Episodic (breakthrough) pain: Consensus conference of an expert working group of the European Association for Palliative Care

Sebastiano Mercadante, Lukas Radbruch, Augusto Caraceni, Nathan Cherny, Stein Kaasa, Friedemann Nauck, Carla Ripamonti, Franco De Conno

Research output: Contribution to journalArticlepeer-review


BACKGROUND. Breakthrough pain is transitory exacerbation of pain that occurs in addition to otherwise stable persistent pain. The wide differences in estimation of incidence reported in literature are probably because of different settings and meanings attributed to the definition of breakthrough pain. METHODS. A panel of experts met to establish the actual knowledge on breakthrough pain, according to the evidence in literature and experience. They agreed that episodic or transient pain could be a more simple and adequate term in most languages, including English, French, Italian, and Spanish. RESULTS. A specific assessment and precise pain characterization are essential to plan the most appropriate treatments. Despite the relevance of this temporal pain pattern for the influence on the outcome and quality of life, few controlled studies have been performed to give evidence of a specific approach. Several experiences have reported the possible efficacy of different drugs, route of administration, and modalities of administration in different circumstances. CONCLUSIONS. Prospective studies with previous treatments using similar terminologies are necessary to find the most convenient therapeutic intervention, according to the temporal pattern characteristics and the pain mechanism involved.

Original languageEnglish
Pages (from-to)832-839
Number of pages8
Issue number3
Publication statusPublished - Feb 1 2002


  • Breakthrough pain
  • Cancer pain
  • Incident pain
  • Nonsteroidal antiinflammatory drugs (NSAIDs)
  • Opioids
  • Pamidronate
  • Radiotherapy
  • Spinal opioids
  • Transient pain
  • Transmucosal fentanyl

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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