ABSTRACT
Background: Hydromorphone is an analogue of morphine used in the treatment of cancer-related pain. There have been few studies that have evaluated the analgesic effect upon transition from hydromorphone injections. The aim of this study was to evaluate the conversion ratio between injection and oral preparation. Methods: We conducted a retrospective chart study of consecutive patients who were admitted to our hospital between July 2018 and December 2019. Results: In six patients, when the conversion ratio from hydromorphone injection to oral was changed at a 1:5 conversion ratio, three patients obtained adequate analgesic effects, the analgesic effect was insufficient in one case and an increased dose was required. Significant drowsiness appeared in two patients who required a decrease in dose. Conclusions: In converting from hydromorphone injections to oral preparations, it is necessary to carefully monitor the analgesic effect and adverse events and adjust the dosage for each case regardless of the conversion ratio.
ABSTRACT
To evaluate the effectiveness and safety of Huachansu in the treatment of cancer-related pain,four Chinese databases( CNKI,VIP,Wan Fang,Sino Med) and three English databases( Cochrane Library,Medline,PubMed) were systematically and comprehensively retrieved since the establishment of each database to October 2018. Randomized controlled trials( RCTs) for the treatment of cancer-related pain with Huachansu were screened out according to pre-established inclusion criteria and exclusion criteria. Rev Man5. 3 software was used for Meta-analysis. A total of 241 articles were retrieved,and finally 10 studies were included. The total sample size was 1 293,including 648 in the experimental group and 645 in the control group. The overall quality of the included studies was generally low. The results of Meta-analysis showed that Huachansu combined with Western medicine acesodynes was superior to the single use of Western medicine acesodynes in the treatment of short-term pain relief,improvement of quality of life and reduction of constipation,nausea and vomiting,dizziness,drowsiness,anorexia and other adverse reactions. And it also has the advantage of a shorter onset time and longer duration time of analgesia,but cannot reduce the incidence of dysuria. Based on the findings,Huachansu had a certain effect in the treatment of cancer-related pain,and a significant positive effect on the improvement of quality of life and the reduction of adverse reactions. No serious adverse reactions occurred. However,due to the small number of studies included,the low quality of the included studies,published biases and other restrictions,the evidence in this study has a low quality,and the conclusion shall be adopted with caution. The effectiveness and safety of Huachansu in the treatment of cancer-related pain remained to be further confirmed in the future with a well-designed,rigorous,and standardized report,with a large sample size,multiple centers,and sufficient follow-up time for randomized controlled trials.
Subject(s)
Humans , Amphibian Venoms , Therapeutic Uses , Cancer Pain , Drug Therapy , Quality of Life , Randomized Controlled Trials as TopicABSTRACT
Objective:To evaluate the safety and efficacy of dosing transdermal fentanyl patch by patient-controlled intravenous anal-gesia (PCIA) with fentanyl to treat opioid-naive patients suffering from cancer-related pain. Methods:In this open non-controlled trial, 30 patients with moderate to severe cancer pain were enrolled in the study. Titration conditions, pain score (NRS), and pain of life im-pact scores were assessed and recorded during four periods of treatment, as follows:before fentanyl-PCIA;during fentanyl-PCIA treat-ment;during Duragesic with fentanyl-PCIA treatment;and during Duragesic treatment. Adverse reactions were assessed and recorded during the two periods of treatment (the period before fentanyl-PCIA and the period after fentanyl-PCIA). Results:A total of 20 cases of titration were a success, whereas 10 cases failed. The general pain score, the most serious pain score, activity pain score, resting pain score, and the pain of life impact scores were all significantly reduced during fentanyl-PCIA treatment, during Duragesic with fen-tanyl-PCIA treatment, and during Duragesic treatment compared with the period before fentanyl-PCIA treatment (P<0.05). Nausea was the only adverse reaction that occurred during treatment. Obvious muscle rigidity, loss of consciousness, cough, respiratory depres-sion, and bradycardia were not observed. Conclusion:Dose titration of transdermal fentanyl patch with fentanyl administrated by PCIA for opioid-naive patients provides an effective and convenient method for pain relief treatment.
ABSTRACT
Nowadays,the lack of medical humane education is an important reason for the increasingly tense relationship between doctors and patients.Cancer-related pain is a common symptom and self-feeling of patients with malignant tumor,leading to extreme agony.Good pain management will control patients' cancer-pain and greatly improve their life quality.It also needs doctors' good communication with patients,their guidance and cooperation,which highlight the medical humanism,and embody the medical humanistic care.Recent strategies of good pain management advocated by the Ministry of Health will help to improve the humanity character education of clinical oncology teaching.
ABSTRACT
<b>Purpose</b>: A case of effective pain control by opioid rotation from fentanyl patch (oral morphine:fentanyl=100: 1 ratio) was succeeded with less than the theoretically equivalent conversion dose. Therefore, an investigation was undertaken to determine the effective rotation dose from fentanyl patch to other opioids. <b>Methods</b>: Retrospective analysis was carried out on patients with cancer-related pain, who were switched from fentanyl patch to other opioids. <b>Results</b>: Fourteen patients were analyzed and the average effective dose of opioids after the rotation was 76% of the theoretically calculated dose. Effective doses after opioid rotation were less than calculated doses in 11 cases (79%) and more than calculated doses in only 3 cases (21%). Effective doses after opioid rotation were 101% of calculated doses in cases (n=5) with less than 75μg/hr of fentanyl patch, but 63% in cases (n=9) with more than 75μg/hr. <b>Conclusion</b>: Opioid rotation should be considered when administration of more than 75μg/hr of fentanyl patch is needed. It is necessary to reduce the amount of applied dose to approximately 60% of calculated dose for safe opioid rotation. Moreover, it is necessary to remain careful and to provide immediate assistance in case of emergency due to withdrawal syndrome. Palliat Care Res 2009; 5(1): 301-307