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

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art_SOUSA_Safety_profile_of_intravenous_patient_controlled_analgesia_for_2014.PDF (204.11 KB)
Citações na Scopus
19
Tipo de produção
article
Data de publicação
2014
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Autores
Citação
SUPPORTIVE CARE IN CANCER, v.22, n.3, p.795-801, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
The 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.
Palavras-chave
Analgesia, Patient-controlled, Adverse effects, Pain management, Neoplasms
URI
https://observatorio.fm.usp.br/handle/OPI/5476
Referências
  1. Ashburn MA, 2012, ANESTHESIOLOGY, V116, P248, DOI 10.1097/ALN.0b013e31823c1030
  2. Aubrun F, 2012, BRIT J ANAESTH, V108, P193, DOI 10.1093/bja/aer458
  3. Breivik H, 2009, ANN ONCOL, V20, P1420, DOI 10.1093/annonc/mdp001
  4. Brogan SE, 2011, PAIN MED, V12, P1758, DOI 10.1111/j.1526-4637.2011.01262.x
  5. Bush SH, 2009, ONCOLOGIST, V14, P1039, DOI 10.1634/theoncologist.2009-0122
  6. Caraceni A, 1999, PAIN, V82, P263, DOI 10.1016/S0304-3959(99)00073-1
  7. Craft Jennifer, 2010, Proc (Bayl Univ Med Cent), V23, P434
  8. Dahan A, 2010, ANESTHESIOLOGY, V112, P226, DOI 10.1097/ALN.0b013e3181c38c25
  9. Dev R, 2011, J PAIN SYMPTOM MANAG, V42, P296, DOI 10.1016/j.jpainsymman.2010.11.020
  10. Duarte RV, 2012, PAIN PHYSICIAN, V15, P363
  11. Grass JA, 2005, ANESTH ANALG, V101, pS44, DOI 10.1213/01.ANE.0000177102.11682.20
  12. Greco MT, 2011, CLIN J PAIN, V27, P9, DOI 10.1097/AJP.0b013e3181edc250
  13. Haugen DF, 2010, PAIN, V149, P476, DOI 10.1016/j.pain.2010.02.035
  14. HOSKIN PJ, 1989, BRIT J CLIN PHARMACO, V27, P499
  15. Ilias Wilfried, 2008, Pain Pract, V8, P164, DOI 10.1111/j.1533-2500.2008.00187.x
  16. INCA, 2012, EST 2012 INC CANC BR
  17. KERR IG, 1988, ANN INTERN MED, V108, P554
  18. Ketwaroo Gyanprakash A, 2013, Curr Gastroenterol Rep, V15, P344, DOI 10.1007/s11894-013-0344-2
  19. Kim SH, 2013, PAIN PHYSICIAN, V16, pE247
  20. Lux EA, 2011, SCHMERZ, V25, P663, DOI 10.1007/s00482-011-1101-9
  21. Margarit Cesar, 2012, J Pain Res, V5, P559, DOI 10.2147/JPR.S36428
  22. Mercadante S, 2011, PALLIATIVE MED, V25, P504, DOI 10.1177/0269216311406577
  23. Nassar AP, 2008, SAO PAULO MED J, V126, P215, DOI 10.1590/S1516-31802008000400003
  24. Nave R, 2013, DRUG DELIV, V20, P216, DOI 10.3109/10717544.2012.762435
  25. NOLAN MF, 1995, PHYS THER, V75, P374
  26. R Core Team, 2013, R LANG ENV STAT COMP
  27. Santini D, 2013, EXPERT OPIN PHARMACO, V14, P425, DOI 10.1517/14656566.2013.774375
  28. Sardin B, 2012, ANN FR ANESTH, V31, P813, DOI 10.1016/j.annfar.2012.08.013
  29. Schiessl C, 2008, SUPPORT CARE CANCER, V16, P531, DOI 10.1007/s00520-008-0408-2
  30. Schiessl C, 2008, SUPPORT CARE CANCER, V16, P917, DOI 10.1007/s00520-007-0352-6
  31. Schiessl C, 2007, SCHMERZ, V21, P35, DOI 10.1007/s00482-006-0500-9
  32. Smith H, 2012, CNS DRUGS, V26, P509, DOI 10.2165/11630580-000000000-00000
  33. Smith Howard S, 2013, J Pain Res, V6, P189, DOI 10.2147/JPR.S40745
  34. Taylor Donald R, 2013, Clin Pharmacol, V5, P131, DOI 10.2147/CPAA.S26649
  35. Vargas-Schaffer G, 2010, CAN FAM PHYSICIAN, V56, P514
  36. World Health Organisation (WHO), 1986, CANC PAIN REL

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/08
Artigos e Materiais de Revistas Científicas - ODS/03