity of pain, with one in three patients reporting inadequate pain management. A better insight into pain management strategies is crucial for improving the quality of life in these patients.

Keywords

• Brief pain inventory-short form, Chemotherapeutics, Platinum compounds, WHO 3-step pain ladder