Page 97 - CPG - Clinical Practice Guidelines - Management of Cancer Pain

Management of Cancer Pain (Second Edition)
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• Think about how your pain has felt over the last week.
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a) NO – my pain doesn’t really feel like this………………………………………………(0)
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a) NO – My pain doesn’t affect the colour of my skin……………………...…………….(0)
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a) NO – My pain doesn’t make my skin abnormally sensitive in that area…………….(0)
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a) NO – My pain doesn’t really fell like this………………………………………….…….(0)
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a) NO – I don’t really get these sensations………………………………….…………….(0)
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presence of allodynia and an altered pin-prick threshold (PPT).
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a) NO, normal sensation in both areas……………………………………...…………….(0)
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Determine the pin-prick threshold by comparing the response to a 23 gauge (blue) needle mounted inside a 2 ml
syringe barrel placed gently on to the skin in a non-painful and then painful areas.
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none/blunt only (raised PPT) or a vary painful sensation (lowered PPT), an altered PPT is present.
If a pin-prick is not felt in either area, mount the syringe onto the needle to increase the weight and repeat.
a) NO, equal sensation in both areas……………..……………………………………….(0)
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If score <12, neuropathic mechanisms are unlikely to be contributing to the patient’s pain
If score >12, neuropathic mechanisms are likely to be contributing to the patient’s pain
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phenomena associated with neuropathic pain: ‘pins and needles’ (paraesthesia); ‘red skin’ (autonomic changes);
‘sensitive skin’ (evoked dysaesthesia); ‘electric shock pain’; and ‘burning pain’ (spontaneous dysaesthesia). The
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the anatomically equivalent non-painful area, and altered pinprick threshold (PPT) by use of a 23-gauge needle to
assess perception of pinprick in the same areas.
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