The concept of breakthrough pain is used to name a picture of pain that appears in patients with chronic painful pathology, generally oncological, which appears suddenly and has a short duration.
It is important to detect these conditions, since when they appear they become unbearable despite receiving adequate treatment for their baseline pain. The pain is controlled and only flares up at certain times.
The complexity of this type of pain lies in its unpredictability, intensity and short duration. For the treatment of pain it is common to resort to rescue analgesics, although the ineffectiveness of some of them, specifically NSAIDs, has been demonstrated. To avoid this problem, opioid analgesics of rapid absorption were later developed.
Fentanyl is the appropriate drug for this purpose due to its pharmacological profile, rapid absorption, short onset period and short duration of action.
Later on, sublingual tablets and mucosal dispersible tablets were incorporated and the latest advances have been: the appearance of nasal mucosal absorption sprays.
These have undoubtedly been a very good solution that solves the problems related to the oral mucosa and the appearance of caries. Despite all the pharmacological innovations and available treatments, breakthrough pain is still a pending subject in medicine and requires an adequate treatment of the underlying condition, generally with multimodal analgesia.