Introduction:

as life expectancy and the incidence of chronic and terminal diseases increase in Latin America, the number of patients requiring palliative care also grows, while the specialized personnel for its management is still limited, thus general practitioners and caregivers being the ones who must support pain management.

Objectives:

provide theoretical and practical tools, both to general practitioners and to the relatives of patients who require palliative care, that facilitate proper pain management in this type of patient.

Materials and methods:

a narrative review of the literature was carried out through different databases, publications of palliative care and anesthesia societies, as well as grey literature.

Results:

among the main results, it was found that the majority of terminally ill patients present moderate or severe pain among their chief symptoms. Of these, a significant percentage did not present adequate pain control at the time of death, mainly due to inappropriate use of opioids, among others due to fear and ignorance on the part of the treating physicians and caregivers. Opioids as a pharmacological group have multiple advantages for use in palliative care, including the possibility of titrating them as needed, rotating opioids, and having multiple routes of administration.

Discussion:

despite the wide availability of opioids, there are still significant barriers to adequate pain management at the end of life, including the lack of knowledge on the part of general practitioners.

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