Both switching from a winged needle to a small plastic intravenous catheter and adding dexamethasone to continuous subcutaneous infusion (CSCI) successfully treated inflammatory skin changes caused by CSCI

ABSTRACT

<b>Purpose</b>: The continuous subcutaneous infusion (CSCI) is one of the most popular methods to reduce cancer pain. Inflammatory skin changes such as redness and induration are sometimes observed around the infusion site of the skin. Although dexamethasone is empirically added to a CSCI regimen to reduce such skin changes, little evidence on this practice has been available. We aimed to demonstrate the effectiveness of the CSCI protocol that we have been using for the treatment of skin changes. <b>Methods</b>: We prospectively observed the incidence of skin changes. When redness or induration at the injected site appeared, a winged needle was switched to a plastic intravenous catheter. When the redness or induration did not resolve with this needle change, dexamethasone was added to CSCI. <b>Result</b>: Sixty-six patients with cancer pain who underwent CSCI using a winged needle were enrolled in this study. The CSCI needles were switched from a winged needle to a plastic intravenous catheter in 20 out of 66 patients who revealed redness at a size of greater than 10 mm in diameter during CSCI. After this needle switch, the skin changes resolved in 15 out of 20 patients. Among the five patients who did not respond to the needle change, the skin changes resolved in three patients by dexamethasone (0.5∼1 mg/day) added to CSCI. <b>Conclusion</b>: These findings suggest that both switching from a winged needle to a small plastic intravenous catheter and adding dexamethasone to a CSCI regimen are effective in the treatment of inflammatory skin changes caused by CSCI.