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Br J Cancer ; 108(2): 259-64, 2013 Feb 05.
Article in English | MEDLINE | ID: mdl-23322191

ABSTRACT

BACKGROUND: This study was designed to evaluate the role of epidural methadone-lidocaine in cancer pain combined or not to epidural dexamethasone. METHODS: In all, 72 cancer patients, 32- to 67-year-old were randomized to six groups (n=12) and prospectively studied to examine analgesia and adverse effects for 3 weeks. Patients received single-dose protocol epidural test drugs: Control group (CG) received epidural 40-mg lidocaine diluted to 10-ml volume with saline. Dexamethasone group (DG) 40-mg lidocaine plus 10-mg dexamethasone. The 2.5MetG 2.5-mg epidural methadone with 40-mg lidocaine; the 5MetG, 5-mg epidural methadone plus 40-mg lidocaine, the 7.5MetG, 7.5-mg epidural methadone plus 40-mg lidocaine and finally the 7.5Met-DexG, 7.5-mg methadone with 40-mg lidocaine and 10-mg dexamethasone. RESULTS: Groups CG, DG and 2.5MetG were similar regarding analgesia and side effects. Patients from 5MetG and 7.5MetG took 3 ± 1 and 5 ± 1 days, respectively, to restart oral morphine. Patients from 7.5MetDG took 14 ± 2 to restart oral morphine (P<0.001). Daily somnolence and appetite improved in the 7.5MetDG during 2-week evaluation (P<0.005). Fatigue improved for both DG and 7.5MetDG during 2-week evaluation (P<0.005). By the third week of evaluation, all patients were similar. CONCLUSIONS: Epidural methadone plus lidocaine resulted in dose-dependent analgesia, further improved by epidural dexamethasone, which also improved fatigue.


Subject(s)
Analgesia, Epidural , Dexamethasone/administration & dosage , Methadone/administration & dosage , Neoplasms/physiopathology , Pain/drug therapy , Adult , Aged , Dexamethasone/adverse effects , Dexamethasone/therapeutic use , Drug Administration Routes , Female , Humans , Lidocaine/administration & dosage , Lidocaine/adverse effects , Lidocaine/therapeutic use , Male , Methadone/adverse effects , Methadone/therapeutic use , Middle Aged , Pain Management
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