Anaes Vivas · Chronic & cancer pain
Chronic & cancer pain — Viva
Clinical viva on mechanism-matched cancer pain, the ladder and PaSo, neuropathic drugs, and neuromodulation rescue
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Prompt
Pancreatic cancer pain on escalating morphine with burning epigastric features
Viva Stems
- This pancreatic cancer pain is unresponsive to morphine escalation. What mechanism, and why did opioids fail?
- Talk me through the WHO ladder and what PaSo changed.
- What neuropathic drugs do you add, and what is the pregabalin evidence?
- When do you offer a celiac plexus block?
- What is the role of peripheral nerve stimulation perioperatively?
- Failed back surgery syndrome, refractory to drugs: SCS then what?
- This patient needs surgery. What predicts chronic postsurgical pain?
- What are the common exam pitfalls in this topic?
References5ShowHide
- [1]Lu H, et al. Consensus on the Clinical Use of Pregabalin in Peripheral Neuropathic Pain CNS Neurosci Ther, 2026.PMID 42310848
- [2]Blero D, et al. Pain management in pancreatic cancer: time to change our strategy! Curr Opin Oncol, 2026.PMID 42240215
- [4]Hagen KMR, et al. PaSo paracetamol with strong opioids trial: paracetamol versus placebo in conjunction with strong opioids for cancer pain-a pilot randomised placebo-controlled withdrawal trial BMJ Support Palliat Care, 2026.PMID 42309698
- [5]Cordero-Tous N, et al. Intrathecal Drug Delivery as a Rescue Strategy in Patients with Spinal Cord Stimulation: A Single-Center Case Series J Clin Med, 2026.PMID 42355686
- [6]Sperandio G, et al. Somatic and psychological predictors of chronic postsurgical pain in cancer patients: a machine learning approach in a longitudinal two-centre study Br J Anaesth, 2026.PMID 41506969