Steroids as pain relief adjuvants
Steroids are among the most commonly used medications in palliative care. A Canadian study of ambulatory palliative care patients with cancer demonstrated that 40% of patients were receiving corticosteroids, and dexamethasone was the medication most commonly added by palliative care specialists. This study echoes European studies in which corticosteroids were among the drugs most commonly prescribed by hospital-based palliative care services.
There is evidence for the use of corticosteroids for specific indications, such as spinal cord compression,raised intracranial pressure, and bowel obstruction. Corticosteroids are also commonly used for broader indications, such as to control pain, stimulate appetite, suppress nausea, and alleviate fatigue. However, there is little objective evidence in the literature for this broader use of corticosteroids. This article will address the role of steroids in controlling pain as an adjuvant analgesic, a practice that is based primarily on expert opinion and empirical evidence. Read More