Patienten in palliativer Erkrankungsphase leiden häufig unter Schmerzen, die zu einer
deutlichen Einschränkung der Lebensqualität führen. Schmerz sollte in der palliativen
Erkrankungssituation nicht nur als eine Erregung von Nozizeptoren verstanden werden,
sondern ist auch Ausdruck der seelischen Belastung. In diesem Beitrag wird ein Überblick
über die zur
Verfügung stehenden Medikamente, Applikationswege und alternativen Behandlungsoptionen
gegeben.
Abstract
Patients in the palliative phase of a disease often suffer from pain, which leads
to a significant reduction in quality of life. Since in most cases there is a progression
rather than an
improvement of the disease over time, pain therapy must also be dynamically adapted.
Due to accompanying symptoms and the physical burden of the disease, treatment of
pain is often
difficult. In the palliative situation, pain should not only be understood as an excitation
of nociceptors but is rather also an expression of mental stress. In this article,
we would like
to give an overview of the available drugs, application methods and alternative treatment
options. Specifically, the article is divided into the following subsections: non-opioid
analgesics,
opioids, co-analgesics, patient-controlled analgesia procedures, neuraxial and peripheral
regional anesthesia procedures, neurolysis, supportive therapies and palliative sedation.
Thus, when
treating palliative patients, the focus should not only be on the one symptom of pain,
but, in the sense of the bio-psycho-social model, a multimodal oriented treatment
of the patient with
all his symptoms, also including his relatives, must be carried out.
Schlüsselwörter
Schmerztherapie - Palliativmedizin - Analgetika - Opioide - Koanalgetika - Patienten-kontrollierte
Analgesie-Verfahren - PCA
Keywords
palliative care - analgesia - non-opioid analgesics - opioids - co-analgesics
