Presse Med
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Pain prevalence increases during cancer course disease. Cancer incidence is increasing in France, but thanks to therapeutic advances in the specific treatment, cancer has become a chronic disease, often associated with persistent pain. Cancer pain evaluation should be multidimensional. ⋯ Today, a wide range of pain medications, including strong opioids, are available. The use of analgesic combinations is strongly recommended for cancer pain management. Medication characteristics knowledge (pharmacodynamics and pharmacokinetics) is essential and must be associated with a good doctor-patient relationship, to ensure optimal treatment of the painful patient at all stages of the disease.
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Prevention of postoperative exacerbation of chronic medical disease requires high standard of safety and quality of care in ambulatory surgery and anesthesia. Age is not a major criterion for selection for ambulatory surgery. Ambulatory surgery may be considered for patients with ASA score I, II or III with stable medical conditions. ⋯ In patients with major comorbidity, ambulatory surgery should be considered instead of conventional hospitalization. Preop treatment must be maintained during the perioperative period. Their interruption does not provide any benefit and could exacerbate an otherwise stable chronic disease.