Approche pharmacologique de la douleur cancéreuse. Principes de base.

Most cancer patients experience pain whatever the stage of the disease. A careful assessment of pain as well as other symptoms and psychosocial conditions is the corner stone of an efficacious analgesia. The guidelines of the WHO analgesic ladder, which recommends the use of non opioids for weak pain and opioids for moderate to severe pain with or without coanalgesic, are useful to control the pain of the majority of patients. Morphine is generally considered as the first choice opioid. As dosage necessary to reach a good analgesia differs from patient to patient, an individual approach by titration is recommended. Bowel dysfunction, the most frequent side effect, can be prevented by the systematic use of laxatives. With a larger use of opioids, unusual side effects are emerging as the neurotoxicity syndrome. [ABSTRACT FROM AUTHOR]