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Rapid titration with intravenous morphine for severe cancer pain and immediate oral conversion
- Source :
- Cancer. 95:203-208
- Publication Year :
- 2002
- Publisher :
- Wiley, 2002.
-
Abstract
- BACKGROUND Cancer pain emergencies presenting with severe excruciating pain require a rapid application of powerful analgesic strategies. The aim of the current study was to evaluate a method of rapid titration with intravenous morphine to achieve relief of cancer pain of severe intensity. METHODS Forty-nine consecutive patients admitted to a Pain Relief and Palliative Care Unit for severe and prolonged pain were enrolled in the study. Pain was evaluated on a numeric scale of 0–10 (0 indicated no pain and 10 indicated excruciating pain). After the initial assessment (T0), an intravenous line was inserted and boluses of morphine (2 mg every 2 minutes) were given until the initial signs of significant analgesia were detected or severe adverse effects occurred (T1). A continuous reassessment was warranted and the effective total dose administrated intravenously was assumed to last approximately 4 hours and was calculated for 24 hours. The dose immediately was converted to oral morphine (a 1:3 ratio for low doses and a 1:2 ratio for high doses). RESULTS Data from 45 patients was analyzed. A significant decrease in pain intensity was achieved in a mean of 9.7 minutes (95% confidence interval [95% CI], 7.4–12.1 minutes), using a mean dose of intravenous morphine of 8.5 mg (95% CI, 6.5–10.5 mg). The doses administered rapidly were converted to oral morphine and pain control was mantained until the patient's discharge, which occurred in a mean of 4.6 days (95% CI, 4.1–5.2 days). The incidence of adverse effects was minimal. CONCLUSIONS The results of the current study demonstrate that cancer pain emergencies can be treated rapidly in the majority of cancer patients with an acceptable level of adverse effects. Intravenous administration of morphine requires initial close supervision and continuity of medical and nursing care. Cancer 2002;95:203–8. © 2002 American Cancer Society. DOI 10.1002/cncr.10636
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
Palliative care
Analgesic
Administration, Oral
Opioid
Injections, Intravenou
Nursing care
Route of administration
Morphine titration
Oral administration
Neoplasms
medicine
Humans
Epidemiologic study
Cancer pain
Adverse effect
Morphine
business.industry
Intravenous route
Middle Aged
Pain, Intractable
Surgery
Analgesics, Opioid
Oncology
Anesthesia
Pain emergencie
Injections, Intravenous
Neoplasm
Female
business
Human
medicine.drug
Subjects
Details
- ISSN :
- 10970142 and 0008543X
- Volume :
- 95
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi.dedup.....64d0b32b68b148c3b4c74ecadc424724
- Full Text :
- https://doi.org/10.1002/cncr.10636