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Clarifying the concept of breakthrough pain 

Clarifying the concept of breakthrough pain
Clarifying the concept of breakthrough pain

Giovambattista Zeppetella

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date: 24 September 2021

The 1990 publication ‘Breakthrough pain: Definition, prevalence and characteristics’ was the first to study to describe breakthrough pain as a discrete pain state. Using the definition that ‘breakthrough pain is a transient increase in the intensity of moderate or severe pain, occurring in the presence of well-established baseline pain’ the authors interviewed 90 cancer pain patients and identified 51 types of breakthrough pain; these varied widely with respect to severity, location, temporal characteristics, relationship to scheduled analgesia, precipitating events, predictability, pathophysiology, aetiology, and palliative factors. As a result of Portenoy and Hagen’s survey, breakthrough pain has been studied as a discrete pain state for almost 30 years, and recognized as an important clinical problem in its own right. An increasing number of published studies exist, with ongoing debate about the breakthrough pain definition, pain assessment, and pain management.

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