Clinical Gastroenterology Vol.22 No.2(2-3)

Theme Pain Management in Gastrointestinal Cancer
Title Non-opioids for Cancer Pain Management
Publish Date 2007/02
Author Motohiro Matoba Team KANWA, Department of Anesthesiology, Kitasato University School of Medicine
[ Summary ] The purpose of this article is to describe the optimal use of nonsteroidal anti-inflammatory drugs and acetaminophen in the management of cancer pain. NSAIDs have been shown to interfere with the formation of prostaglandins and prostacyclins by their inhibitory effects on cyclo-oxygenase. The World Health Organization has suggested a three step analgesic ladder, using NSAIDs in the management of cancer pain, to be combined later with opioids to provide additional pain relief. Whether used initially or added to an opioid regimen, NSAIDs may reduce the daily dosage of opioids needed to control pain adequately. Acetaminophen has no inhibitory effects on cyclo-oxygenase. The mechanism of action is unknown, however. The indications of acetaminophen for cancer pain management are renal dysfunction, bleeding tendency, gastric ulcers and others.
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