Smertekontrol

Smertekontrol is the clinical practice of systematically managing a patient’s pain to improve comfort, function, and quality of life while minimizing adverse effects. It encompasses acute and chronic pain, including cancer pain, postoperative pain, and pain in palliative care, and it aims to tailor approaches to individual needs and circumstances.

Assessment is a core component, employing standardized pain scales such as the numerical rating scale (0-10) or visual analog scales, alongside questions about location, quality, timing, and somatic or emotional impact. Regular reassessment tracks changes in pain and tolerability of treatments. Effective smertekontroll relies on clear communication with patients and, when needed, caregivers, to align goals and expectations.

Modalities include pharmacological and non-pharmacological strategies, used in a multimodal approach. Pharmacological options range from systemic non-opioid and opioid medications to adjuvants, regional anesthesia, nerve blocks, local anesthetics, and patient-controlled analgesia. Non-pharmacological methods include physical therapy, cognitive-behavioral therapy, relaxation techniques, heat or cold therapy, acupuncture, and pacing of activities. The goal is to maximize analgesia while reducing dose-related risks and side effects.

Implementation often relies on guidelines and multidisciplinary teams, involving physicians, nurses, pharmacists, and therapists. Patient involvement and education are essential, as is monitoring for safety concerns such as oversedation, respiratory depression, and potential misuse of opioids. Special considerations apply to children, older adults, patients with kidney or liver disease, and those with communication challenges.

Challenges in smertekontrol include variability of individual response, risk of undertreatment or overtreatment, tolerance, hyperalgesia, and balancing relief with functional goals. Ongoing research supports multimodal regimens and personalized plans to improve outcomes.