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clinmed/2000070006v1 (August 15, 2000)
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The management of neuropathic pain in cancer: questionnaire on the treatment choices of palliative medicine physicians in the UK.
Ian N Back
A questionnaire was sent to senior palliative care physicians in the UK asking them to rank 12 treatments for neuropathic pain in the order they would use them. The questionnaire specified a clinical scenario of pain, and limited the treatments to twelve predefined options. 162 valid results were analysed (66% response rate). The median rank order when treating moderate pain was morphine, amitriptyline, dexamethasone, sodium valproate, TENS, diclofenac, clonazepam, flecainide, epidural or intrathecal analgesia, ketamine, methadone and ketorolac. For severe pain, epidural, ketamine, methadone and dexamethasone were ranked significantly higher, and TENS, diclofenac, sodium valproate and amitriptyline were ranked significantly lower. If lancinating pain was present, 57% would rank an anticonvulsant higher.