Patient-Controlled Analgesia for Cancer Pain: A Long-Term Study of Inpatient and Outpatient Use

Abstract

The safety and efficacy of patient-controlled analgesia for the long-term control of cancer pain was tested prospectively. Respiratory rates, mental status, and pain relief were recorded at baseline and compared with those during the study period. Patients had a lower analgesic demand (i.e., self-administered less morphine during the nighttime); specifically, dosing declined 48% from the daytime level. Respiratory rates did not change appreciably during the study and no cases of significant respiratory depression were encountered. Patients self-administered sufficient morphine to produce adequate but not complete pain relief in almost all trials. Pain relief was safely achieved by both intravenous and subcutaneous routes of administration in both the inpatient and outpatient settings. Mean 24-h morphine use stayed relatively constant even for patients receiving more than 2 weeks of treatment. In conclusion, patient-controlled analgesia is effective and safe therapy for the long-term control of severe cancer pain.

Intravenous morphine consumption in outpatients with cancer during their last week of life—an analysis based on patient-controlled analgesia data

“…Thus, they Cancer pain patients at their end of life and PCA Changing to parenteral (subcutaneous or intravenous) opioids is an established and often successful treatment option for patients who fail on conventional oral or transdermal opioid therapy [9]. In terminal cancer patients, seldom parenteral opioids are delivered by PCA, although the studies generally report the achievement of very good pain control and few side effects with such a regime [2,5,6,16,21,25]. In the study of Meuret et al, morphine PCA provided adequate pain control in about 96% of patients poorly responsive to oral opioids.…”

Treatment of pain in older patients

“…Some patients may also benefit from patient controlled anesthesia devices (PCAs), a technique of parenteral drug administration where the patient controls a pump that delivers doses of medications according to parameters set by the physician. Typically dosing involves both a bolus dose for breakthrough pain in addition to a continuous infusion [40].…”

Zirkadianer Rhythmus des PCA-gesteuerten Opioidverbrauchs bei Kindern mit chemotherapiebedingter Mukositis

“…Auch bei erwachsenen Krebspatienten wur de der Opioidverbrauch in Abhängigkeit von der Tageszeit untersucht. Hier zeigte sich ebenfalls ein geringerer Opioidbedarf während der Nacht [8,19].…”