Safety profile of intravenous patient-controlled analgesia for breakthrough pain in cancer patients: a case series study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSOUSA, Angela Maria
dc.contributor.authorSANTANA NETO, Jose de
dc.contributor.authorGUIMARAES, Gabriel M. N.
dc.contributor.authorCASCUDO, Giovana M.
dc.contributor.authorNETO, Jose Osvaldo B.
dc.contributor.authorASHMAWI, Hazem A.
dc.date.accessioned2014-04-28T22:07:04Z
dc.date.available2014-04-28T22:07:04Z
dc.date.issued2014
dc.description.abstractThe WHO analgesic ladder supports medication choice according to pain intensity. The use of the analgesic ladder in an inverse way, has the advantage of using the same principles of the original ladder to treat crisis of pain in cancer patients. The purpose of this study is to describe the use of intravenous patient-controlled analgesia (IV-PCA) technique in patients admitted to an oncological Hospital. This is a case series study. Patients assigned to receive IV-PCA between March 2011 and May 2012 were selected for the study. Medical records were reviewed, patients stratified according to the Karnofsky Performance Score (KPS). The primary outcome was to verify if different IV-PCA opioid solutions could be equally effective providing pain relief. Secondary outcomes were the incidence of clinical side effects that can be associated to IV-PCA infusions. A total of 95 medical records were reviewed. Most patients used IV-PCA with morphine (42.1 %), fentanyl (42.1 %) or methadone (15.7 %) to treat exacerbation periods of cancer pain. IV-PCA used as supplementary therapy successfully improved pain control in 78.9 % of the patients, without any difference related to opioid solution. KPS < 40 was related to higher rate of pain relief, without any difference in side effects in this group of patients. The most common side effects were sedation (10.5 %) followed by constipation (9.4 %) and nausea (4.2 %). Morphine presented a higher risk than fentanyl for sedation. Analgesia-related delirium or respiratory depression were not reported in this case series study. IV-PCA provided timely, safe and useful analgesia for patients with severe breakthrough pain and may be useful to help titration of opioids, weaning to oral analgesia and to decide for interventional procedures.
dc.description.indexMEDLINE
dc.identifier.citationSUPPORTIVE CARE IN CANCER, v.22, n.3, p.795-801, 2014
dc.identifier.doi10.1007/s00520-013-2036-8
dc.identifier.eissn1433-7339
dc.identifier.issn0941-4355
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/5476
dc.language.isoeng
dc.publisherSPRINGER
dc.relation.ispartofSupportive Care in Cancer
dc.rightsrestrictedAccess
dc.rights.holderCopyright SPRINGER
dc.subjectAnalgesia
dc.subjectPatient-controlled
dc.subjectAdverse effects
dc.subjectPain management
dc.subjectNeoplasms
dc.subject.otheroutpatients
dc.subject.othermorphine
dc.subject.otherbioavailability
dc.subject.othermanagement
dc.subject.otherpca
dc.subject.wosOncology
dc.subject.wosHealth Care Sciences & Services
dc.subject.wosRehabilitation
dc.titleSafety profile of intravenous patient-controlled analgesia for breakthrough pain in cancer patients: a case series study
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus20
hcfmusp.contributor.author-fmusphcANGELA MARIA SOUSA
hcfmusp.contributor.author-fmusphcJOSE DE SANTANA NETO
hcfmusp.contributor.author-fmusphcGABRIEL MAGALHAES NUNES GUIMARAES
hcfmusp.contributor.author-fmusphcGIOVANNA MAIA ROSADO CASCUDO RODRIGUES
hcfmusp.contributor.author-fmusphcJOSE OSVALDO BARBOSA NETO
hcfmusp.contributor.author-fmusphcHAZEM ADEL ASHMAWI
hcfmusp.description.beginpage795
hcfmusp.description.endpage801
hcfmusp.description.issue3
hcfmusp.description.volume22
hcfmusp.origemWOS
hcfmusp.origem.pubmed24258354
hcfmusp.origem.scopus2-s2.0-84895868170
hcfmusp.origem.wosWOS:000330978800025
hcfmusp.publisher.cityNEW YORK
hcfmusp.publisher.countryUSA
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