黑料网

Pain is a universal human experience, often serving as the foremost reason individuals seek medical care, especially in the Emergency Department (ED). While pain management is a critical aspect of patient care, recent studies have highlighted significant disparities in the provision of analgesics, leading to treatment delays and inadequate pain relief, particularly among cancer patients. This article delves into the complexities of pain management in the ED, focusing on cancer patients who face unique challenges in pain control. Our objective is to explore the underutilization of analgesics, the impact of inadequate pain management on cancer patients, and potential avenues for improvement in emergency care. The management of pain related to cancer has historically posed significant challenges and remains a substantial concern in the comprehensive care of patients with ongoing cancer. Cleeland et al. noted that around two-thirds of individuals with advanced cancer required analgesics for pain control, yet approximately 40% of these patients experienced inadequate pain management [1]. Despite several efforts to enhance pain relief in cancer patients, subsequent investigations revealed that even with targeted interventions, about 33% of individuals with cancer still faced insufficient pain control [2]. In an endeavor to elucidate the marginal advancement in addressing cancer pain, previous researchers have endeavored to identify barriers hindering improved pain management. These obstacles encompass inadequate pain assessments by healthcare practitioners, patients' apprehensions regarding opioidrelated complications, and patients' hesitancy in reporting pain [3-5]. While a considerable portion of existing research is concentrated on outpatient settings, the applicability of these findings to acute care environments, particularly Emergency Departments (EDs), remains uncertain. Cancer-related issues contribute to over 4.5 million ED visits annually in the United States, a figure that continues to rise [6]. A multicenter cohort study conducted in 2019 revealed that the majority of individuals with active cancer who sought care in the ED did so due to pain as their primary complaint. Furthermore, over half of these ED visits resulted in hospital admissions. Although pain ranks among the most prevalent chief complaints in the Emergency Department (ED), the utilization of analgesics may be suboptimal, often leading to treatment delays. This concern gains heightened significance in the context of patients with active cancer, who are inherently susceptible to inadequate pain control. Recent findings underscore that individuals grappling with moderate-to-severe cancer-related pain frequently receive insufficient pain medication doses during their ED visits. Given the substantial portion of cancer patients seeking ED care for painrelated issues, ensuring effective pain management for this vulnerable demographic presents a formidable challenge. Our primary objective is to meticulously evaluate the potential impact of specific variables, encompassing patient demographics, cancer-related attributes, functional status, and ED treatment factors, on patient outcomes [7]. We posit that an imperative exists for enhancements in the emergency care of cancer-related pain and anticipate that an intricate analysis may unveil future avenues for implementing quality improvement initiatives.

The landscape of emergency pain management: Pain management in the ED is an intricate balancing act that requires timely intervention and accurate assessment. Unfortunately, despite pain being a common chief complaint, the administration of analgesics often falls short of optimal standards, resulting in prolonged suffering and distress for patients. Delays in pain relief can lead to worsened outcomes, increased healthcare utilization, and diminished patient satisfaction. The implications of inadequate pain management are especially profound in patients with active cancer, a population already burdened by the physical and emotional toll of their illness [8].

Inadequate pain control for cancer patients: Cancer patients represent a particularly vulnerable group in the ED, as their pain experience can be multifaceted due to disease progression, treatment side effects, and comorbidities. A recent study shed light on the concerning trend of cancer patients receiving inadequate doses of pain medication while seeking care in the ED. This sobering reality not only exacerbates their pain but also contributes to a compromised overall quality of life. Furthermore, suboptimal pain control may deter patients from seeking timely medical attention, potentially leading to more severe health complications. To address these disparities, an indepth analysis of various contributing factors is imperative. Variables such as patient demographics, cancer characteristics, functional status, and ED treatment protocols play a crucial role in shaping pain management outcomes. By unraveling the intricate interplay of these factors, healthcare providers can gain a deeper understanding of the unique challenges cancer patients face in the ED. Our hypothesis posits a pressing need for the enhancement of emergency pain care for cancer patients [9,10]. As we delve into the nuanced landscape of cancerrelated pain management, we envision that this exploration will unearth valuable insights that can guide the implementation of targeted quality improvement measures. Such initiatives may encompass refining pain assessment protocols, optimizing analgesic administration strategies, and fostering multidisciplinary collaboration between emergency physicians, oncologists, and palliative care specialists.

Conclusion

Inadequate pain management in the ED remains a critical concern, particularly for cancer patients who deserve comprehensive and compassionate care. By acknowledging the disparities in pain control and dedicating resources to rectify them, healthcare providers can empower themselves to make informed decisions that positively impact patient outcomes. As we endeavor to bridge the gap between pain experience and pain relief, the collaboration between various medical specialties becomes pivotal in ensuring that cancer patients receive the pain management they deserve promptly, effectively, and with utmost empathy.

Acknowledgement

Not applicable.

Conflict of Interest

Author declares no conflict of interest.

1. Pisani L, Hill NS, Pacilli AMG, Polastri M, Nava S (2018) Chest 154:925-934.

, ,

2. Turner JP, Shakib S, Singhal N, Hogan-Doran J, Prowse R, et al. (2014) J Am Geriatr Soc 62:1900-1905.

, ,

3. Scott IA, Hilmer SN, Reeve E, Potter K, Le Couteur D, et al. (2015) JAMA Intern Med 175:827-834.

, ,

4. Meyer-Junco L (2021) J Palliat Med 24:273-284.

, ,

5. Todd A, Al-Khafaji J, Akhter N, Kasim A, Quibell R, et al. (2018) Br J Clin Pharmacol 84:2802-2810.

, ,

6. Ravindrarajah R, Hazra NC, Hamada S, Charlton J, Jackson SHD, et al. (2017) Circulation 135:2357-2368.

, ,

7. Meyer-Junco L (2021) J Palliat Med 24:273-284.

, ,

8. Dewhurst F, Baker L, Andrew I, Todd A (2016) Int J Clin Pharm 38:1044-1047.

, ,

9. Morin L, Wastesson JW, Laroche ML, Fastbom J, Johnell K (2019) Palliat Med 33:1080-1090.

, ,

10. Schenker Y, Park SY, Jeong K, Pruskowski J, Kavalieratos D, et al. (2019) J Gen Intern Med 34:559-566.

, ,